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. 

Highlights from the 2019 Critical Care Canada Forum


Thursday, February 06, 2020 Jenny Ryan

The 2019 Critical Care Canada Forum (CCCF) took place in Toronto Nov. 10-13. This year marked the fifth annual Deceased Organ Donation Symposium, a two-day symposium held during CCCF that promotes scientific research and discussion about organ donation and transplantation and its application to critical care practice. 

Presented by Canadian Blood Services, Trillium Gift of Life and the Canadian Donation and Transplantation Research Program, this year’s event did not disappoint. Presentations from this session were recorded and can be found on Canadian Blood Services’ professional education website.

Highlights

Opt-out (presumed/deemed consent) — In April 2019, Nova Scotia became the first jurisdiction in Canada to pass opt-out legislation, designed to increase organ and tissue donation. To better understand the real-world implications and impact of this consent model, attendees heard from Phil Walton, the United Kingdom’s deemed consent project lead.  His message for Canadian jurisdictions considering this legislation change was to ensure the right people were around the table and that true collaboration among these groups was employed – legislators, regulators, faith groups, organ donation organizations, patients, families, as well as media and ethics experts. 

 

For health care professionals, the legislation should not change end-of-life conversations with families. The patient and unique life-saving opportunity at hand should remain the focus of every family discussion. The legislation is simply a tool to help the family support a decision. 

 

Randall Tressider presents at Canadian Critical Care Forum in 2019, alongside a photo of his deceased wife Shelly Sarwal

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. Randy Tresidder, whose wife Dr. Shelly Sarwal was the first person to undergo MAID and organ donation in Nova Scotia, shared his story. His honesty about the personal conflicts he experienced in order to accept and wholly support his wife’s decision to become an organ and tissue donor brought great insight to a sensitive subject.

The incredible story of Dr. Sarwal is captured in the documentary film Her Last Project, which attendees also had the opportunity to view during the conference.

Non-Perfused Organ Donation – Dr. Marcelo Cypel, from the Toronto Lung Transplant Program, described an innovative technique that is being used to expand the donor – non-perfused organ donation (NPOD). 

At select hospitals in Ontario, patients who were unable to be resuscitated after an unexpected death, such as a cardiac arrest, are referred to the organ donation organization for initial suitability screening.   Potential NPOD donors have their lungs inflated with oxygen for up to three hours; the timeframe permitted for family approach and consent, deployment of the recovery teams, and lung recovery to take place.  After recovery, the lungs are placed on an ex-vivo lung perfusion machine to evaluate the quality of their function prior to transplantation. 

Dr. Cypel shared that this type of donation had resulted in five transplants to date.  One recipient was a surprise guest at the Symposium.  Eric Celentano’s gratitude for a second chance at life reminded attendees why this work is so important. 

Recordings from all of the Deceased Organ Donation Symposium sessions are posted on the Professional Education website, available here.

Check out the gallery for more photos, including one of the inaugural meeting to begin development of a national pediatric donation and transplantation strategy focused to optimizing neonatal and pediatric donation, organ utilization and transplant outcomes. The meeting included more than 30 participants from pediatrics, critical care, donation, transplantation, research as well as donor families and Canadian Blood Services. Meagan Mahoney, a pediatric intensivist from Calgary; Laurie Lee, a pediatric nurse practitioner from Calgary; and Lee James from Canadian Blood Services’ Deceased Donation team will lead and support a steering committee to advance this important work.

Did you miss the 2018 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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Tuesday, November 06, 2018
Jenny Ryan

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.


Tuesday, October 08, 2019
Jenny Ryan

This year marks the fifth annual Deceased Organ Donation Symposium at the Critical Care Canada Forum in Toronto. This two-day symposium held Nov. 11–12, 2019 promotes scientific research in organ donation and transplantation and its application to critical care practice.


Wednesday, December 20, 2017
Jenny Ryan

Canadian partners bring experts together for two-day Deceased Donation Symposium as part of CCCF

Memories of CST 2019


Thursday, October 24, 2019 Jenny Ryan

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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Friday, November 02, 2018
Jenny Ryan

Health professionals, patients, and policy makers gathered in Ottawa to discuss the future of transplantation in Canada at the Canadian Transplant Summit 2018 — October 16-20, 2018. The Canadian Society of Transplantation, Canadian Blood Services, the Canadian Donation and Transplantation Research...


Wednesday, April 20, 2016
Michelle Hampson

Transplanting organs, tissue or stem cells from one person to another saves lives. It was not easy to figure out what facilitates a healthy and successful transplant though. Efforts over a long time reveal the complexity of the procedure and that very specific circumstances are required. As researchers’ understanding of the immune system improved, so did the success rate of transplants.


Tuesday, January 15, 2019
Jenny Ryan

Five hundred kidney transplants made possible through national highly sensitized patient program

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


Tuesday, October 08, 2019 Jenny Ryan

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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Wednesday, December 20, 2017
Jenny Ryan

Canadian partners bring experts together for two-day Deceased Donation Symposium as part of CCCF


Wednesday, May 08, 2019
Jenny Ryan

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...


Tuesday, November 06, 2018
Jenny Ryan

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.

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


Tuesday, June 25, 2019 Jenny Ryan

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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Wednesday, May 08, 2019
Jenny Ryan

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...


Wednesday, November 09, 2016
Maeghan Toews

The James Kreppner Award program supports legal research relevant to Canadian Blood Services. Research priorities for the James Kreppner Award include the legal and regulatory aspects of (a) donation, collection, storage, and use of blood, blood products, and hematopoietic stem cells; and (b) organ and tissue donation and transplantation. The 2016 James Kreppner Award will support one project with up to $50,000 for a period of one year. This year’s competition closes Nov. 30 2016.


Tuesday, November 15, 2016
Marco Ouji

Documentary brings to the screen the lasting impact and major importance of organ donation across the country.

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


Wednesday, May 08, 2019 Jenny Ryan

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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Tuesday, November 06, 2018
Jenny Ryan

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.


Wednesday, December 20, 2017
Jenny Ryan

Canadian partners bring experts together for two-day Deceased Donation Symposium as part of CCCF


Wednesday, November 09, 2016
Maeghan Toews

The James Kreppner Award program supports legal research relevant to Canadian Blood Services. Research priorities for the James Kreppner Award include the legal and regulatory aspects of (a) donation, collection, storage, and use of blood, blood products, and hematopoietic stem cells; and (b) organ and tissue donation and transplantation. The 2016 James Kreppner Award will support one project with up to $50,000 for a period of one year. This year’s competition closes Nov. 30 2016.

Expert guidance seeks to improve identification of potential organ donors


Tuesday, April 23, 2019 Jenny Ryan

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. 

 

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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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Tuesday, November 27, 2018
Jenny Ryan

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...


Wednesday, November 09, 2016
Maeghan Toews

The James Kreppner Award program supports legal research relevant to Canadian Blood Services. Research priorities for the James Kreppner Award include the legal and regulatory aspects of (a) donation, collection, storage, and use of blood, blood products, and hematopoietic stem cells; and (b) organ and tissue donation and transplantation. The 2016 James Kreppner Award will support one project with up to $50,000 for a period of one year. This year’s competition closes Nov. 30 2016.


Tuesday, January 15, 2019
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National organ sharing leads to 500 kidney transplants for highly sensitized patients


Tuesday, January 15, 2019 Jenny Ryan

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.

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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.

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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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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.

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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

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


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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.

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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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