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BC Transplant
BC Transplant Update
BC Kidney Days, October 6, 2016
Dr. David Landsberg, Physician Lead, Transplantation
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BC Transplant
BC Transplant provides oversight for all aspects of organ donation and transplantation across BC.
Provincial scope and model of care is unique in Canada.
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Strategic Direction
BCT’s 3 key Operational Goals in support of the PHSA Mission: • Increase organ donation • Reduce the number of patients on the transplant waitlist • Improve how we deliver care to patients and donor families
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Deceased Donation by Province (pmp)
22.0 Call to Action
Target
23% 59% -19% -14% 23% 30% 13% -27% 4% -55%
-5.0
0.0
5.0
10.0
15.0
20.0
25.0
30.0
Cda. B.C.* Alta.** Sask. Man. Ont. Que. N.B. N.S.*** N.L.
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Notes *Rates for BC - population of Yukon is included **Rates for Alberta - populations of NWT & Nunavut are included *** Rate for Nova Scotia – population of PEI included
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Factors Contributing to Higher Donation Rates (2015)
B.C. ALTA. SASK. MAN. ONT. QUE. N.B. N.S. N.L.
Mandatory Referral
Donation Physicians
NDD Leading Practices
DCD Programs
(% DCD donors)
(25%)
(13%)
(10%)
(0%)
(31%)
(11%)
(0%)
(15%)
(0%)
Donor Management LP
Deceased Donors (DPMP) (Number of donors)
20.1* (95)
12.2**(52)
8.8 (10)
13.1 (17)
19.5 (269)
20.8 (172)
10.6 (8)
21.2* **(20)
15.2 (8)
2011-2015 % change DPMP 76 33 -17 89 22 26 14 -20 -20
Implementation complete or near completion Implementation in progress Implementation not started
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Living Donation by Province (pmp)
20.0 Call to Action
Target
-9% 1% 8% -243% -89% -7% -2% -81%
-3000%
-2500%
-2000%
-1500%
-1000%
-500%
0%
500%
0
5
10
15
20
25
30
Can B.C.* Alta.** Sask. Man. Ont. Que. Atlantic
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Notes *Rates for BC - population of Yukon is included **Rates for Alberta - populations of NWT & Nunavut are included Atlantic includes New Brunswick, Nova Scotia, Prince Edward Island and Newfoundland and Labrador.
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Kidney Transplants – Deceased and Living Donors
44.0 Call to Action
Target Call to Action Target 44
12% 51% -8% -57% -35% 15% 27% -28%
-30000%
-25000%
-20000%
-15000%
-10000%
-5000%
0%
5000%
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
Can BC AB SK MB ON QC Atl
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 % Increase in 10 Years
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2016 Donation and Transplant Statistics
DONOR_TYPE 2015 2016*
DCD 24 17
NDD 71 55
Total 95 72
*Jan. 1- Sept. 30, 2016
# of Deceased Donors originating in BC
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2016 Donation and Transplant Statistics 2015 2016 (January 1 – Oct. 3)
Heart 19 24
Kidney – deceased donor 161 131
Kidney – living donor 110 77
Liver – deceased donor 76 62
Liver – living donor 3 0
Liver-Kidney 2 0
Pancreas 3 3
Pancreas Islet 9 4
Pancreas-Kidney 1 1
Lung 35 30
TOTAL 422 332
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Kidney Paired Donation Successes Candidates and Transplants by Transplant Centre
SPH VGH
FMC
UAH SPH HS
C SJH LHSC
TOH
HSC
SMH
TGH
HMR
HND
HRV
HDQ
CHS QEII QEII QEII QEII
BC AB SK MB ON QC NB NS NL PEIRegistered Candidates 116 76 50 46 21 41 34 15 50 8 68 114 7 22 24 20 4 15 21 12 2Transplants to Reg. Recipients 73 41 18 19 10 16 8 6 19 5 34 49 4 11 5 5 2 5 7 7 1
0
20
40
60
80
100
120
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Kidney Paired Donation Successes Power of the Domino
21 31 38 41 55
43 48
12
4 16
20 20
25 23
40
18
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0
20
40
60
80
100
2009 2010 2011 2012 2013 2014 2015 2016
Domino Closed % from Dominos
# NDADs Donated:
6 11 9 13 15 11 17 4
% from Dominos: 84% 66% 66% 67% 69% 65% 55% 40%
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BCT 2016 Priorities
• Living Donation First • Introduce preemptive living donation into KCC’s • Education • Donor Outreach
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Dialysis Exposure (months)
Blood type ALL patients 2014
ALL patients 2015
A 31 31.5
AB 26.6 15.7
O 58.3 52.1
B 87.7 73.3
*By age and blood type, 2014, 2015
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Unadjusted Patient Survival, by Centre
Center 5 Year Patient Survival 10 year Patient Survival
Overall 92 84 A 90 80 B 98 95 C 94 87 D 90 73 E 95 84 F 95 85 G 92 82
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Unadjusted Graft Survival, by Centre
Center 5 Year Graft Survival 10 year Graft Survival
Overall 87 72 A 85 68 B 96 85 C 88 73 D 85 62 E 92 71 F 86 69 G 86 78