Jenny Ryan

Jenny is the Science Communications Specialist at Canadian Blood Services working out of head office in Ottawa. She works closely with the Medical Affairs and Innovation division to interpret and showcase new research and discovery in transfusion and transplantation science. 

Memories of CST 2019


Thursday, October 24, 2019

The 2019 Canadian Transplant Summit took place Oct. 15-19 in iconic Banff, Alta. Presented by the Canadian Society of Transplantation (CST), Canadian Blood Services and the Canadian Donation and Transplantation Research Program (CDTRP), this annual event is a unique opportunity to bring together medical professionals, scientists, patients and stakeholders of all interests in organ donation and transplantation from across Canada.

This community works together to foster a future which will increase access to organs, cells and tissues, and improve health outcomes for Canadians living with a transplant. The meeting was a key networking and knowledge exchange event that attracted more than 350 participants.

Highlights

As part of the opening keynote address on Oct. 16, the audience experienced two very diverse life-saving perspectives.

Winner of the 2012 Nobel Prize in Economics, Alvin Roth of Stanford University, presented the opening plenary titled “Kidney Exchange: an opportunity for cooperation in North America”, a look at the impacts of cross-border kidney sharing. Dr. Roth helped design the high school matching system used in New York City, and is one of the early founders and designers of kidney exchange in the United States, which helps incompatible patient-donor pairs find compatible kidneys for transplantation.

The parents of Logan Boulet, Toby and Bernadine, shared their perspective on organ donation and transplantation as a donor family. Logan Boulet made the decision to be an organ donor just weeks before his passing in the tragic Humboldt Broncos bus crash in April 2018. Inspired to register by his coach and mentor, Ric Suggit, who became an organ donor following his death in 2017, Logan registered his decision and took the wise and necessary step of sharing his decision with his family. 

Tweet from CST participant with photos of the Boulets presenting

Logan’s legacy lives on and continues to inspire Canadians to register their intent to become organ donors. The first annual Green Shirt Day was held on April 7, 2019 in Logan’s honour. This annual tribute continues to raise awareness and honour the selfless gift that is organ donation.

Bernadine and Toby Boulet share their perspective as a donor family
Bernadine and Toby Boulet share their perspective as a donor family

A number of sessions throughout the conference provided insight into the work being done in Canada and internationally to push the boundaries of ‘higher risk’ donors, and especially to increase the uptake and usage of Hepatitis C (NAT positive) donor organs for healthy waitlisted patient.

On Oct. 17, during a lunch symposium, Sean Delaney, associate director of listing and allocation at Canadian Blood Services, brought his unique perspective as both transplant professional and as a kidney recipient (a generous gift from his brother), currently on the waitlist for a second kidney. His presentation was titled “Patient perspective on the marginal or high risk offer vs. waiting for a 'better' offer.”

Delaney, based in Edmonton, Alta., was part of building the original Kidney Paired Donation (KPD) program, as well as implementing the highly sensitized patient (HSP) interprovincial kidney sharing program. Together, the programs have produced more than 1,000 transplants for Canadian patients through interprovincial sharing. Most recently, he has been working to advance heart and liver sharing through the Canadian Transplant Registry.

Photo of Sean Delaney speaking at a podium

 

 

Artificial intelligence and machine learning were hot topics at this meeting and the subject of a half-day workshop presented by the CDTRP.

On Oct. 19, a morning session shared further insight into living donation. Dr. John Gill with the University of British Columbia presented about costs incurred by living donors that present a barrier or disincentives to donation. Dr. Rahul Mainra, a transplant nephrologist in Saskatchewan, presented about the impact of kidney paired donation and the importance of ‘matchability’ for kidney paired donation and transplantation. Allison Hunt, who donated her left kidney to a total stranger after a snap decision made at a cocktail party, provided perspectives from an altruistic living donor.

Tweet reading . @amhealey  provided an insightful overview of DCD Hearts: A possible medical legal/ethical framework in  @cst_transplant  Heart Concurrent Session. The patient/donor family engagement that has occurred to investigate this issue is very impressive. #PatientsIncluded #CdnTxSummit2019

 

 

 

Kathy Yetzer, associate director of living donation with Canadian Blood Services, presented a poster about key success factors for Canadian living kidney donation transplant programs.
Kathy Yetzer, associate director of living donation with Canadian Blood Services, presented a poster about key success factors for Canadian living kidney donation transplant programs.

The poster sessions brought great insight into the wealth and breadth of research underway across the field. Kathy Yetzer, associate director of living donation with Canadian Blood Services, presented a poster about key success factors for Canadian living kidney donation transplant programs. The findings show that performance success was most influenced by implementation of living donation evaluation efficiencies; engaging program stakeholders; broadening living donation identification and awareness strategies; access to quality assurance resources; increased living kidney donation transplant funding; and operating room availability. 

