New program will help transplant patients find a living donor

By John Gillis, Health Reporter

February 17, 2009

Atlantic Canadians who need kidney transplants should have a better chance of being matched with a live donor through a new exchange program.

Last year at the Queen Elizabeth II Health Sciences Centre in Halifax, 39 people had new kidneys transplanted from relatives or friends who were willing to donate one of their own organs, said Dr. Ian Alwayn, surgical director of the program.

But before now a person with kidney disease who couldn't find a match among loved ones would have to go on a waiting list to receive an organ from a deceased person. And those who were willing to donate a kidney but were not matched to their intended recipient would be unable to donate their organs.

There are about 220 Atlantic Canadians on the waiting list for kidney transplantation. Their average wait can range from one to four years depending on their blood type, Dr. Alwayn said.

Under the new living donor paired exchange registry, willing donors could give a kidney to a stranger in need and in exchange their loved one would get an organ from a matching person who had intended to donate to the same stranger but was incompatible.

For example, Bill wants to donate a kidney to his brother Bob but does not match. Alice wants to donate a kidney to her sister Anne but does not match. It might be determined through the registry that Bill is compatible with Anne and Alice with Bob and both would be able to receive the their kidney transplants.

In that way, instead of two patients going on waiting lists, two patients get new kidneys, Dr. Alwayn said.

"We're expecting that we can increase our program by about 20 per cent with this paired exchange program," he said. "It all depends on how many people we can enter into the registry. Because the more people from Halifax or from Nova Scotia or from the Atlantic provinces, for that matter, we can enter into the registry, the more likely . . . that potential combinations will come out of it."

The national program is administered by Canadian Blood Services.

Dr. Alwayn came to Halifax last year from the Netherlands, where such an exchange program has been in place for some time.

People who receive kidneys transplanted from living donors fare better than those whose organs come from deceased people, Dr. Alwayn said. That's partially because the organs can be transplanted sooner after removal and also because recipients can often have the operation before they become so ill they require dialysis.

The Halifax transplant program has also recently instituted an altruistic donation system, meaning a healthy person can register to donate a kidney without having a specific recipient in mind. That should also help increase the number of live donors in this region, Dr. Alwayn said.

People interested in altruistic donation should contact Rachelle LeBlanc through QEII locating at 473-2222.

These paired exchanges already happen locally in some centres in Canada, Ron Vezina, Canadian Blood Services spokesman, said from Ottawa.

In that city, there have been instances of "domino donations," in which a series of willing but mismatched donors have been able to give kidneys to other recipients.

"What it lacks is a critical mass," he said. "The only population they have to draw from is about one million in the Ottawa area. If all of a sudden you network the country together, with a base of potentially 33 million to draw from, there's a lot more of these matches that are going to take place."

Nova Scotia will join the new exchange program next week. It is already up and running in Ontario, Alberta and British Columbia and should include all of Canada by June.

"The beauty of this thing is someone in St. John's could be donating to someone in Victoria, or anywhere in between," Mr. Vezina said.

Figures from the Canadian Organ Replacement Register, cited by Canadian Blood Services, indicate about 35,000 Canadians suffer from kidney disease and 3,000 people in this country are on waiting lists for a kidney transplant.

Copyright © 2009 The Halifax Herald Limited.

This article posted March 8, 2009.