Trans­plant turn­around

Penticton Herald - - OPINION -

There has been a re­mark­able ac­cel­er­a­tion in B.C.’s or­gan-trans­plant pro­gram. Ten years ago, we had one of the worst records in Canada. To­day, our rates have dou­bled, and we are first in the coun­try. How did this come about?

There are two im­me­di­ate parts to this story. One is that in years gone by, or­gan re­trieval was not al­ways a pri­or­ity in hos­pi­tal ICUs.

B.C. Trans­plant — the agency re­spon­si­ble for over­see­ing or­gan re­cov­ery — took the step of en­cour­ag­ing hos­pi­tals to hire trans­plant co-or­di­na­tors. This brought fo­cus and physi­cian buy-in to what had been, at best, a hap­haz­ard process.

This turn­around is one of the ma­jor suc­cess sto­ries in our provin­cial health-care sys­tem. Credit is due to all in­volved.

The sec­ond part is more dif­fi­cult to tell, be­cause it in­volves an el­e­ment of tragedy. A decade ago in B.C., the num­ber of or­gans col­lected from peo­ple who died of opi­oid over­doses rep­re­sented just five per cent of the to­tal.

Be­cause of the fen­tanyl cri­sis, to­day that fig­ure is 30 per cent. This, too, has boosted the sup­ply of re­cov­er­able or­gans.

It might be thought that tis­sues re­trieved in this way would be un­us­able — that the fen­tanyl would be trans­mit­ted to the re­cip­i­ent. But or­gans are fully flushed be­fore they are trans­planted, and even in over­dose cases, the amount of opi­oids at any one lo­ca­tion in the body is small.

Painful as this is to re­late, per­haps it might bring so­lace to fam­ily mem­bers who have lost a loved one to this dev­as­tat­ing scourge.

But there are also for­ward-look­ing el­e­ments in the trans­plant pic­ture. It is pos­si­ble to cre­ate new or­gans us­ing 3D com­puter print­ing. While the tech­nol­ogy is still in the early stages, and not yet avail­able in B.C., com­puter-printed blad­ders have al­ready been trans­planted in the U.S.

The im­pli­ca­tions are pro­found. Cur­rently, 665 Bri­tish Columbians are on the wait list for a trans­plant. Of these, more than 100 will die be­fore an or­gan be­comes avail­able.

The prob­lem is not a lack of pub­lic sup­port. More than one mil­lion Bri­tish Columbians have joined the donor reg­istry. You can add your name on­line at trans­plant.bc.ca.

The prob­lem is that his­tor­i­cally, less than one per cent of fa­tal­i­ties oc­curred in a way that would en­able a tis­sue trans­fer. Now that is chang­ing.

Per­haps the day is not too far off when no one need die wait­ing for an or­gan trans­plant. — Vic­to­ria Times Colonist

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