Tweet reading: Thank you  @umtincka  for an outstanding talk on “Canada’s National Multiorgan Willing to Cross Strategy” - Technology, DNA and Policy/Analysis is the how!  @cst_peds   @cst_transplant  #2019CanadianTransplantSummit

 

 

Altogether, CST 2019 was great forum for knowledge exchange and to advance organ and tissue donation and transplantation in Canada. Kudos to the organizing teams at the Canadian Society of Transplantation, Canadian Blood Services and the Canadian Donation and Transplantation Research Program.

Learn more about CST 2019

A tweet from the summit showing animals that look like deer or caribou walking down a path

 

 


Canadian Blood Services – Driving world-class innovation

Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.

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The 2019 Critical Care Canada Forum hosts fifth annual Deceased Organ Donation Symposium


Tuesday, October 08, 2019

This year marks the fifth annual Deceased Organ Donation Symposium at the Critical Care Canada Forum in Toronto.

Presented by Canadian Blood Services, Trillium Gift of Life and the Canadian Donation and Transplantation Research Program (CDTRP), this two-day symposium held Nov. 11–12, 2019 promotes scientific research in organ donation and transplantation and its application to critical care practice. 

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Highlights from the 2019 Symposium program:

Donation after circulatory determination of death is responsible for the largest quantitative increase in deceased donation and transplantation in Canada. This year’s Deceased Donation Symposium will feature presentations on the latest research about the physiology of dying and the impact of withdrawal of life sustaining measures procedures on donation after circulatory determination of death. A panel discussion will highlight some of the tensions – old and new – that surround this type of donation.

Presumed consent In April 2019, Nova Scotia became the first jurisdiction in Canada to pass presumed consent (opt-out) legislation, designed to increase organ and tissue donation. Though countries with deemed consent models generally have higher donation rates, this consent model is only one of the many key components necessary for an optimal organ donation and transplantation system. After a presentation by Phil Walton, the United Kingdom’s deemed consent project lead, we’ll hear Canadian perspectives on what this legislation means, not only for Nova Scotia, but for the rest of the country and whether Canada is really ready for this. 

Medical assistance in dying and organ donation — The legalization of medical assistance in dying (MAID) in Canada has led to requests for donation after circulatory determination of death from patients who are conscious and competent. The 2019 Deceased Donation Symposium will look at the state of MAID and organ donation today and what it might look like in the future. A donor coordinator who, instead of speaking to substitute decision makers about donation opportunities, is speaking directly to the patient themselves, will describe how and why MAID cases are different from other DCD cases.  

A family perspective — Finally, Randy Tresidder, whose wife was the first person to undergo MAID and organ donation in Nova Scotia, will share his experience and perspectives on MAID and organ donation. The incredible story of Randy’s wife, Dr. Shelly Sarwal, is captured in the documentary film Her Last Project. CCCF attendees will have an opportunity to watch the film on Wednesday, November 13 at 12:30pm. 

https://herlastproject.files.wordpress.com/2019/09/hlp20190913_2.jpg?w=1024

About the Critical Care Canada Forum

The Critical Care Canada Forum is a four-day conference focusing on topics that are relevant to the individuals involved with the care of critically ill patients, wherever the patients are located. Internationally recognized, the Critical Care Canada Forum focuses on leading-edge science through informative and interactive sessions, led by an outstanding international faculty, with poster presentations and exhibits with the latest products and services for the critical care professional.

Did you miss last year’s event? Videos from the 2018 Deceased Donation Symposium at CCCF are available here.


Canadian Blood Services – Driving world-class innovation

Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.

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Organ and tissue donation by those who choose medical assistance in dying: new guidance for professionals


Tuesday, June 25, 2019

new publication in CMAJ (Canadian Medical Association Journal) aims to help health care teams navigate clinical issues surrounding organ and tissue donation by patients who choose to donate after medical assistance in dying (MAID) or withdrawal of life-sustaining measures. 

 

In collaboration with the Canadian Critical Care Society, the Canadian Society of Transplantation, and the Canadian Association of Critical Care Nurses, Canadian Blood Services brought together medical, legal and ethics experts to inform this work, as well as patient partners who brought unique perspectives and thoughtful insight. 

The new publication, Organ and Tissue Donation for Medical Assistance in Dying and Other Conscious Competent Patients: Expert Guidance for Policy, makes key recommendations, including:  

  • Protection for patients – the decision to have MAID or withdrawal of life-sustaining measures must occur before any discussion of organ donation. 
  • Choice – medically suitable conscious competent patients who provide first-person consent to end-of-life procedures should be given the opportunity to donate organs and tissues. 
  • Consent – the patient must be able to provide first-person consent and be able to withdraw consent for MAID or donation at any time. 
  • Donor testing – physicians, transplant teams and other staff should try to minimize the impact and disruption of donating (such as testing) for the patient. 
  • Determination of death – the dead donor must be respected, meaning vital organs can only be removed from deceased donors after determination of death according to accepted criteria. 
  • Conscientious objection – health-care professionals may choose not to participate in MAID or withdrawal of life-sustaining measures, but they should work to support the patient’s wishes to donate.

