Montreal

CHUM doctor on a mission to convince Quebecers to spare a kidney

Quebec has the lowest rate of living organ donors in the country but a new project is trying to double the numbers.

Project aims to double the number of living donors in the province

Dr. Michel Pâquet, transplant nephrologist at the CHUM hospital centre in Montreal, has been tasked to double the number of living donors in Quebec. (CBC)

When it comes to organ transplants, Quebec is moving in the right direction. The number of people waiting for an organ hit a 10-year low at the end of 2016.

According to numbers from Transplant Quebec, 841 people were on the waiting list — compared to the all-time high of 1,264 in 2011. This translates into fewer deaths while waiting for a transplant.

Still, 40 people died last year while waiting for a donor — the majority were waiting for a kidney.

(Darcy Hunter/CBC)

Although Quebec has one of the highest organ donation rates in Canada, there remains a problem — most of the donors are deceased. To increase the supply of organs, Quebec is looking to find more living donors.

One man has been tasked with doubling the number of living donors in the province over the next five years —Michel Pâquet is a nephrologist at the Centre Hospitalier de l'Université de Montréal. "I think it's a realistic goal," he said.

"It would bring us to the national average." 

Last year, only 56 Quebecers donated a spare kidney, or part of a liver — a rate of 6.7 donors per million people. Recent data from the Canadian Institute of Health Information (CIHI) shows the national average is 15 per million.  

In British Columbia, it's more than 20.

Organ donation rates by province (Darcy Hunter/CBC)

Why Quebec is lagging

Are Quebecers less generous? According to a report by the Fraser Institute, Quebecers give less to charity and volunteer fewer hours than other Canadians.

Quebec had the lowest national average, with 19.3% donating to charity during the 2015 tax period, while Manitoba has the highest at 24.6%.

Many theories try to explain the figures, such as higher taxes and lower incomes. Quebecers are also less religious, and religious people tend to give more to charities.

But none of this explains the low rate of living donors, according to Pâquet.

"There's really no cultural reason. The reason is that collectively, doctors and transplant teams have put a lot of effort in deceased donors, and less on living donors. It's a question of where provinces put more effort," he said.

British Columbia had the opposite problem. The province has the country's highest rate of living donors, but few deceased — an effort to balance the numbers worked.

"It's possible to have a high rate on both," said Pâquet.

"If we put in the effort, we can succeed." 

Successful pilot project

In 2009, Pâquet tried to increase the number of living donors at the CHUM's Notre-Dame hospital where he works. He formed a team of surgeons, nurses, psychologists and social workers. Their job was to train health professionals about the benefits of living organ donations.

They also talked about the issue with patients and their families. A critical element was ensuring the safety and health of the donors.

The experiment worked. The hospital went from eight living donors before 2009 to 20 by 2012.

Now Pâquet's job is to replicate the success at Quebec's five transplant hospitals. For the past year, a provincial team that includes past donors and recipients has been working on the project.

Pâquet says they have another four years to bring the living donor rate to the national average of 15 donors per million people.

Why living organs are better

To be a living donor, one must go through a battery of tests — both physical and psychological. It's to ensure the donor is healthy and that the transplant will be done as safely as possible.

As a result, transplants from living donors last longer than those from deceased donors — who often have health problems at the time of death.

Transplants are also cheaper for the health system than alternatives, like dialysis. In the long term, the savings can total as much as $50,000 per patient per year, Pâquet said.

"But there's a price to pay. You have to put in the effort, hire personnel in large numbers to run the program, and have a nephrologist dedicated to just this," he said.

But Pâquet says the hardest part of his mission has already been accomplished: convincing the government that it's possible, and to devote staff and resources to the task.

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