Thank you, Mr. Vice-Chairman, ladies and gentlemen.
I am a transplant surgeon from the University of Alberta. I am the immediate past-president of the Canadian Society of Transplantation. I am joined today by Drs. Lori West, Tom Blydt-Hansen, Lee-Ann Tibbles, and Marcelo Cantarovitch, all of whom are executive members of council of the Canadian Society of Transplantation.
What is our society? It represents our membership of 560 key leaders, physicians, surgeons, nurses, and managers in all provinces and all programs across our country. We are the voice of transplantation in Canada.
The gay donor exclusion is a very important issue. It marginalizes Canadians and it's not acceptable. Monogamous relationships are not associated with increased risk. In practice, organs are utilized, and the laws do permit their transplantation under this exceptional release waiver, which must be signed by the recipient before transplantation. The newly introduced CSA standards have become so stringent, at least in Alberta, that the majority of organ transplants must now proceed under the exceptional release in our site. On occasion this may lead to compromise or potential compromise in donor anonymity.
This issue speaks to a much more fundamental issue, the fact that we lack a national infrastructure for transplantation in Canada. The provincial health care delivery has failed to provide adequate national coordination and accountability for the delivery of transplantation. Organ donation has fallen through the provincial cracks, and as a result, Canada is underperforming. We need a national structure that must be accountable to our Canadian public and to government.
Canada is one of the only remaining western countries not to have a national strategy for organ donation and transplantation. The International Transplantation Society and the World Health Organization have called us to task and have emphasized that in order to diminish trends in transplant tourism, every country must ensure an adequate supply of donor organs for its citizens.
There are 4,167 Canadians currently awaiting an organ transplant, a figure that has remained nearly constant since 2000--and this is an underestimate. However, there were only 492 deceased donors in Canada in 2007. That's a donor rate per capita of 14.7 per million population. Canada's deceased donor rate is half that of countries such as Spain, which has a rate of around 32 per million.
The deceased donor rates in certain provinces are not acceptable. For example, in British Columbia it was 5.9 per million, and in Manitoba 5.1 per million, compared to the average of 14.7 per million. That was in 2005. This falls far short of our national average.
Canada does 40% fewer deceased kidney transplants than the U.S. per capita. We were the same 20 years ago. Canada's current rate of deceased donor kidney transplantation is the same as that of Croatia. This costs lives: 146 Canadians died in 2007 while waiting for an organ. The true cost of loss of life cannot easily be measured.
Transplants save lives. Transplants save costs for health care. The cost of dialysis and other organ-supportive care is enormous. Each kidney transplant results in $100,000 in net savings. We should have done over 500 more kidney transplants last year, which would have saved our health care systems $50 million per year.
The Canadian Blood Services--and you heard from Graham Sher this morning--will take on the initial task of developing a national framework. The Canadian Society of Transplantation has engaged with this process with the Canadian Blood Services and strongly embraces this initiative. The CBS has secured federal and provincial support for the next five years. The Canadian Society of Transplantation enthusiastically applauds Canada's federal government's vision in participating in this process. This is an important start, but it may not be sufficient.
So on behalf of the Canadian public, the transplant community, the Canadian Blood Services, and the Canadian Society of Transplantation, we believe this Standing Committee on Health must commission a task force to work with the CBS. This task force should formulate a report defining Canada's deficiencies in donation and transplantation and offer potential solutions.
The task force should turn to the U.K., for example, where the Department of Health has recently completed its report by the Organ Donation Taskforce. It should turn to the U.S., with its United Network for Organ Sharing, UNOS, and the National Organ Transplant Act, NOTA, and to other countries, such as Spain, that are head of the pack.
We owe it to our Canadian public and to our governments to restore our performance rates in transplantations. The solutions lie in ABCDE: we must “advocate” for our patients, “benchmark” with other countries and between provinces, “collect” reliable data, “distribute” organs as necessary, and “engage” with other international agencies.
Thank you for allowing us to be here today.