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Missed Opportunities: Non-Referral of Potential Organ and Tissue Donors in the RQHR

Missed Opportunities: Non-Referral of Potential Organ and Tissue Donors in the RQHR. Craig Schmidt, BSc, RN Saskatchewan Transplant Program. Saskatchewan Transplant Program. Established in 1989 Under a provincial mandate Provide services Public and professional education

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Missed Opportunities: Non-Referral of Potential Organ and Tissue Donors in the RQHR

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  1. Missed Opportunities:Non-Referral of Potential Organ and Tissue Donors in the RQHR Craig Schmidt, BSc, RN Saskatchewan Transplant Program

  2. Saskatchewan Transplant Program • Established in 1989 • Under a provincial mandate • Provide services • Public and professional education • Coordinate donation and transplantation • Assist with out of province transplant needs • Long term follow up of transplant recipients

  3. What we do in Saskatchewan • Organ and tissue retrievals • Adult kidney transplants • Adult cornea transplants • All other transplants go out of province • All pediatric transplant needs • Heart, lung, liver, combined kidney/pancreas

  4. Background • Potential organ donors • In ICU setting, on ventilator, have been determined brain dead • Canadian average is 14 donors per million population

  5. Background Potential tissue donors Can come from any unit, after heart has stopped beating There is currently no data on percentage of tissue donors

  6. Referral of Potential Donors in RQHR • No consistent set of criteria for referral to SK Transplant Program • Often, referred at family request • Referrals at discretion of attending health care personnel

  7. Research Overview • Retrospective chart audits • Purpose: to obtain data on “missed opportunities” for organ/tissue donation • People who would have been eligible to donate, but who were not given the opportunity because they were never referred

  8. Methods • 2008-2009 fiscal year • 7 units in RQHR • Assessed eligibility for 5 types of organs and 6 types of tissue • Screened for final diagnosis • Nationally accepted criteria used to assess eligibility to donate

  9. Results

  10. Results *The skin and deceased donor bone donation programmes are not yet in effect.

  11. Results • 138 patients would have been eligible to donate, but were not referred • These 138 patients could have made up to 369 donations (excluding skin and deceased donor bone)

  12. Results • However, not all people who were eligible would have become donors • 46.2% of eligible people referred to the SK Transplant Program in 2008 became donors • Using this rate: • Approx. 64 people may have become donors, providing • An additional 12 organs, and • An additional 159 tissue donations

  13. Referring and Requesting • In Manitoba, British Columbia, and Ontario, mandatory referral is legislated • In Manitoba, New Brunswick, and Nova Scotia, mandatory requesting is legislated

  14. Research Impact • RQHR Organ and Tissue Donor Collaborative is developing a mandatory referral pilot program • Aim to include a minimum of 3 units for 6 months • Projected start date: September 2010

  15. Although this study and presentation have focused on giving organs and tissue, the ultimate goal is to provide end of life care options to families with dying loved ones and to save/improve the lives of persons requiring organs and tissues.

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