 

For access to professional education resources related to leading practices and clinical guidelines visit Canadian Blood Services' professional education website

This report and the published manuscript have been endorsed by the Canadian Critical Care Society, the Canadian Society of Transplantation, and the Canadian Association of Critical Care Nurses.

 

Learn more:  CMAJ podcasts — Organ Donation After MAID 

In this interview, Dr. James Downar (co-author of policy guidance) and Dr. Jennifer Hancock (an intensive care physician in Halifax) take listeners through considerations of having a patient who requests medical assistance in dying (MAiD) or withdrawal of life-sustaining measures (WLSM) and who also requests to have his or her organs donated.

https://soundcloud.com/cmajpodcasts/181648-guide

 


Canadian Blood Services – Driving world-class innovation

Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.

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Recordings from the CCCF 2018 Deceased Donation Scientific Symposium now available online


Wednesday, May 08, 2019

Canadian Blood Services, Trillium Gift of Life Network and the Canadian Donation and Transplantation Research Program partnered to host the Deceased Organ Donation Symposium that took place at the Critical Care Canada Forum (CCCF) on November 7 – 8, 2018.

The CCCF is a national forum attended by hundreds of health care professionals, primarily physicians, working in critical care. The Deceased Organ Donation Symposium is an opportunity for these health care professionals to engage in discussions about relevant and emerging topics in deceased donation.

A key event at the symposium was the unopposed plenary on brain death. Recent legal cases that challenge the acceptance of brain death as death are concerning to the critical care community. To better understand the issues surrounding brain death, experts presented medical, legal, ethical and international perspectives. 

The two-day symposium program reviewed the changing demographics of deceased organ donors; provided updates on evolving donation science, clinical leading practices, and advancements in perfusion technology; and highlighted new research on physician attitudes toward organ donation as well as donor family experiences along the donation pathway. 

Having generated much esteem and excitement, the brain death plenary and symposium sessions were recorded to ensure those who were unable to attend have the opportunity to access and share this important information. Videos from this session are now available on Canadian Blood Services' professional education website. 

Canadian Critical Care Forum (CCCF) – Deceased Donation Scientific Symposium 2018 - Videos

Videos from this session were recorded in partnership with Trillium Gift of Life Network and the Canadian National Transplant Research Program at The Canadian Critical Care Forum between November 6 to 9, 2018. 

View videos here


Canadian Blood Services – Driving world-class innovation

Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.

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Expert guidance seeks to improve identification of potential organ donors


Tuesday, April 23, 2019

Publication supports the critical care community in donor identification and referral allowing more potential organ donors to save more lives, and more donor families to be enabled to fulfill their loved one’s wishes

Just published in the Canadian Journal of Anesthesia: Potential organ donor identification and system accountability: expert guidance from a Canadian consensus conference

A Q&A with lead author Dr. Samara Zavalkoff

Deceased donation rates in Canada lag behind leading countries. A key area of focus to improve the system for all Canadians is to ensure health care professionals are able to identify and refer potential organ donors. If they are not equipped to identify and refer potential organ donors to organ donation organizations (ODOs) in a timely manner, patients on transplant waiting lists are left waiting and the wishes of potential donors and their families remain unfulfilled.

A Potential Organ Donor Identification and System Accountability (PODISA) Workshop was held September 20-21, 2016 in Ottawa. A collaboration between Canadian Blood Services and the Canadian Donation and Transplant Research Program (CDTRP), this workshop engaged representatives from critical care, neurocritical care, emergency medicine, donation, transplantation, research, health care administration, family partners, and patient safety and quality organizations. The results have now been published in the Canadian Journal of Anesthesia.

To better understand the importance of donor identification and referral, we spent some time with lead author Dr. Samara Zavalkoff a pediatric intensivist at Montreal Children’s Hospital. 

 

Dr. Samara Zavalkoff

Who are you and what do you do?

My name is Samara Zavalkoff and I am a pediatric intensive care physician at the Montreal Children’s Hospital. I look after children of all ages who are critically ill.  I am an expert in patient safety and quality improvement. I have a keen interest in organ donation.

 

Can you tell us a bit about donor identification and referral?

Donor identification and referral is the process of recognizing when a patient who is gravely ill, dying or brain dead, has the potential to become a deceased organ donor and should be referred to an organ donation organization for follow up.

What are the issues that prevent potential donors from being identified as potential donors and referred to organ donation professionals?

