Skinder Mangat has been waiting for a kidney transplant for 11 years, enduring dialysis three times a week as part of her routine, leaving her exhausted, anxious and unable to work.
“I haven’t been on vacation in the last 11 or 12 years,” Mangat said of a four-hour appointment at a regional dialysis facility in Richmond, British Columbia, where blood passes through machines that remove waste and excess fluid. told before. Because the kidneys cannot do their job.
“I basically just go home, have dinner and go to bed,” said the 59-year-old.
Mangat is on the waiting list for a second kidney transplant after the first one failed due to a virus infection.
However, patients awaiting a second transplant are thought to be “highly sensitized,” and immune systems stimulated with high levels of antibodies after the first transplant may predispose to rejecting the new kidney. Therefore, obtaining a compatible kidney can be difficult.
But there’s a bigger problem for those awaiting kidneys in British Columbia, where only four surgeons are doing all the transplants at two hospitals in Vancouver. Kidneys that can no longer be used are shipped to other prefectures.
BC Transplant, the state agency responsible for organ transplants, said 56 kidneys were sent elsewhere last year.
“We are making every effort to ensure that appropriate organ transplants are successful, respecting the wishes of deceased donors and their families,” the agency said in an emailed response.
In response, the Ontario Department of Health, which has seven transplant centers, said 10 kidneys from the province were shipped to other provinces last year. Ontario has 25 kidney transplant surgeons, the Ontario Medical Association said, adding that Ontario has three times the population of British Columbia.
David Harriman, M.D., a kidney transplant surgeon at Vancouver General Hospital, says British Columbia needs eight to 10 surgeons so that residents awaiting kidneys can benefit from organs donated in the province. said.
“We have fewer surgeons than other regions for the amount of work we do,” said Harriman, adding that kidney donations have increased in British Columbia even though the number of transplant surgeons has remained the same. I added that there is.
“It’s not a sustainable situation here,” he said.
British Columbia’s Department of Health announced that there were six kidney transplant surgeons in the province in 2018.
BC Transplant, a program under the Department of Health Services, said the department and health officials are prioritizing new contracts with four surgeons as they seek to recruit more specialists.
But Harriman predicted some challenges in attracting doctors to jobs that require 24-hour availability whenever a kidney is available.
“Anyone who comes into our landscapes and situations will be thrown right into the wolves, so to speak,” he said. “We have already lost two potential employers to other jobs that were viewed more favorably than our jobs here in Vancouver.”
Doctors from the BC Medical Association echoed Harriman’s concerns. Each of the four B.C. surgeons has performed more transplants than their colleagues in other parts of Canada and worked more often on call, according to the paper.
For example, in 2020, each surgeon in BC performed 70 kidney transplants and was on standby every other day, the association said.
By comparison, Calgary surgeons each transplanted 27 kidneys and waited every three days, while surgeons at Toronto General Hospital transplanted 37 kidneys each, but waited every eight days.
“As things stand, the remaining four surgeons have to take on a greater workload. They are understandably overworked, frustrated and tired,” BC Doctors said in an email. said in his reply.
Data from the Canadian Institute of Health Information (CIHI) show that 288 kidney transplants were performed in British Columbia last year, or about 55 per million population. By comparison, Ontario has 730 transplants, or 49 organs per million people.
CIHI data show that 37 transplants were performed in Saskatchewan last year, for a rate of 31.4 per million people. But the Saskatchewan Department of Health says there are three transplant surgeons in the state.
Dr. John Gill, a nephrologist at Vancouver University, said 10 kidneys were not recovered from elderly donors last year because there were not enough surgeons to transplant them, but they were sent to other states because the organs were too fragile to be transported. Said it couldn’t be shipped. good.
“These transplant opportunities just never happened,” Gill said.
He also said B.C. was recently unable to accept two kidneys for “highly sensitive” patients like Mangat from a national program run by the Canadian Blood Authority.
“This is probably their only chance of a transplant because they are so hard to fit in. We couldn’t accept that kidney because there was no one to do it,” Gill said.
“This is the human toll caused by this surgical crisis.”
Gill said patients awaiting kidneys continue on dialysis instead of receiving life-saving transplants that improve their quality of life and enable them to work. People of childbearing age may also have children after transplantation.
“What should concern us all from a societal perspective is that each transplant provides more than $500,000 in health care savings[over 10 years]compared to treatment with dialysis.”
This report by the Canadian Press Agency was first published on June 30, 2023.
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