Organ Donation

Photo of Audrey and Melinda Weimer
Photo shows on the left Audrey Weimer, 46-year-young patient with renal failure and her twin sister Melinda Fischer who received a kidney transplant in July.

Dear Dr. B: I love reading your column. On August 2, in the Medicine Hat News, there was a front page article on the taking of organs on Falun Gong prisoners in China, and our Canadian $50.00 bill in the photo. Can you please explain to your readers that purchasing organs is illegal in Canada, and what a tremendous gift of life organ donation means to people waiting for an organ. I am a pre-renal patient, and someday will also be on the transplant list. Thank you from the bottom of my heart. Yours sincerely, Audrey Weimer.

Fours years ago Audrey had chronic cough, lethargy and anemia. She was diagnosed to have kidney failure due to Wegner’s disease. The disease is also known as Wegner’s granulomatosis. It is a rare form of inflammation of the blood vessels that affects many organs. The lungs and kidneys are most commonly affected. Audrey new she would need a kidney transplant in the future. Her twin sister Melinda would be the best match as a donor.

Audrey asked Melinda to go get herself checked as a possible donor. But as fate would have it, Melinda was diagnosed to have Wegner’s disease as well. Melinda’s kidneys failed faster than Audrey’s and she went on dialysis. After waiting for three years, she received a kidney transplant in July from a deceased donor.

According to Health Canada website, in 2001, more than 3,700 Canadians were awaiting organ transplants for kidneys, hearts, lungs, or livers, and thousands of others were in need of replacements for tissues such as corneas, heart valves, bone grafts, and skin.

In year 2000 alone, 147 Canadians died while waiting for organs that never came because suitable donors were not found in time. Canada has one of the lowest organ donation rates among industrialized nations.

Organ transplant surgery has made significant progress in the last few years. We know that nearly 98 per cent of all kidney transplants, 90 per cent of liver transplants, and 85 per cent of heart transplants are successful. And the number of patients receiving solid organ transplant has increased by 22 per cent in the last decade.

Is this enough? No. Why should 147 or more Canadians die each year while waiting for a suitable donor? Something needs to be done to improve the situation. We need to raise the public’s awareness.

You can be a donor by signing an organ and tissue donor card (see on the other side of Alberta Personal Health Card) or by registering your consent through the provincial registry. You should also discuss with your loved ones your desire to be a donor. This is very important. Ninety-six percent of relatives agree to organ donation if they already know the wishes of the donor, while only 58 per cent agree when they have not been included in the process in advance, says Health Canada. Do it today. Talk to your family and sign the card. And yes, purchasing organs in Canada is illegal.

Signing an organ donor card does not mean you will not get appropriate care if you are seriously ill. The organ transplant team does not wait outside your hospital room ready to grab your organs as soon as you are pronounced dead. There is a strict protocol to follow before anybody can touch your body. The process is complex and requires a coordinated team approach.

In Alberta, the government has established the HOPE (Human Organ Procurement Exchange) program for the coordination of donation, recovery and distribution of organs for transplantation within Alberta. For southern Albertans the office is in Calgary. For more information phone 403-944-8700 or visit their website:

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Blood Transfusion

Dr. B, is blood transfusion safe?

Susan, blood can never be 100 percent safe. Therefore, it is important for health care professionals to develop strategies to avoid the need for blood.

But this not always possible. In Canada, approximately 600,000 people receive blood each year. It saves lives of critically ill patients. It also improves the quality of life of other patients who require blood transfusion.

So the need never stops!

Then, Dr. B., how safe is it to have a blood transfusion?

The safety level of blood transfusion in Canada has improved a lot. Recently, a not-for-profit, charitable organization called Canadian Blood Services (CBS) was given the task of collection and distribution of blood.

Susan, unlike Red Cross, blood is the sole focus for CBS. Safety, through research and development, is a priority for the Canada’s new blood agency, says Lynda Cranston, CEO of CBS in a recent article in Hospital Quarterly.

CBS spends $20 million annually for a new screening weapon that allows earlier detection of the viruses that cause hepatitis C and AIDS. Further $10 million is spent annually on leukoreduction – a process in which white blood cells are removed from the blood supply. This will further reduce the risk of transfusion reaction and infection.

Currently, the risk of viral infection to a recipient is too low to measure.

Dr. B, is it true that only 5 percent of the population donates blood, yet virtually all Canadians will need blood or blood products in their life time?