Many reasons prevent identification and referral. They include:

  • lack of proper education for health care professionals about how and when to identify potential donors,
  • discomfort of healthcare professionals in discussing organ donation with family members,
  • preconceived notions about what a family may want in terms of donation,
  • limited access to resources to support identification and referral,
  • little or no consequence when a potential organ donor is missed because many provinces do not have legislation that requires doctors to refer potential donors,
  • lack of understanding about the impact a potential organ donor could have on a transplant candidate waiting for a life-saving organ, and
  • circumstances whereby health care professionals become overburdened with other tasks and concerns when a patient reaches end-of-life.

Why is donor identification and referral so important?

Donor identification and referral is the first and most essential step in the deceased donation process. If a potential donor is not identified and referred, organ donation cannot happen. Failing to identify and refer a potential donor can have catastrophic consequences for transplant candidates awaiting an organ. A patient on the transplant list may die if a suitable donor is not found in time. Circumstances when a doctor does not identify and refer a potential organ donor, should be considered critical patient safety events.

Is it law that doctors in all provinces have to refer potential donors?

Today, referral of potential organ donors is law in only five provinces. Currently, British Columbia, Manitoba, Ontario, Quebec and Nova Scotia require that the provincial organ donation organization must be notified when death is imminent or established.

Would you consider this workshop a success?

Very much so. These guidelines are the result of a workshop hosted by Canadian Blood Services and the Canadian Donation and Transplant Research Program (CDTRP) that engaged representatives from critical care, neurocritical care, emergency medicine, donation, transplantation, research, health care administration, family partners, and patient safety and quality organizations. We gathered experts from areas across the organ donation community in Canada, including the very important perspectives of patients and donor families. They are the ones most impacted by donor identification and referral.

Ultimately, the meeting generated 37 expert consensus statements to establish best practices for healthcare professionals and the healthcare system with respect to donor identification and referral.

Why is collaboration among the healthcare community so important when it comes to potential donor identification and referral?

Donation opportunities are rare. Of 250 000 Canadians who die each year, only 2000-4000 will meet eligibility criteria for donation, and yet only 600 will become donors. In contrast, well over 4000 Canadians are waiting for an organ transplant.

This huge gap between actual donors and waiting recipients, the low-volume nature of organ donation and the high cost to patients if they do not receive a donated organ are the reasons that the healthcare system – and every professional working within it – must be highly coordinated in identification and referral of potential organ donors. Together, we must ensure that there are no missed opportunities in this complex process.

What are the outcomes from this collaboration?

Some of the key consensus statements developed as a result of the workshop are described as follows at both the professional and the system level. 

At the healthcare professional level, key statements include:

  1. donation should be consistently addressed as part of end-of-life care but only after a decision to withdraw life-sustaining treatment;
  2. healthcare professionals should know how and when to identify and refer potential donors; and
  3. transplant candidates should be informed of local allocation guidelines and performance.

At the healthcare system level, key statements include:

  1. national adoption of clinical criteria to trigger identification and referral;
  2. dedicated resources to match donation activities, including transfer of a potential donor;
  3. performance measurement through death audits;
  4. reporting and investigation of missed donation opportunities;
  5. recognition of top performers; and 
  6. missed donor identification and referral should be considered a preventable and critical patient safety incident

Why is it so important for Canadian patients that every potential donor is identified?

When we fail to identify and refer a donor, harm is caused to another patient who is awaiting an organ transplant. This harm is disconnected, as we don’t know the name or face of this patient on the transplant list, but it is a critical patient safety issue and an example of harm that should be prevented.

What is the impact on patients (donors and/or recipients) and their families?

Every Canadian who meets eligibility criteria has the right to be considered for organ donation. Every time a potential donor is not identified or referred, we deprive the patient and their family of fulfilling their wish to become a donor. For some families, organ donation is an important part of their grieving process and helps them attach meaning to their loved one’s death.

For transplant recipients, optimal compliance with donor identification and referral means the difference between life (receiving a transplant) and potentially death.

How can we make donor referral part of standard component of end-of-life care?

Making donor referral a part of end-of-life care falls into four key areas:

  1. The community needs proper data tracking in the form of donor audits across the country. We need to know the details (understand) of when and where and why donors are not being identified and referred. We need this data on an ongoing basis in real-time so the impact of interventions can be quickly measured.
  2. There is a need for education of healthcare professionals to know when and how to identify and refer potential donors.
  3. There is a need for legislation and policy to support compliance with donor identification and referral. For example, ALL provinces should have required referral legislation and an accreditation body that evaluates hospital performance in this area.
  4. It is essential that we advance the idea that failing to identify and refer a potential organ donor in a timely manner is a source of preventable patient harm and a public health concern. For every potential donor that is not identified and referred, a patient on the waitlist continues to wait.

In February Dr. Zavalkoff presented about this topic to the Donation Physician Network via webinar. A recording of that session can be found below. Additional webinars designed for Donation Physicians can be found on Canadian Blood Services' Professional Education website

Further reading

About the collaboration that enabled this expert guidance

Canadian Blood Services works with the Organ and Tissue Donation andTransplantation (OTDT) community to improve national system performance. We do this through the development of leading practices, professional education, public awareness and data analysis and reporting. We also manage clinical programs that support interprovincial sharing of organs. 

