Organ and tissue donation rates increase with implementation of new legislation

Additional steps to be taken to ensure increases continue

March 21, 2006

THE HOSPITAL FOR SICK CHILDREN, TORONTO /CNW/ - Trillium Gift of Life Network (TGLN) indicated today that in the 10 weeks following the enactment of legislation to improve organ and tissue donations throughout the province, referrals from hospitals have tripled leading to increases in organ and tissue donation.

On January 9, 2006, the McGuinty government enacted a section of the Trillium Gift of Life Network Act requiring routine notification and request ("RNR"). RNR requires the 13 type 'A' hospitals to report every death to TGLN. Reporting of every death ensures that accurate identification can be made of a potential donor and that eligible families be provided the opportunity to fulfill their loved one's wishes.

"The early statistics we've seen from the phased-in implementation of RNR in the largest hospitals in the province show very promising results," said Dr. Frank Markel, President and CEO of TGLN.

"When you compare organ and tissue donation rates since the implementation of RNR over results from the same period last year - both the referrals from hospitals and the actual organ and tissue donations rates have increased significantly. We are confident with the full implementation of RNR and the additional measures TGLN is prepared to take, we have the framework to provide us with the tools needed to continue to increase donor rates in Ontario," he added.

Trillium Gift of Life Network is a not-for-profit agency of the Government of Ontario and is responsible for planning, promoting, coordinating and supporting organ and tissue donation across Ontario and improving the system so that more lives can be saved. Currently in Ontario, organ donation occurs after brain death and only a small percentage (approximately 1.5%) of all hospital deaths (on average 30,000 per year) result from a determination of neurological death (brain death).

Dr. Markel detailed a series of initiatives that will be undertaken to increase organ and tissue donation rates in Ontario:

Full implementation of Routine Notification and Request by the end of 2006/07
Introduction of Donation after Cardiac Death
Effective requesting training for all TGLN in-hospital coordinators
Adoption of best practices from the United States' "Breakthrough Collaborative"
Increased education and awareness of the facts around organ and tissue donation aimed at the general public and healthcare providers

"This regulation is paving the way to ensuring that eligible donors are identified in a timely manner, and we are very proud of that," said George Smitherman, Minister of Health and Long-Term Care. "We remain committed to increasing organ and tissue donation rates in this province so many more lives can be improved or saved by this extraordinary gift."

Trillium Gift of Life Network is working to ensure that Ontario has an effective, efficient and safe organ and tissue donation and organ transplantation system that works for all Ontarians - for donors, their families and the patients who need an organ transplant.

"These initiatives are focused and we are confident they will make a real difference to the more than 1800 Ontarians who have been on the waiting list far too long," said Sue Wilson, Chair of TGLN's Board of Directors.

"One organ and tissue donor can save up to seven lives and enhance the lives of up to 75 others. It is imperative that families view organ and tissue donation as an essential part of end-of-life care," she added.

Today in Ontario, 1866 patients are on the transplant waiting list. Of those, 1148 are men, 718 are women and 49 of those patients are children.

The plan announced today will be implemented over the next twelve months and will require the collaborative efforts of TGLN, hospital administrators, doctors, nurses and other healthcare providers and professional organizations alike.

"Organ and tissue donation saves many lives in our province," said Dr. Greg Flynn, President of the Ontario Medical Association. "While we have seen recent improvements, we must continue to work to educate and inform Ontarians about what they can do to help save many more lives. Ontario's doctors will do what we can to help ensure our patients have the information they need to make informed choices."

Backgrounder

TRILLIUM GIFT OF LIFE NETWORK'S INITIATIVES INCLUDE:

Full implementation of Routine Notification and Request by the end of 2006/07

Routine Notification and Request (RNR) is a strategy to improve organ and tissue donor rates to save and enhance more lives in Ontario. This updated legislation requires 13 type "A" designated hospitals to report every death to Trillium Gift of Life Network (TGLN). Reporting of every death ensures that accurate identification can be made of a potential donor and that eligible families are provided the opportunity to donate and fulfill their loved one's wishes. Hospitals currently participating in RNR include: Children's Hospital of Eastern Ontario, Hamilton Health Sciences, Hospital for Sick Children, Hotel-Dieu Grace (Windsor), Kingston General Hospital, London Health Sciences Centre, The Ottawa Hospital, St. Michael's Hospital, Sudbury Regional Hospital, Sunnybrook and Women's College Hospital, Thunder Bay Regional Hospital, Trillium Health Centre and University Health Network.

Introduction of Donation after Cardiac Death (DCD)

Organ donation after cardiac death should be an option for families of patients who have decided to withdraw life support after a physician has determined that there is no long-term prognosis for recovery and for those patients who do not meet the criteria for neurological death (brain-dead). Improved medications and surgical techniques have dramatically improved the outcomes for recipients of DCD donated organs. These advances combined with the severe shortage of organs make organ donation after cardiac death another option for patients and families interested in giving the gift of life. DCD is widely accepted in the U.S. and donation rates increased upwards of 20 percent.

Effective requesting training for all TGLN in-hospital coordinators

This new, value-positive approach to consent for organ (and tissue) donation involves special training that supports donor families while advocating for the nearly 2000 individuals in Ontario who continue to wait for transplant. Public opinion surveys consistently indicate over 80% of Ontarians support organ and tissue donation yet consent rates average at 50%. This new approach aims to close this gap by building on the supports for donation that Ontarians have expressed while building on the belief that most people, given the opportunity to save lives and help people, would. The new approach incorporates important feedback from donor families on why they chose to donate (i.e. to leave a legacy, to help others, to honour the generous nature of their loved one) and recognizes the individuality of each person and family through exploring the unique meaning of donation to that person or family. This approach will enable many families to act on their support for donation during what for many will be the most difficult time in their life.

Implementation of 'First Things First' from the United States Breakthrough Collaborative

The Organ Donation Breakthrough Collaborative is an initiative for increasing organ donor rates organized by the U.S. Department of Human and Health Services and the Institute for Health Care Improvement. Evidence-based strategies are implemented with joint accountability from hospital staff and Organ Procurement Organizations (OPO) members focusing on performance improvement efforts and outcomes. Sharing of ideas occurs through a network of these teams in the collaborative, each building on the others' learning and success.

Increased education and awareness of organ and tissue donation

It is the intention and goal of TGLN to ensure that all Ontarians know how large the organ and tissue waiting list is at all times and to inform the public of the benefits of organ donation. One donor can save the lives of up to seven people and enhance the lives of up to 75 others through tissue donation. It is imperative that families view organ and tissue donation as an essential part of end-of-life care.

For further information: Jennifer Tracey, Director, Public Affairs and Communications, Trillium Gift of Life Network, (416) 214-7796 (direct line), (416) 573-0977 (cell)

This article posted April 8, 2006.

Organ and tissue donation rates increase with implementation of new legislation

Additional steps to be taken to ensure increases continue

Backgrounder

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