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Transplant: Keeping donated organs ‘alive’ outside the body

Last year more than 1900 Canadians received a life-saving transplant, yet 3400 people were on the wait list. Some just couldn’t hang on long enough. 161 people died. Five of them were children. Right now, 506 British Columbians are waiting, most of them needing kidneys.

There is a chronic shortage of organs available for transplant. Canada’s organ donor rate falls far below that of the leading countries – Spain has a deceased donor rate of more than 30 per million, ours is less than half that. Portugal, the US, France, Italy, Norway and Austria are all doing better than we are. Yet the overwhelming majority of us agree with the concept of organ donation, and would willingly accept a donated organ if we were in need.

Many experts have been trying to develop ways to alleviate the shortage. For kidney and liver transplants, there has been a push for more living donors. Kidneys are desperately short in supply, so the program has gone even one step further. The Living Donor Paired Exchange is essentially a kidney swap where a potential recipient has a willing donor who is not a match. That donor agrees to donate their kidney to another recipient who has a willing unmatched donor. Some cross-Canada exchanges have involved 10+ donors and recipients.

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Another way to increase supply is by maximizing the potential of all available organs. Right now, it’s estimated only about 20 per cent of donor lungs are suitable for transplant. The rest are either damaged or in questionable condition. Dr. Shaf Keshavjee at Toronto General Hospital has pioneered the Ex-Vivo technology to keep lungs alive outside the body so they can be repaired and thoroughly assessed before transplant. Over the past two years, this has led to nearly 30 per cent more lung transplants.

There is an Ex-Vivo liver machine coming to Canada soon, and a heart machine undergoing approval for use here. The TransMedics OCS Heart system has just finished a trial in the US on 128 patients.

Only 18 percent of British Columbians are registered to be an organ donor. A single donor can potentially save eight lives. Please register today at http://www.transplant.bc.ca/index.asp.

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Part 1 – The search for a cure

Part 2 – Unlocking the secrets of the immune system

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