The Potential Organ Donor Identification and System Accountability (PODISA) Workshop was held September 20-21, 2016 in Ottawa. It was an important collaboration between Canadian Blood Services and the Canadian Donation and Transplant Research Program (CDTRP). This workshop engaged Pan-Canadian representatives from critical care, neurocritical care, emergency medicine, donation, transplantation, research, health care administration, family partners, and patient safety and quality organizations. The results have now been published.

This important evidence-based leading practice:

  • provides a national framework and consistent approach for donor identification and referral and system accountability,
  • spearheads a culture shift around organ donation and end-of-life care, and
  • unlocks potential opportunities for national collaboration, to support implementation, with patient safety and quality organizations.

 

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.

 

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National organ sharing leads to 500 kidney transplants for highly sensitized patients


Tuesday, January 15, 2019

The gift of transplantation has meant so much to the patients within the highly sensitized patient registry in Saskatchewan and all of Canada.” – Dr. Rahul Mainra, St. Paul’s Hospital, Saskatoon

The Highly Sensitized Patient (HSP) program is a national organ sharing program operated by Canadian Blood Services in collaboration with all provincial donation and transplant programs. The HSP program gives provincial programs access to a larger national pool of kidney donors for highly sensitized patients who need a more specific donor match.

Patients who are highly sensitized have very few potential donors with whom they are compatible and therefore need to have as many opportunities for transplantation as possible.

“In Saskatchewan, roughly 12 to 20 deceased donors give this gift every year to patients with end stage renal disease. For some highly sensitized patients, it would take years before they would find a compatible kidney transplant within our province,” explains Dr. Rahul Mainra, Vice Chair of the national Kidney Transplant Advisory Committee and nephrologist at St. Paul’s Hospital in Saskatoon. “The highly sensitized patient registry has given our patients the opportunity to be matched to all deceased donors in the country. This has provided our patients with significantly more options for transplantation.

Rahul Mainra, MD FRCPC FRACP MMed
Rahul Mainra

Dr. Rahul Mainra, Vice chair, Kidney Transplant Advisory Committee, Director of Undergraduate Medical Education, Department of Medicine, Clinical Associate Professor of Medicine, Division of Nephrology, St. Paul’s Hospital, Saskatoon

“We have seen the success of this program as many of our highly sensitized patients have already received a transplant after waiting years on our local wait list. Five hundred patients have a renewed lease on life with a new kidney transplant as a direct result of the Highly Sensitized Patient kidney program. The gift of transplantation has meant so much to the patients within the highly sensitized patient registry in Saskatchewan and all of Canada.”


What does being highly sensitized mean?

It means that the patients have a sensitized immune system. Immune system sensitization may be a result of blood transfusions, previous transplants or pregnancies, which is why many highly sensitized patients are women. As a result, patients who are “highly sensitized” are at higher risk of rejecting an organ transplant. This makes it very difficult to find a suitable donor match.


How does the program help highly sensitized patients?

The HSP program makes it more likely that people who need a kidney transplant, and who are hard to match, will find one. The program uses sophisticated technology to match the right kidney to the right patient anywhere in Canada with accuracy and efficiency.

An organ matched through the HSP program reduces the risk of potential rejection. This means highly sensitized patients have improved chances that their body will accept the new organ; the organ will last longer; and they will not end up back on a wait list. 

A collaboration with provincial HLA (human leukocyte antigen) testing laboratories is part of the national advisory structure organized by Canadian Blood Services, unique to Canada and is foundational to the success of the program.


Why is the Highly Sensitized Patient program so important?

Approximately 20 per cent of patients on provincial wait lists are highly sensitized and in need of a kidney transplant. Yet, these same patients historically receive fewer than one per cent of available organs. With access to a limited number of donors in their home province, highly sensitized patients wait much longer for a kidney transplant and have a greater chance of becoming more ill or dying while they wait. By providing access to donors across the country, the HSP program increases the chances of finding kidney transplants for these hard-to-match patients.

The implementation across Canada began in October 2013 and by November 2014, all provinces and territories had joined the HSP program. The provincial and territorial Ministries of Health and provincial organ donation organizations worked together to implement this critically important national program.

Arnold Dysart, first HSP recipient and Dr. Peter Nickerson, at HSP launch in 2015.

Arnold Dysart (left) pictured with Dr. Peter Nickerson (right), Medical Advisor, Organ and Tissue Donation and Transplantation, Canadian Blood Services at the launch of the national HSP program . Mr. Dysart was the first recipient to receive a kidney through the Highly Sensitized Patient program in spring 2014. Formerly the superintendent of the Frontier School Division, Mr. Dysart is now retired and lives in Manitoba.

