Ottawa Hospital effort aims to speed up, boost living kidney donations

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Across Canada, between 60 and 100 people die every year while waiting for kidney transplants.

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Becoming a kidney donor is a life-changing decision. Officials with The Ottawa Hospital’s living kidney donor program hope to make that decision easier for potential donors.

The hospital’s living kidney donor program has streamlined its system of evaluating potential donors. Now a process that had been taking an average of six months can be accomplished in a single day. It’s part of an effort to encourage more people to become living kidney donors at a time of growing need.

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“Our goal is to increase living donor transplant rates,” says Dr. Ann Bugeja, a nephrologist and medical director of the living kidney donor program at The Ottawa Hospital. She is hoping other hospitals will follow TOH’s lead.

Results of the program have been encouraging since it started in 2021, Bugeja said, as the living donor rate increased. But it is too soon to say whether that increase will be sustained over time.

Over the past decade or more, rates of living donations across Canada have stagnated at about 12 donors per million population, Bugeja says. Meanwhile, demand continues to outstrip available donor kidneys.

Across Canada, between 60 and 100 people die every year while waiting for kidney transplants. Over the past 10 years, the number of people with end-stage kidney disease has increased by 17 per cent, according to the Canadian Institute for Health Information. Among common causes of kidney failure in Canada are diabetes and hypertension.

The Ottawa Hospital completed a record 119 kidney transplants in 2023, 36 of which were from living donors. Bugeja wants to see that number increase.

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living kidney transplant
This file photo shows a living kidney donation surgery in progress in the United Kingdom. Photo by Christopher Furlong /Getty Images

For patients with end-stage kidney disease, a kidney from a living donor is considered the best treatment. It usually lasts longer — around five years longer — than a kidney from a deceased donor. And a living kidney donation can prevent or reduce a patient’s need for dialysis, something Bugeja describes as the gold standard in treatment of end-stage kidney disease.

Donors can usually be home after two days and back doing regular activities after four to six days, Bugeja says. People can live healthy, normal lives with one kidney, she adds.

The hospital’s living kidney donor program does not solicit donors. Often potential donors come forward because a loved one or friend needs a kidney, she says. Unmatched donors can take part in a national program that transplant candidates with suitable living donors. It gives each person the chance to become a living kidney donor while ensuring that someone they want to help receives a needed kidney, even if they are not a direct match. The program is run by Canada Blood Services.

Potential donors must undergo a series of tests and evaluations to determine whether they are good candidates to donate, and matches with their desired recipients. Typically, that process can involve numerous hospital visits for a variety of tests and a wait to know whether donations are possible.

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Under the expedited process, most of those evaluations, including bloodwork, CT scans, nuclear imaging and more, can be done in a single day. Potential donors usually have a virtual meeting with a social worker a week earlier and the final results are known within weeks, rather than months.

Bugeja says about three potential donors a month take part in the one-day evaluations, something that could be expanded. Some potential donors still prefer to do the evaluation over a longer time frame.

But the more efficient system suits many people, including those who travel from outside Ottawa, and reduces the lag time until transplants can be done.

“I would love the public to know this exists, that it is safe and that this improves the lives of people with kidney failure,” Bugeja says.

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