Thank you, Mr. Chair, and committee members. On behalf of the Kidney Foundation of Canada, I am very pleased to be here today with Ms. Laurie Blackstock, who has a family member on dialysis due to kidney failure, and her husband and her aunt were both deceased organ donors. I'll speak a little bit first and then she'll speak about her experience after.
I would like to start by thanking you for your invitation to appear as a witness today. In spite of the advances in the number of organ transplants over the last few yeas, Canada is still significantly short on the number of organs available to meet the needs of thousands of Canadians awaiting life-saving transplants. There is an urgent need to improve our organ donor and transplantation system.
About 4,500 Canadians are waiting for an organ transplant, and more than 75% of those on the waiting list are waiting for a kidney. There are far more people waiting for transplants than just those on the wait-list. Of the 22,000 Canadians whose kidneys have failed, who require dialysis to live, only about 16% of them are on the transplant wait-list. Access to a transplant is a matter of life and death for people with kidney failure.
The other treatment option is dialysis, which is a life-sustaining form of therapy. Dialysis saps away patients' time, energy, quality of life, and eventually, life itself. The five-year survival rate for someone on dialysis is less than 45%, which is a worse prognosis than that for many cancers. In contrast, the five-year survival rate for someone with a deceased donor transplant is 82%.
Gwen, a nurse and mother of two, describes dialysis as more like life-support than living. She describes kidney disease as having eroded her life, thereby robbing her of her profession, her energy, and her ability to think clearly, until all that she was left with was “a tired, painful, small, isolated life”. After her kidney transplant, she got her life back and is living a life filled with creativity, laughter, and meaningful work.
In addition to giving a patient survival and quality of life, transplants can save the health care system significant money. The total annual cost of dialysis ranges from $56,000 to $107,000 per patient. The cost of a transplant is about $66,000 in the first year and about $23,000 in subsequent years. Therefore, the health care system can save up to $84,000 per patient transplanted, annually.
In spite of all the benefits of a kidney transplant over dialysis, the number of people waiting for a kidney transplant is roughly double the number of kidneys transplanted. There were 1,731 kidney transplants in 2016. The median wait time for a kidney transplant is four years, ranging from 5.7 years in Manitoba to three years in Nova Scotia. Every year kidney patients on the wait-list die while waiting for a transplant or are removed from the wait-list because they are too sick to undergo a transplant. This is the tragic reality for thousands of Canadians who suffer from kidney disease as well as for their families.
The biggest tragedy is that many of these deaths could be avoided if improvements were made to the donation and transplant systems across the country. In an environment where the supply of donor organs is low and demands are high, missed opportunities for donation are a matter of life and death. Only 2% of hospital deaths meet the criteria for deceased organ donation, yet only one in six becomes a deceased donor. Donor organs are rare and precious. Each deceased donor donates four organs, on average, so every missed potential deceased donor means depriving at least four Canadians of a life-saving transplant. People are needlessly dying because of system failures for organ transplants.
The federal government can improve Canada's organ and tissue donation and transplantation system by implementing a national strategy. Oversight is required to ensure that every potential deceased donor is identified and has the opportunity to save lives through organ donation and so that every person awaiting transplant has equitable access to organ transplantation across the country.
This includes the implementation and monitoring of best practices, public and professional education, and the development and coordination of an advanced interprovincial organ-sharing system.
The federal government can also improve the system and save lives by promoting living donation through public awareness and reducing barriers for the donor and recipient. This includes implementing practices to reduce the amount of time it takes for a potential donor to be screened and continuing to support living donors and living donation programs such as the kidney paired donation program.
Finally, the government can support research to improve graft outcomes and the availability of organs for transplant for more people with kidney failure.
Thank you.