Further reading


Canadian Blood Services – Driving world-class innovation

Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.

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Looking back on 2018: Top-five most-read stories from the RED blog


Tuesday, January 01, 2019

As the year comes to a close and 2019 is set to begin, we take a moment to reflect on the 2018 articles that were among the most popular.

#5: Raising awareness for living organ donation

In April each year, we honour organ donors and their families during National Organ and Tissue Donation Awareness Week and encourage Canadians to consider organ donation, register their intent to donate, and discuss their wishes with families. This article focuses on raising awareness for living organ donation and was published in November on Giving Tuesday.

Kidney transplantation is life-saving and life-altering. Until we can clone or grow or print kidneys (who knows what the future holds), there will continue to be a need for kidney transplants. Transplantation through living donation has the potential to remove many people from dialysis and the transplant waitlists and alter the lives of not just the patients, but their families as well.”
– Kathy Yetzer, Associate Director, Living Donation, Canadian Blood Services.

Read more

 

#4: Meet the Researcher: Dr. Elisabeth Maurer

For the last few years, we’ve been fortunate to conduct interviews with our staff and adjunct scientists in this series of blog posts titled “Meet the Researcher…” This interview with Dr. Elizableth Maurer was number 4 on our most-read list.

"It is my vision that my work could improve the lives of others — if screening platelets could help reduce the number of patients who do not respond as well as hoped to platelet transfusion, and save more lives, this would be very rewarding.”" ~ Dr. Elisabeth Maurer, adjunct scientist, Canadian Blood Services

Read more

 

#3 In the news: UBC research brings us one step closer to universal blood

Exciting research from the University of British Columbia could make it easier to match blood to patients, by turning all blood into type O, the universal donor. This work was presented earlier in 2018 at the American Chemical Society National Meeting in Boston, and created quite a buzz. We chatted wit our Chief Scientist, Dr. Dana Devine, and  Dr. Jayachandran Kizhakkedathu to learn more about this exciting advance.

Read more

 

Our top two blog posts are related to blood donor eligibility criteria and the research program that is working toward evolving the eligibility criteria for men who have sex with men.

#2 MSM Research Grant Program launches second funding competition

The objective of the MSM Research Grant Program is to ensure the generation of adequate evidence-based research for alternative screening approaches for blood or plasma donors, which could evolve the current eligibility criteria for MSM while maintaining the safety of the blood supply. The program is administered by Canadian Blood Services and Héma-Québec with funding support from Health Canada.

Read more 

#1 The evolution of a donor deferral policy: where do we go from here?

Dr. Mindy Goldman, medical director at Canadian Blood Services, along with coauthors Dr. Dana Devine and Dr. Sheila O’Brien also from Canadian Blood Services and Dr. Andrew Shih with the Vancouver General Hospital,  published a review article in the scientific journal Vox Sanguinis, titled Donor deferral policies for men who have sex with men: past, present and future. This blog post provides an overview of the publication.

Read more

For the latest on this topic, an update on the MSM Research Program was published in December 2018

Thank you for reading about Research, Education and Discovery at Canadian Blood Services. We look forward to reporting on more exciting science, researchers and innovations in 2019 related to blood, plasma, stem cells, and organs and tissues. Happy New Year!

Happy New Year

Canadian Blood Services – Driving world-class innovation

Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.

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Raising awareness for living organ donation


Tuesday, November 27, 2018

This #givingtuesday — November 27, 2018 — organizations across the country are raising awareness about living donation. 

Did you know that more than 3,000 Canadians are on a waiting list for kidney transplantation?

When the kidneys are no longer able to remove waste products from the blood, either dialysis (artificial filtering of blood) or a transplant is required for survival. Dialysis alone can lead to health complications and severely impact quality of life.

A transplant is the preferred treatment for most patients suffering from kidney failure, yet there are not enough deceased kidney donors to help every patient in need. Living kidney donations offer patients a higher chance of receiving a transplant.

Kidney transplantation is life-saving and life-altering. Until we can clone or grow or print kidneys (who knows what the future holds), there will continue to be a need for kidney transplants. Transplantation through living donation has the potential to remove many people from dialysis and the transplant waitlists and alter the lives of not just the patients, but their families as well.”
– Kathy Yetzer, Associate Director, Living Donation, Canadian Blood Services.

Potential donors can help someone they know who needs a kidney transplant, or they can donate anonymously to help someone in need of a kidney on a waitlist somewhere in Canada. Patients with end stage kidney disease often wait many years for a kidney transplant from a deceased donor. Having a living kidney donor may decrease this wait time for the patient.

Learn more about living kidney donation.

 

What is Kidney Paired Donation?

