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Half a century of success for the Kidney Transplant Program

Toronto, January 22, 2019

By Ana Gajic

In the early 90s, a young man from Vietnam traveled to Canada to donate a kidney to his brother
Transplant reunites brothers image: In the early 90s, a young man from Vietnam traveled to Canada to donate a kidney to his brother. Not only did he give him the gift of life, but it was the first time the two had seen each other since their childhood. Click here to see a larger version of the image. (Photo: Courtesy of St. Michael's Hospital Archives.)

The newspaper pages are faded but the stories shine through: two strangers become connected after each receiving a kidney from a deceased donor in 1979; a woman donates her kidney to a sister and marks the 300th transplant at St. Michael’s Hospital in 1984; a brother travels from Vietnam to Canada in the ‘90s to save his sibling’s life with a kidney transplant.

These are just a few of the stories the Kidney Transplant Program at St. Michael’s has seen over its 50-year journey.

Now, to celebrate half a century of success, the program is launching a campaign called #MyTXanniversary to encourage more people to register as organ donors and highlight its patients and staff by sharing stories of their own transplant anniversaries.

“We have grown to be one of the largest kidney transplant programs in Canada,” said Dr. Jeff Zaltzman, a nephrologist who has worked with the program since the early 1990s. “Despite that, we never take a transplant for granted, even after doing it for 50 years. Every transplant is a unique experience and story for that individual and we always remember that.”

The road to 50 years

Though the program is now one of the largest in the country, it started with humble roots. Fifty years ago, St. Michael’s successfully completed Canada’s first heart transplant, but kidney transplantation was the only organ transplant program that stuck.

When Maureen Connelly, a registered nurse in the program, first started to care for transplant patients in the late 1970s, the surgery was considered a risky last resort. Now, transplant is considered the preferred treatment option for those with end stage kidney disease.

Connelly has watched the program grow from about 200 patients in the early 1980s to nearly 2,000 today.

Transplant today

Since the program’s launch in 1969, the science and medicine behind transplant surgery has grown and improved. Opportunities for donors and recipients have also increased through the work of the Trillium Gift of Life Network (TGLN), making it possible to expand potential donor pools for patients.

“We’ve had a lot of progress in terms of the anti-rejection medication, treatment of infection, and the technology of immunological surveillance to identify risk factors for rejection,” Dr. Zaltzman said.

“We are transplanting patients who are older and sicker with donors who are older and we’ve adapted to that process.”

In 1979, two strangers become connected through transplant at St. Michael's: one deceased donor had donated each kidney to one of them
Celebrating a year with new kidneys: In 1979, two strangers become connected through transplant at St. Michael's: one deceased donor had donated each kidney to one of them. Click here to see a larger version of the image. (Photo: Courtesy of St. Michael's Hospital Archives.)

One unique opportunity St. Michael’s offers is the out-of-country donation option. This program has yielded donors from countries such as Vietnam, Pakistan, India, the Philippines, Australia, Myanmar, the United Kingdom, the United States, Malaysia and Sudan. This speaks to the diverse patient population the program at St. Michael’s serves in Toronto.

The National Kidney Paired Donation Program has also offered many St. Michael’s patients the gift of life. Through it, connections are made with two separate but willing donors who are each unable to donate to their intended recipients due to incompatibility. The willing donors are matched so that each recipient can receive a kidney with a compatible blood type. The National Registry is managed by Canadian Blood Services.

And most recently, the Kidney Transplant Program has been able to combat incompatibility barriers through a protocol called Blood-Type (ABO) Incompatible Direct Kidney Transplantation. With this option, new technology has allowed patients who meet the right criteria to receive a transplant from a donor who does not have the same blood type as them.

“The success of transplant has allowed us to look after patients who no one would have imagined transplanting even 15 years ago,” Dr. Zaltzman said.

In addition to the options available to patients, both Dr. Zaltzman and Dana Whitham, the clinical leader manager of the Kidney Transplant Program, note that its culture of excellence, camaraderie and collaboration with patients makes it special.

“Last year we created the tag line, ‘People Transplanting People,’ and I do really feel that it summarizes our team and what we bring to our patients,” Whitham said.

The need for donors

Despite the advancements in kidney transplantation over the past 50 years, more than 1,100 people in Ontario are waiting for a kidney transplant.

“People don't think about their kidneys until it becomes a problem because many don't understand that it's a chronic illness,” Connelly said. “But the impact is quite devastating — it can affect people's social and financial circumstances more than many other chronic diseases.”

The Kidney Transplant program at St. Michael's celebrates its 300th transplant when a woman donates her kidney to her sister in 1984
She gets 300th photo: The Kidney Transplant program at St. Michael's celebrates its 300th transplant when a woman donates her kidney to her sister in 1984. Click here to see a larger version of the image. (Photo: Courtesy of St. Michael's Hospital Archives.)

She encourages everyone to at least consider registering to become an organ donor.

“The likelihood of actually needing a transplant is probably about 10 to 15 times greater than ever being an organ donor,” Dr. Zaltzman said. “It’s important to check your status as an organ donor online and make sure your family knows what your wishes are. In a time of tragedy, being able to donate a loved one’s organs is often something a family can hold onto as a fulfillment and meaning despite loss.”

Looking forward

As the Transplant Program continues to grow at St. Michael’s, the team sees a bright future. Whitham hopes to see the program continue to deliver patient-centred care to its community.

“Our vision is to provide the best patient experience possible,” she said. “That means a smooth flow in clinic, with experienced clinicians who take the time to empower and educate our patients. One of the ways I see us achieving that goal is to elevate our education platform and extend our reach beyond St. Michael’s walls.”

For Dr. Ramesh Prasad, the director of the Kidney Transplant Program, the first 50 years are a solid foundation for the program to build on.

“I am extremely proud of the team and the culture we’ve built here together over the past 50 years, and I am both humbled and honoured to be part of it,” he said.

“With continued developments in organ donation and the collaboration of our new partners through Unity Health Toronto, I look forward to an even brighter future in transplant medicine through world-class patient care and cutting-edge research.”

Sign up to be a donor, or check your registration status online today at our donor drive.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.


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