A little over two years ago, I was fortunate enough to
act as a living liver donor to an 11-month old infant in
need of a transplant. While I have always been a firm
believer in organ and tissue donation, the process of
becoming a donor myself truly opened my eyes to the
dire need for improvement within the realm of organ
and tissue donation in Canada. In the time since, I have
been able to research the topic in greater depth, and
have come to realize, as many others have, that the
answer to the organ/tissue shortage across the country is
multifaceted, and as with everything, changes can, and
must be made from the level of primary care upwards if
we hope to succeed.The good news is that there are a number of initiatives
currently being implemented throughout the country.
This past August, it was announced that a series of new
national registries will be created through the work of
the Canadian Council for Donation and Transplantation
which has merged with Canadian Blood Services. These
new registries will allow for greater inter-provincial
coordination, hopefully increasing the efficient use of
donor organs, both living and deceased (1).
Furthermore, the acceptance of organs for donation
after cardiac death has also contributed positively to the
organ crisis currently being faced in Canadian
healthcare.Despite these advances however, more can be done at
a primary care level. The reality is that while many of
us may not personally require the services of an organ
donor in the future, each of us has the potential to assist
others once we have passed away. Misinformation and
lack of understanding of the processes of organ and
tissue donation abound in the Canadian public, and only
through education can we hope to remedy this situation.Many of the more common fallacies are very quickly
and easily addressed, taking at most a few minutes of
discussion to clear up any uncertainty on the part of the
patient. Questions of who may donate, what can be
donated, and religious viewpoints on donation are on
the minds of many people, but few get the opportunity
to ask these questions of their healthcare provider. In a
system where the decision to donate is left up to the
individual, it is imperative that people be wellinformed,
so as to be able to make the right decision for themselves, based on their own opinions and beliefs.It is for these reasons that I call upon every primary
care practitioner (present and future), be they family
doctors, nurse practitioners, or otherwise, to at the very
least address the topic of organ and tissue donation with
their patients. Below are a few examples of how the
topic can be quickly and easily broached with a large
number of patients.Firstly, a brief section addressing the patient’s wishes
regarding organ and tissue donation can easily be added
to a new patient intake form. With every new patient
coming into your practice, a thorough medical history is
always taken, and a few simple questions during the
course of this first visit could easily identify the
patient’s familiarity with the subject, as well as discern
their current views on the topic.The same idea can be applied to existing patients by
adding a few select questions to any existing “routine
physical” information sheet. While these brief
encounters may not lead the patient to immediately go
out and sign a donor card (if they haven’t already done
so), at the very least they may stimulate some thought,
and research on the part of the patient.Finally, an extremely simple way of increasing
awareness of organ and tissue donation within your
patient population is to have reading materials such as
pamphlets and donor cards, available for use in your
waiting rooms. Not only will this be of interest to some
of your patients, but it will also ensure that these
informational aids are available for you to dispense to
any patients that have expressed interest in the subject
through the course of your discussion/interaction with
them. All of these materials are available free of charge
from your provincial organ and tissue donation body.Each of these measures is simple enough that it could
easily be adapted into any practice model, while
concurrently enhancing patient education on a very
relevant and important topic. In the world of organ and
tissue donation the old adage of “every little bit helps”
is completely true, and it is my sincerest hope that those
of you reading this article will at the very least be more
conscious of the subject within your practice. The harsh
reality is that on December 31, 2007, there were 4,195
Canadians on wait-lists for organ transplants (1), and
many more who would be able to benefit from tissue
donations.As someone who has seen first-hand the incredible
benefits of organ transplantation, I implore you to help promote this life-saving process to your patients, and in
turn help to alleviate the disheartening wait-lists across
Canada.Sincerely,