The Kidney Paired Donation (KPD) program is a national program operated by Canadian Blood Services in collaboration with Canada’s living kidney donation and kidney transplant programs. Learn more about how KPD chains work:

kidney donor domino effect 
Kidney Paired Donation Domino Effect

Transplantation is a kidney replacement therapy alternative to dialysis for patients who are eligible. It provides the best long-term outcome and a better quality of life than dialysis, and although recipients require life-long medications to prevent transplant rejection, patients no longer have diet and fluid restrictions and do not need to stay close to a dialysis centre at all times. But, there are not enough deceased donors in Canada to provide a kidney transplant for everyone on the waitlists.  Therefore, living donation is another incredibly important option for patients, especially since a kidney transplant from a living donor lasts longer and does better, on average, than a kidney from a deceased donor.

Even when a patient finds someone who is willing to donate a kidney to them, they are often not a blood group and tissue type match, so the transplant cannot occur. This is where Canadian Blood Services' Kidney Paired Donation (KPD) program can help some of these patients to find a medically suitable living kidney donor. These incompatible donors and transplant candidates enroll as incompatible pairs in the KPD program through the Canadian Transplant Registry  and we use a sophisticated matching algorithm to find situations where the donor in the pair can give to someone with whom they are compatible and another donor can give to the transplant candidate of the pair.

How do I become a live organ donor?

Start by contacting the kidney or live liver transplant centres in your province. You will need to undergo mandatory medical examinations and tests to determine if it is safe for you to become a live donor. These tests will also determine if you are an appropriate match for your intended recipient.

 

 

Help spread the word about living donation on social media by sharing the following message:

Did you know that more than 3,000 Canadians are on a waiting list for kidney transplantation. Find out how you can become someone’s hero through #livingdonation at blood.ca/organs-tissues @CanadasLifeLine #OrgansandTissuesForLife

Learn more about living donation on blood.ca/organs-tissues

 


Canadian Blood Services – Driving world-class innovation

Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.

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Unleash your inner writer – Enter our first-ever lay science writing competition


Thursday, November 15, 2018

Use plain language to tell the story of your research in blood, plasma, stem cells or organs & tissues.

Call for submissions – Deadline: January 18, 2019

Theme: Research that matters!

We’re excited to announce the launch of Canadian Blood Services’ first-ever Lay Science Writing Competition. We’ve connected with key partners in the science writing and research communities (Science Borealis and the Centre for Blood Research) to host a competition that will put your plain language writing skills to the test. 

Submissions are open to members of the Canadian Blood Services extended research trainee network including graduate students, postdoctoral fellows and research associates directly or indirectly supported by Canadian Blood Services.

Don’t miss out on the opportunity to showcase to the public your research in the domain of blood, plasma, stem cells, or organs and tissues and take an exciting new step in the development of your vital communication skills…. Not to mention the opportunity to win a prize and get published. 

This year’s Competition theme is “Research that matters!”. Your entry must describe the impact of your (your lab’s) research on the transfusion and transplantation system and/or on our society. The work must be original, in English, and not previously published. Length of submission must not exceed 800 words. 

Canadian Blood Services will convene a jury to review and rank the submissions. Submissions will be judged on their writing and storytelling merits.

lay science writing competition poster 2018

The winning writer will receive a $300 prize and the two runners-up will each receive a $100 prize. Selected entries will be disseminated through the Canadian Blood Services, Science Borealis and the Centre for Blood Research online platforms and social media channels.

Good luck!!

Find out more about the competition and download the competition guidelines

If you have questions, contact the Centre for Innovation by email at centreforinnovation@blood.ca 

Presented in partnership with the Centre for Blood Research and Science Borealis. 


Canadian Blood Services – Driving world-class innovation

Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.

 

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Critical Care Canada Forum 2018


Tuesday, November 06, 2018

The Critical Care Canada Forum (CCCF) takes place this week in Toronto. The annual event is attended by hundreds of health professionals working in critical care, primarily physicians.  A key event within the Forum is an unopposed plenary on brain death determination, to be held on Wednesday, November 7th.

I had the opportunity to chat with Dr. Sam Shemie, Canadian Blood Services’ medical advisor for deceased donation, about this important plenary session, as well as the World Brain Death Project, and the launch of a new professional education resource on neurological determination of death.

CCCF 2018

Why is brain death the focus of this CCCF plenary session and why is it an important subject for the critical care community right now?

A bit of context… Before the 1960s, and the introduction of technical advances like artificial breathing machines, diagnosis of death was clear. Back then, if the brain stopped functioning, the body would stop receiving the signal to breathe and eventually the heart would stop.  The ability to replace breathing with a machine and prevent cardiac arrest was a great advance in the effort to save lives. For the brain injured patient, replacing breathing allowed doctors to try to understand the brain injury and to potentially reverse or improve the cause of that brain injury.

This advance also led to a certain type of patient that was never seen before: a patient with a brain injury who, despite all effort, had deteriorated to a state of complete and irreversible loss of all function of the brain.

