Organ donation: the final gift

In 2003, a family friend in his early 20s fractured his ankle. But more trouble followed: after a year, it had still not healed and was beginning to deteriorate. His name was put on the waiting list for a replacement anklebone. He met with a social worker who arranged for a pager and recommended he stay in town. Eight months later, the pager went off and, within hours, he was in hospital where his surgeon removed the failing bone and successfully implanted the new one.

Organ and tissue donations
Based on 2001 figures, approximately 3,800 Canadians are waiting for a kidney, heart, liver or lungs. Thousands are also waiting for tissue donations – skin, a cornea for someone whose sight has been damaged, a heart valve to replace a faulty one or a bone graft for a bone ravaged by cancer, just to name a few. In 2000, more than 1,900 organ transplants were performed in Canada, and a remarkable 98 per cent of kidney transplants, 90 per cent of liver transplants and 85 per cent of heart transplants were successful. But time ran out for almost 150 Canadians who died before suitable donors could be found. (Data from Health Canada – <a href="" arget=”_blank”>

Don’t assume your organs would be too old to offer. Donors are assessed individually, as was the case when a 92-year-old woman’s family agreed to donate her liver, giving a recipient the chance for a healthier life.

Human Tissue Gift Act
Each province has an act, usually called the Human Tissue Gift Act, which gives you the right to indicate you want to be an organ or tissue donor. The provinces run their own organ donation and transplant programs and maintain databases of people waiting for a transplant.

Canada has not yet implemented a nationwide program, even though in 2001, the then federal health minister Allan Rock announced a five-year plan to co-ordinate organ and tissue donation across Canada. Until the national program is up and running, the provinces will try to co-ordinate their registries as much as possible.

Tell your next-of-kin 
To indicate you would like to be an organ or tissue donor, you can:

• Sign the consent form on the back of your driver’s licence.
• State you want to be a donor in your legal directives for health and personal care.
• Sign an organ donor consent card from your province’s transplant program.

In some instances, the hospital will also ensure that the closest relatives are aware of and agree with the donation. So don’t just sign the paper: discuss your wishes with your family so they understand and are somewhat prepared if and when they find themselves at your bedside. At that time, a close family member may also be required to sign a consent form. If you hadn’t previously indicated your wishes regarding organ and tissue donations, your family may volunteer or may be offered an opportunity to consent to donating your organs.

At the time of death
Once death occurs, decisions regarding organ donation need to be made quickly while the organs are usable. To be considered an organ donor, the deceased must still have a beating heart and be declared brain dead by two independent doctors. Brain death is the irreversible end of all brain function. Because the deceased/donor is kept on a ventilator and the heart is still beating, the body’s organs continue to receive oxygen and stay functional.

We each have to consider our own values and personal issues for this very individual decision. Organ and tissue donation is a way to make a meaningful contribution even after death. It may be a way to ease some of the pain of bereaved loved ones, a way for something positive to come out of even the most tragic deaths. The recipient’s life or quality of life depends on this gift.