In Canada, approximately 4,500 men, women, and children are waiting for organ transplants to save or improve their lives. Many thousands more wait for a tissue donation to improve the quality of their lives. How do patients get on the transplant waiting list? How is it decided which patient gets the donated organ?
Liver and heart patients are approved for transplant following intense physical and psychosocial assessments by the specialized health-care team at the transplant hospital. The transplant surgeons make the final decision, based on their knowledge of the patient and the input from other members of the health-care team. The potential recipient is ranked according to the severity of their illness. This number changes as the patient's condition changes so that any available organ is offered to the sickest patient first. A sharing agreement exists across Canada so that the sickest person on the list, regardless of location, is transplanted.
For kidney patients, the selection process is different because we use tissue-typing tests. The Transplantation and Immunogenetics Laboratory at LHSC performs tests that "type" donors and recipients and measure antibody levels (crossmatching) that are important in avoiding kidney rejection. The donor's blood and spleen are tested against blood samples from potential recipients. The kidney is transplanted into the recipient who has the closest tissue match and the greatest likelihood of success.
In Ontario, the Trillium Gift of Life Network is responsible for establishing and managing waiting lists for organs and tissue, as well as ensuring a system of fair allocation.