STONY PLAIN, Alta. – A proposal to implement a mandatory referral
program should encourage more people to donate parts of their body
after they die, a tissue specialist told an Alberta Women’s Institutes
conference.
The Comprehensive Tissue Centre, based at the University of Alberta
hospital, had only 158 referrals last year compared to more than 3,000
in British Columbia.
The difference is that B.C. has a mandatory referral program where
families of people who die are referred to a tissue centre to talk
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about the possibility of providing tissue for transplant. They are not
obligated to donate, but are given the opportunity to discuss it, said
Jared Zsombor, a tissue centre specialist in Edmonton.
“We should be turning away donors,” not looking for them, he told the
women at the annual AWI conference.
Of the 15,000 eligible to donate tissue last year, only 158 people were
referred to the Comprehensive Tissue Centre. Of those, only tissue from
58 bodies could be used because of a series of rejections including
age, and medical, sexual or drug-use
history.
The tissue centre was formed in the late 1990s as a combination of the
Lion’s Eye Bank and the Fire Fighter’s Skin Bank. The centre now
recovers more than eyes and skin.
Zsombor said a mandatory referral process is still far away. The centre
has proposed a pilot project for the University Hospital to the Capital
Health Region, the regional health authority that looks after Edmonton
hospitals. If the project is successful, the centre wants to expand the
referral program to other hospitals.
“We think that will be key to increasing our donors,” he said.
Now the centre gets its referrals only if people are aware of the
program. Zsombor spends as much time as possible giving clinics to
nurses, doctors and other groups to raise awareness of the program.
The tissue program is not an organ donor program where a person must
meet strict criteria to donate hearts, lungs or other organs for
transplant.
With organ donation the body must be brain dead. With tissue
transplant, the tissue is still useful even if the heart has stopped
beating.
But the tissue must still be taken eight to 24 hours after death,
limiting the distance donors can be from Edmonton.
The tissue centre uses the eyes for cornea transplants or the sclera,
the white part of the eye, for reconstructive eye surgery.
Skin is used to help burn victims heal faster.
Valves from a heart can replace damaged or diseased valves in children
or adults.
Bone can be used to replace those destroyed by cancer or accidents.
Zsombor said he’s been accused of being an ambulance chaser and of
talking to relatives when they’re at their most vulnerable.
“It’s a rather unpleasant time to do this, but we do have time limits.”
The donors he talks to have
either requested to donate their family’s tissue or have been asked to
see a transplant specialist.
“We don’t keep an eye on the unit to see who has died. The people know
we’re coming.”
Several AWI members wanted to know if signing their organ donor card
would automatically make them eligible for tissue or organ donation.
But Zsombor said a tissue transplant could only take place if a family
has given written consent.
“Signing a donor card is fine, but the centre must have a signed
release from a family member. The value of a donor card is that you’ve
talked about this with someone.”
Common law spouses are not allowed to sign the consent form.
One woman told Zsombor her doctors and family knew about her wishes for
organ donation, but Zsombor said that isn’t good enough.
“The bottom line is unless you get a signature or verbal consent from
family, we can’t go ahead.”
Another woman worried there was a negative stigma attached to
transplants if people think the bodies are roughly handled.
But Zsombor said bodies are treated with dignity and respect and all
the operations are done in the operating room to keep the tissues
sterile.
“I’ve been working on bodies for a long time. I always say ‘that’s
somebody’s mother or sister,’ ” said Zsombor, who has worked as an
evidence analyst helping to uncover mass graves in Kosovo.
Tissue centre specialists like Zsombor do everything from the initial
discussion and questionnaire with the family to recovering tissue in
the operating room, processing, packaging and storing it and getting it
ready for distribution.
In Canada, it is illegal to sell tissues for profit.
