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White Coat Black Art26:30The kidney transplant waiting game
Judith Morrison is very conscious of the condition of her kidneys.
She has polycystic kidney disease (PKD) and needs a kidney transplant. Over the past five years, she has seen her kidney function drop to 5%.
“It's very scary to watch that slowly wane,” she told CBC host Dr. Brian Goldman. White coat, black art.
Judith's sister, Katherine, also has PKD but doesn't need a transplant. She is leading the search for a living kidney donor, which is usually a quicker process than finding a deceased donor. Both sisters are based in Calgary.
“We know she's going to have a kidney transplant, we're just waiting to find out when that is. We can't wait,” Katherine said.
Some Alberta patients report having difficulty finding donors TestedThis involves blood tests and a medical history check. Nephrologists and national kidney experts across Canada say the testing process can be difficult for both potential living donors and recipients who need a kidney.
Efficiency is key
The demand for kidney donations is high. Oversupply In Canada for many years.
According to the Canadian Institute for Health Information, the number of people living with end-stage renal disease in Canada continues to rise. End of 2022Approximately 73% of people waiting for an organ transplant in Canada (more than 2,750 people) were waiting for a kidney transplant.
In 2022, 117 people in Canada Died While waiting for a kidney transplant.
The testing process is plagued with delays, which some donors and potential recipients say make the situation worse.
In Judith's case, two potential donors told her they called the Southern Alberta transplant program but got connected to voicemail. After the phone conversation, they had to wait weeks, or even months, for the next step in the process.
“There's no one making sure everything is lined up correctly and happening at the right time so that things move through the system as efficiently as possible,” Catherine says.
Experts say health officials need to address inefficiencies in the live donor testing process and make sure potential donors can get tested as quickly as possible.
“It's about being safe and at the same time being as efficient as possible,” said Dr. Anne Bugeja, a nephrologist at The Ottawa Hospital and director of the hospital's living kidney donation program.
Alberta Health Services (AHS) would not make anyone available for interview, instead issuing a statement saying the current timeline for screening donors is between six months and a year.
AHS said a maximum of two donors per recipient are tested at a time, which it said is the most efficient use of hospital resources and reduces the chance of unnecessary testing on donors who are unlikely to move forward.
In a statement, the health department said that as of May 9, they had returned one call, that all messages left on phone lines are tracked, and that response times vary from the same day to two business days.
Why Living Donation is the Best Choice for Patients
For patients with kidney failure, dialysis or kidney transplant are the main treatment options.
Patients who need a kidney can wait for a kidney transplant from a deceased or living donor.
Transplants from living donors are considered ideal because they last an average of 21 years, nearly double that of transplants from deceased donors.
Plus, waiting for a cadaveric donor can be a long process in Canada. on average Four to five years.
In the case of living donor organs, patients have two options: find a donor themselves or wait for a donation through Canadian Blood Services (CBS). Kidney Pair Donation ProgramOver the past five years, an average of 80 transplant surgeries have been performed nationwide each year.
Once a potential donor is found, both parties must undergo testing. Living kidney donations are most often made by people the recipient knows, but anonymous donations are also available.
System “glitches”
Alberta patients say even when they finally find someone interested in donating one of their kidneys, they can be frustrated to hear they've run into obstacles.
Kelly Konieczny, who lives just outside Edmonton and has PKD, estimates that more than 10 people have inquired about donating a kidney in the past four years.
Some of those people, she said, said they hadn't received a call back from the state's living donor program.
“It's a very strict system and they work really hard, but it feels like there's something wrong,” said Konieczny, who is still waiting for her transplant.
“We recipients looking for donors sometimes get phone calls at any time of the day or night. [the] If things aren't working properly behind the scenes, it's all for naught.”
Living organ donors are often called heroes, but what drives them to undergo surgery to save the lives of others? CBC's Ioanna Roumeliotis explores what science has learned about these extreme acts of kindness, and why some people can't help but help.
One potential donor was Jim Storch, a man often seen at local coffee shops.
He began testing in late 2022 but ended up not being a match, and he said he sometimes had to deal with phone calls with officials through the state's living donor program during the six months of testing.
“It may seem a little vague at times, but please bear with us as it is a worthy cause,” he said.
Dr. Braden Manns, a Calgary-based nephrologist, said Alberta's testing process needs to be better understood.
“We don't know how long people will wait on average, both for recipient testing and donor testing,” Manns said.
“Trajectory” Improvements
Canada has no national standards for how long donor evaluations should continue, according to a recently published study by researchers in Ontario. review A look at St. Joseph Healthcare Hamilton's one-day testing clinic.
Potential candidates who do not have any complications, such as required weight loss, should ideally be assessed for suitability within three to six months.
Bugeyya is the study Potential living donors need help to better understand the “trajectory” from coming forward as a potential donor to what happens after they become a donor.
Researchers from B.C. also found “Timely and efficient medical evaluation is considered an important motivator for organ donation among former and potential living donors.”
Finding problems in health care programs is a critical but necessary step in improving the process, Bugeja said.
After doing that, she and her colleagues at The Ottawa Hospital streamlined most testing, including blood tests and nuclear medicine scans. One day process.
Catherine and Judith Morrison look at the program with longing, and wish Alberta had a similar program to make living organ donation a little easier and more attractive.
“I know it's a big sacrifice, but I've spoken to donors and heard it's one of the most amazing things in the world you can do for someone,” Katherine said.
