practice partner
Organ donation:
Rare opportunity
too often lost
By Dr. Andrew Healey, Chief Medical Officer, Trillium Gift of Life Network and Medical Director of
Critical Care, William Osler Health System
O
rgan and tissue donation pro-
vide a rare opportunity to save
or improve lives; however that
rare opportunity is too often
lost.
In 2016, Trillium Gift of Life Network
approached more than 1,200 families about
organ and tissue donation. Just over half of
those families and patients consented to do-
nation – and still – only half of those could
go on to donation due to medical suitability.
Even with these difficult odds, there were
more donors and more lives saved than ever
before in Ontario. Why? Owing to a culture
shift amongst families and health-care pro-
viders, organ and tissue donation is increas-
ingly recognized as an integral component of
end-of-life care.
Organ donation, with the potential to save
up to eight lives, can occur after a patient or
family decides to withdraw invasive physi-
ologic support, i.e., ventilator and other
life supports (non-heart beating donation).
Organ donation can also occur after a severe
neurological injury which leads to deter-
mination of death by neurological criteria
(heart beating donation). Tissue donation,
with the potential to improve the quality of
up to 75 lives, occurs after death.
There are many legitimate reasons why a
potential donation opportunity does not
proceed to transplantation – active meta-
static malignancy or extreme organ dysfunc-
tion, for example. But unfortunately, many
patients at risk of imminent death or who
die are not referred to Trillium Gift of Life
Network until the opportunity to speak to
families has been lost. Although there has
been an increase in the number of families
approached for organ donation, many times,
the window of opportunity has been closed.
As physicians, our role is to ensure this deci-
sion is never made for a family by default.
All of us would want that information
delivered to the substitute decision-maker,
and where possible the patient, in the most
Issue 2, 2017 Dialogue
49