Yes Susan, that is correct. In the last 10 years, the amount of blood collected in Canada has dropped from 1.2 million units a year to just under 700,000 units. This is not good.

CBS needs donors. The bottom line is without donors there would be no Canadian Blood Services, says Gaylene Smith, Communications Coordinator of CBS in Calgary. She adds, “Medicine Hat is a terrific supporter of our mobile clinics.”

In the first five months of this year, Medicine Hat and Lethbridge have had 6 blood donor clinics each. The average attendance in Medicine Hat is 214 with average collection of 190 units of blood at each clinic. Figures for Lethbridge are: 211 and 186 respectively.

How much blood do we use in Medicine Hat?

In 1984, we used 80 units of packed red blood cells per month. In the last one year we have used 150 units per month, says Dr. Michael O’Connor, pathologist at Palliser Health Authority. He adds, “Like other places our need never stops either!”

“We certainly need more donors. Donors should remember that they are at no risk of contracting viral infection,” emphasizes Dr. O’Connor.

Dr B., can I be a donor?

Sure Susan, you can be a donor if you are between 17 and 61 years of age. You should weigh 50kg (110 lbs.) or more. Have a proper ID. You should not be on any medication, which will affect the recipient. You should wait at least 56 days between donations.

Thank you Dr. B. I better phone the toll free number (1-877-444-9284) and find out the date of next blood donor clinic in Medicine Hat.

Sounds like a good idea! Remember, a unit of blood saves more than one life! Good luck, Susan.

This series of articles explore the health problems of Dave and his family. They are composite characters of a typical family with health problems.

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Organ Transplant

“Don’t take your organs to heaven. Heaven knows, we need them here.” This is a slogan used by the Kidney Foundation of Canada.

Recently, we had “Organ and Tissue Donor Awareness Week”. This is a good way to remind people like me to sign the Universal Donor Card. So I check with my wife if I have signed one. She couldn’t remember.

I check my driver’s license. The new one has no donor card at the back. I check my Alberta Personal Health Card. I see my wife has witnessed my signature where I make “anatomical gift” of organs and tissues for transplantation and research upon my death.

Well, memory is one thing my wife and I should not donate to anyone!

In any case, events like “organ donor awareness week” reminds us of many things in life which we take for granted.

Donation of solid organs and tissues does not start when life ends. During their lifetime, family members and relatives of potential organ recipients help their loved ones when there is a need for liver, kidney, lung, and bone marrow transplants.

But lot more work needs to be done to encourage such donations after death for potential organ recipients who have no family attachment and are not emotionally related to deceased donors.

Why do we need to do this?

Because 150 Canadians on waiting list for organ transplants die every year. In 1997, more than 3000 Canadians were on the waiting list. Only 1600 transplants were performed due to shortage of appropriate organs.

Alberta has done little better. According to Alberta Health, our provincial donor rate has remained on average about 2 percent above the national rate.

Alberta Health’s Province-Wide Services 1998 Annual Report says that in 1997-98, there were 22 heart, 128 kidney, 31 liver, 126 bone-marrow, and 10 lung transplants in Calgary and Edmonton. This is a total of 317, compared to 291 for the previous year. But this is not enough.

How can we improve the situation?

This can be done by: 1) improving public’s awareness and acceptance of the importance of organ donation, 2) adequately train health care professionals to handle the sensitive issue of discussing the options with a grieving family.

There are 4 major stages to be undertaken before the organ or tissue is available to a potential recipient. These are: recognizing and declaring brain death, notifying the organ procurement organization, presenting the option of donation to the grieving family, and clinical care of the brain dead donor.

This is where the Palliser Health Authority (PHA) has made a difference by setting aside $15,000 to formalize the organ donation process in our region.

“Palliser’s contribution is significant indeed. The program is now up and running,” says Mr John Boksteyn, chair of PHA. Medicine Hat will be the first regional hospital to do this.

So, how can we help? 1) Make a decision to be a donor and share your wishes with your family. 2) Decide if you want your organs and tissues for transplant and/or for research. 3) Sign a Universal Donor Card on the other side of Alberta Personal Health Card.

Organs and tissues which you can donate are: heart, lungs, kidneys, liver, eyes, skin, bone marrow, veins, and pancreas. The list may not be complete. Age restrictions are now minimal. People over 80 years may still be good candidates.

So, think carefully. Make up your mind. Discuss with your family and sign the donor card. Otherwise it will never happen!

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