What we now call brain death is death determined by brain-based criteria. These criteria are the loss of capacity for consciousness, the absence of brain stem reflexes, and the absence of the ability to breathe. (Severe brain injury to neurological determination of death: Canadian forum recommendations. CMAJ 2006 Mar 14)

The term “absence of capacity for consciousness” is a bit difficult for people to understand. What it means is that all functions of the brain have completely stopped and will never resume. Thinking, planning, moving, feeling, seeing, hearing, smelling — no ability to interact with environment, etc. There is no brain function. However, if one artificially replaces breathing, the organs of the body will continue to function.

Brain death is accepted medical practice in most countries of the world, including Canada,  yet recent legal cases in the US and now in Canada where families have challenged the diagnosis of Brain Death on religious grounds.  This ongoing legal challenge to the acceptance of Brain Death as death is concerning to the Critical Care community.  Throughout the legal challenge process, the body of the individual who has been declared brain dead continues to be supported by machines. However, this is the complete cessation of all brain function and there is no returning from the state.

Of course, the topic of death determination is of concern to the Critical Care community. These professionals are the ones who are most likely to work with patients with devastating brain injury who can deteriorate to brain death. To better understand the issues surrounding medical and legal determination of death, the Critical Care Canada Forum (CCCF) is hosting an unopposed plenary session on Nov. 7th to allow for medical, legal and ethical discussion of brain death.

The plenary session is unopposed — which means no other sessions will take place at the same time so all delegates can attend. It will involve 90 minutes of expert presentations from the medical, legal, ethical and international perspectives, followed by a 30-minute Q&A period.

Plenary Session: Threats to the Concept of Brain Death

  • B Kavanagh Case Presentation
  • A Joffe – Medical: Death is Not Brain-Based
  • S Shemie – Medical: Death is Brain-Based
  • H Scher  Legal Uncertainty
  • D Jarvis  Legal Coherence
  • R Sibbald  Ethical Reflections
  • D Greer International Perspectives on Threats to Brain Death
  • Panel Discussion and Audience Questions

Read more in the CCCF program

What is the World Brain Death Project?

Brain death is accepted medical practice in most countries, though there may be variations in practice and understanding. The World Brain Death Project is an international collaboration of medical experts, professional societies and organizations that manage patients with devastating brain injuries leading to brain death.  These professionals include world societies of Intensive Care (adult and pediatric), Neurocritical care, Neurology and Neurosurgery.  This collaboration aims to develop an international minimum standard of practice to enhance the current medical and legal standing for the brain-based determination of  death or as it is also called, death by neurological criteria. The goal is the harmonization of international practices to address the inconsistencies among practice in countries and between countries and identify gaps in knowledge that can be addressed by research.

The project is led by representatives from Canadian Blood Services including myself and Sylvia Torrance along with leading experts in neurocritical care including Gene Sung from UCLA ,Ariane Lewis (New York Univeristy) and David Greer )Boston Univeristy).

You are also involved in the development of a new professional resource related to Neurological Determination of Death (NDD), can you tell me more about that?

Canadian Blood Services’ work in organ and tissue donation and transplantation includes supporting the development of leading practice and increasing opportunities for professional development and education. Historically, there has been no national curriculum to train specialists in organ donation. This project is changing that.

Ken Lotherington (Canadian Blood Services) and Jennifer Hancock (Dalhousie University) along with Pierre Cardinal and Aimee Sarti (The Ottawa Hospital Research Institute) are developing an online e-learning platform for various aspects of deceased organ donation. This ongoing, multi-year initiative will release two new national curriculum modules this year. The first module NDD/brain death is intended to be used as part of the required training for critical care residents and fellows. The teaching of NDD in Canada will be harmonized with existing leading practice and be available as a learning and teaching tool to train people -- enhancing the rigour of the determination of death to make sure there are no diagnostic errors is key.

Module 1: Canadian Clinical Guide to Organ Donation to launch

At CCCF 2018 members of our deceased donation team will be on hand to launch and demo the first module of the Canadian Clinical Guide to Organ Donation – an online e-learning curriculum that is Royal College accredited. Professionals will be able to register for the first module “Neurological Determination of Death”.

Canadian Clinical Guide to Organ Donation

Module 1 learning objectives:
  • Discuss normal CNS pathology and the pathophysiology leading to neurological death.
  • Describe physician standards required for declaration of neurological death.
  • Describe how to perform declaration of neurological death.
  • Discuss confounding factors that preclude a clinical diagnosis of neurological death.
  • Discuss the different acceptable ancillary tests for neurological determination of death.
  • Explain some common confusing exam findings in a patient who has been pronounced neurologically dead (spinal reflexes, ventilator auto-triggering, etc).

If you’re attending CCCF 2018, visit Canadian Blood Services’ booth to learn more and to register for this new professional education resource. 

For more professional education resources visit blood.ca/profedu

 


Canadian Blood Services – Driving world-class innovation

Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.

 

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