Saskatchewan patients getting operation at an all-time low

Kidney transplants stall

Saskatchewan patients getting operation at an all-time low

By Lana Haight, of The StarPhoenix June 26, 2010

The number of Saskatchewan patients to receive transplanted kidneys is the lowest in years with only a trickle of patients being sent to Alberta for the life-saving surgery.

"There's no doubt that their living-donor program has suffered and that we have not been able to give them the (operating room) time in a timely fashion because of our own demands on that O.R. time," said Dr. Sandra Cockfield, medical director for the northern Alberta renal transplant program based at University of Alberta Hospital.

The surgical component of the Saskatchewan kidney transplant program was suspended in July 2009. Since then, only 14 people have received kidney transplants and all had to travel to Edmonton. In previous years when patients were operated on in Saskatoon, more than twice as many patients received new kidneys.

As of this week, 104 people in Saskatchewan are waiting for kidney transplant surgery.

They fall into two groups: Those who are waiting to be matched with a kidney made available after someone dies and those already matched with a living donor who are waiting to be scheduled for surgery.

In April, Health Minister Don McMorris said he wanted the surgical program reinstated in three or four months. The clock is ticking on that commitment with the deadline landing in mid-July to mid-August.

A Moose Jaw woman, scheduled for a transplant with her father as the donor at the end of August at University of Alberta Hospital, is doubtful the government will deliver.

"That makes me wonder if the transplant program will even open up until the fall," said Stacey Simms, who demonstrated her dialysis routine at the Saskatchewan Legislature this spring to draw attention to the need for transplant surgeries to be performed in the province.

If surgeries were going to be performed in July and August in Saskatchewan by Saskatchewan doctors, she would have expected to be booked for the transplant in Saskatoon rather than in Edmonton.

The medical director of the Saskatchewan transplant program, Dr. Ahmed Shoker, referred questions about the future of the program based at St. Paul's Hospital to the Saskatoon Health Region, which, in turn, referred questions to the provincial government.

Surgeries will be performed again in Saskatoon in short order, insists the government's spokesperson.

"We're still working with Saskatoon Health Region and we're still exploring options to get (the Saskatchewan kidney transplant) program up and running this summer," said Duncan Fisher, special advisor to the deputy minister of health.

A lack of organ donors, and not the lack of a Saskatchewan surgical program, is the main reason for the drop in kidney transplants this past year, according to Fisher.

"If we don't have the donors, whether we have a program here or whether we send people to Edmonton, it doesn't matter because the surgery can't be done without the donated organ," he said.

Standard practice in Canada is for residents of a province to have first call on organs harvested from people who die in that province.

While that might explain the drop from 21 deceased-donor kidney transplants in 2008 to 10 this past year, it doesn't explain the drop from 13 living-donor kidney transplants in 2008 to four this past year.

It's those living-donor transplants that are receiving special attention.

Plans are in the works in Edmonton to ramp up the number of Saskatchewan residents who will travel for their surgery this summer. Rather than Saskatchewan patients getting "left-over" operating room time as has been the case this past year, time will be allocated every second week until mid-September at University of Alberta Hospital for a Saskatchewan patient to receive a living-donor transplant. The goal is to deal with the backlog of those patients waiting in Saskatchewan, said Cockfield.

And the Edmonton program is preparing to accept higher-risk patients from Saskatchewan. So far, only those patients who are healthy and at low risk of rejecting the donated organs have been considered for surgery in Edmonton.

"Obviously, the cherry-picking of the best patients off the list is not really the way you want to do it in the long haul," said Cockfield.

It appears the Saskatchewan government is considering the long haul as it negotiates with the northern Alberta renal program on an agreement that would see patients continue to travel to Edmonton for surgery until at least November.

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SASKATCHEWAN ADULTS TO RECEIVE KIDNEY TRANSPLANTS

Deceased donor

1999: 35

2000: 19

2001: 28

2002: 18

2003: 29

2004: 18

2005: 15

2006: 21

2007: 21

2008: 21

July 2009-June 2010: 10

Living donor

1999: 15

2000: 6

2001: 8

2002: 14

2003: 10

2004: 12

2005: 11

2006: 9

2007: 7

2008: 13

July 2009 to June 2010: 4

Total

1999: 50

2000: 25

2001: 36

2002: 32

2003: 39

2004: 30

2005: 26

2006: 30

2007: 28

2008: 34

July 2009 to June 2010: 14

Sources: Canadian Institute for Health Information (1999 to 2008 data) Saskatchewan Health (July 2009 to June 2010 data)

lhaight@sp.canwest.com

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