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The Trillium Gift of Life Network (TGLN), a provincial organization, operates a call centre 24 hours a day, seven days a week. Ontario hospitals contact TGLN when a patient dies, and TGLN helps determine if this deceased person is suitable for organ and/or tissue donation. If potentially suitable, an Organ and Tissue Donation Coordinator will obtain consent when the family wishes to proceed with donation.
If a patient is a potential donor for tissue, and if consent is obtained, recovery teams are organized to retrieve the tissues and deliver to tissue banks. If the deceased person is a suitable organ donor and consent has been obtained from the next of kin, organs are then recovered. Retrieval teams can spend more than six hours carefully removing organs. There may be as many as four surgical teams with each team retrieving a different organ. Because surgical teams may arrive from different centres across Canada, the organ retrieval process requires a lot of organization, which is done by a Transplant Donation Specialist.
During the surgery, the surgeons carefully cut away (dissect) the tissue surrounding the organ that will be removed. The organ is flushed with a specially-prepared, ice-cold solution that serves two purposes: the organ is flushed free of any blood and the organ temperature is lowered, which helps to preserve the organ. Cooling acts as a metabolic brake, reducing the oxygen requirements of the organ to near zero while it is transported to the recipient's hospital. The organ is then packed in more cold solution and placed in a cooler, full of ice, for the return trip.
While organ recovery is taking place, suitable recipients are being prepared in their own transplant centres. Through a lot of cooperation and coordination, the organs arrive at various hospitals where the recipients are waiting for their transplant surgeries.
Usually, kidneys are transplanted into patients living in the same region as the donor. About one-third of donated lungs, hearts, and livers are given to patients who live in another region of the country. This organ sharing results from several factors: 1) Not all provinces offer all types of transplants; 2) Patients who urgently require a transplant are offered a suitable organ first; and 3) Organs are offered to other regions when no suitable local patients are identified. The extent of organ sharing shows the cooperation among transplant programs and organ procurement organizations across Canada.
When organs are removed from a donor, there is a limited period of time in which they can be preserved before being transplanted. If too much time passes, the organs are no longer usable. Different organs can last different amounts of time – for example, a heart needs to be transplanted within four to six hours while kidneys can last for 24 hours. Organs are generally allocated to the sickest patient who is a compatible match and has been waiting the longest.