Susan Pigg and Barbara TurnbullStaff reporters | The Star
Ontario’s Auditor General has identified “serious deficiencies” in the province’s organ-donor system that have cost lives, says Toronto’s leading expert on transplantation.
“The auditor general has hit the nail on the head. We’ve lost donors,” said Dr. Gary Levy, a transplant surgeon at Toronto General Hospital and author of a 2009 report on wait times across Ontario.
“Because we’ve lost donors we’ve been unable to save as many lives. There’s no question we could have done better and saved more people,” says Levy.
A stunning 40 hospitals were not required to alert the Trillium Gift of Life Network that they had patients on life support, says the report by Auditor General Jim McCarter released at Queen’s Park Monday. That alert is the vital first step in both identifying potential donors and seeking approval from next of kin for organs that could save some of the 1,600 people currently on the wait list, his report notes.
McCarter also called for Ontario-wide wait lists for kidneys and livers to replace the current five regional wait lists, noting that in 40 per cent of the cases he reviewed, organs were not allocated to the highest-priority recipient. Instead, the organs went to the neediest person on the regional wait list.
That’s because areas such as London and Sudbury have higher donor rates — as high as 44 per cent compared to Toronto’s 13 per cent — and fear sending the organs elsewhere could cause a donor backlash, he said.
The lack of province-wide priorities for some organs has contributed to wildly differing wait times across Ontario — in the case of kidneys, anywhere from four to nine years, he said.
Some 61 Ontario hospitals with ventilators are required by law to alert Trillium when they have a patient on life-support so trained transplant staff can determine if the organs are suitable for donation.
But Trillium claims it only has the budget for coordinators at 21 hospitals, McCarter said.
Donor experts lauded the auditor general’s report.
“To us the big issue is getting that donor rate higher and consistent across the province,” said Kirsten Krull, vice president of integrated surgery services at London Health Sciences Centre. “This is a great document that people really need to pay attention to because it’s important to our health system.”
Trillium president Frank Markel defended his agency which coordinates tissue and organ donation and transplantation, saying donations are up 59 per cent since it was created in 2002. The report should be “enormously useful” in further boosting those numbers, he said.
McCarter said he was surprised to find out that the old paper consent form he carried for years in his wallet is “meaningless” because no one tends to look for them in a medical emergency. Instead, people need to be able to register their desire to be a donor online, he said.
Among his seven recommendations for improving Ontario’s organ donation system is that it be mandatory for health-care professionals to seek approval from next of kin for organ donations before a patient is removed from life support, as they are required to do in the United States.
Almost 1,000 organ transplants are now taking place in Ontario a year. But Ontario still lags considerably behind countries such as the United States and the United Kingdom.
As of last year, just 17 per cent of Ontarians over the age of 16 were registered donors, compared to 30 per cent in the U.K. and 37 per cent in the U.S.