Donations of human tissue — think skin, bones, heart valves and eyes — may not pack the emotional wallop of life-saving organ transplants. Yet they can save what makes life worth living — restore sight, renew strength, increase mobility and relieve chronic pain.
Except across Ontario, there just isn't enough to go around, a problem Toronto may hold the key to solving.
The lack of medically suitable tissue donors has come at a financial cost, according to the Trillium Gift of Life Network (TGLN). The agency, in a report released Friday, estimates that Ontario spends $13 million per year importing human tissue, mostly from the U.S., to satisfy patient demand.
As of June 30, Toronto’s 18 per cent organ and tissue donor registration rate ranks the city 170 out of 179 in Ontario, according to the latest TGLN data. Both the city and surrounding GTA hold an untapped potential for solving the inadequacy of current tissue donation levels.
In contrast, smaller and more isolated places are posting some of the highest registration rates across the province. In northwestern Ontario, Thunder Bay placed 16th, boasting a registration rate of 47 per cent.
The discrepancy illustrates what appears to be a province-wide trend where registration rates in cosmopolitan areas are lower than small rural communities.
Experts cite several reasons why people elect not to register as tissue donors. U.S. studies point to cultural differences that lead to a reluctance to register in ethnic minority communities. Living in a large urban centre isn’t always helpful, either.
Jennifer Chandler, who holds the University of Ottawa’s Bertram Loeb Chair in Organ and Tissue Donation, says an individual’s sense of belonging in the community can factor into a choice to donate or not.
“To give a part of your body to the general pool, you need to feel a part of it,” she said.
It was Christmas Eve three years ago when Cody Darcis committed suicide in Shuniah, a township just outside Thunder Bay. Later that evening, the coroner called his mother, Michele, to ask some questions about her 20-year-old son’s eyes.
Compared with organs and other tissues, the corneas do not deteriorate as quickly without oxygen. Michele knew it was something that Cody, who had signed his donor card years prior, would have wanted to do.
“He always radiated positivity even though he was in a dark place himself,” said Michele, now a vocal advocate for donor registration. “He gave people sight, and that is what he believed in, a vision of a better a place, a better world.
“It’s what you do to help others after you are gone, is how you are remembered ... that one last act of kindness.”
For years, Toronto resident Martin Imrisek suffered from a degenerative eye disease that caused his left cornea to thin, bulge and contort into a cone-like shape.
It wasn’t until he was 26 that he received a “generous gift” in the form of a corneal implant from an anonymous donor (not Michele’s son). It restored his sight.
“It was as if you were trying to see through a piece of glass that had Vaseline smeared all over it,” he said. “I would have been legally blind in that eye.”
“Now I can do the things that people with their sight take for granted ... read, go cycling, play video games.”
As demand continues to grow, stories like these demonstrate the importance of expanding and revamping the effort to ensure there is enough tissue for those who need it.
The 169-page report, titled Tissue Banking in the Province of Ontario: Review and Analysis, outlines what it will take to build a more self-sufficient tissue donation and transplant system in Ontario.
“Our ultimate goal is the best tissue, Ontario tissue, for Ontario patients,” Ronnie Gavsie, CEO of TGLN, told the Toronto Star.
The proposed redesigned system is based on several recommendations, including:
• Building a new multi-tissue Toronto facility that will process musculoskeletal, skin and cardiac tissue.
• Establishing a formal Coroner screening, consent and recovery program.
• Stationing donor recovery teams in several densely populated areas in the province, including the GTA.
“The supply and demand needs are not met through the existing system, although Ontario’s population of 13.6 million people would suggest a foundation for a high level of tissue donation,” says the report produced by GJC Consulting Group.
For example, the report notes, the skin bank at Sunnybrook hospital did not have an adequate supply of skin to provide other Ontario hospitals, outside of the institution’s own burn centre. An additional 60 skin donations on top of the 40 the bank already processes would allow the bank to maintain an adequate supply for every hospital in Ontario.
Recruiting new donors is, however, no easy task.
Linda Sharpen, who manages the eye bank on College St., said Trillium’s success will rest on the agency’s ability to hold a conversation with Ontarians they aren’t used to having.
“I think the big problem is, almost all of the public relations documents you see are always predicated on organs, because that is the, sob, life-saving story,” she said. “We need to turn this story around.
“Highlight the baseball player who tears his ACL (the major ligament that holds the knee in place) and needs a new one. Think of the aging population, and how many thousands of hips will need to be replaced. It can only happen if there are enough bones to cement it all.”
Sign up to be a donor or check your registration status at www.beadonor.ca.