Enhancing living donation - A Canadian Forum (2006)

Enhancing Living Donation: A Canadian Forum

February 9-12, 2006 | Vancouver, British Columbia

Executive Summary

This forum was the sixth in a series of CCDT initiatives focused on providing stakeholders with an opportunity to explore issues and make recommendations to the Conference of Deputy Ministers of Health in the area of organ and tissue donation and transplantation. The purpose of this forum was to build national agreement on strategies to enhance living organ donation within a safe and ethical environment, and to overcome the barriers that are current disincentives to live organ donation in Canada.

Forum objectives were to:

Describe and confirm current and recommended practice (e.g., medical and psychosocial) for evaluating potential donors and determining eligibility for live kidney, liver and lung donation.
Address consent and ethical issues to support safe, well-informed choices for potential living donors.
Explore medical and psychosocial considerations in donor follow-up and health maintenance, and continuity of care practices in Canada.
Recommend options for clarifying and overcoming barriers related to reimbursement for non-medical expenses incurred by donors.
Clarify and discuss current life, disability and medical insurance practices affecting live organ donors.
Identify the implications to health care systems (e.g., financial and human resources) of increased live donation activity in Canada.
Identify important areas for future study and research in live organ donation.
Facilitate national and international networking.

The scope of the forum addressed the care of the living organ donor from the possibility of donation, through the assessment phase, and along the continuum to long-term follow-up. The following issues were not included in the scope of this forum: paired donor exchange, solicitation, buying and selling of organs, issues related to organ allocation and management of recipients of living donor organs.

Forum participants represented a multidisciplinary mix of living donation stakeholders, ensuring an inclusive approach and a range of perspectives on issues. Forum discussions focused on building consensus on key challenges and were both lively and reflective, resulting in practical and thoughtful recommendations. Extensive background documentation was provided by the Steering Committee in advance of the forum, including comprehensive literature reviews and related environmental scans. This documentation was augmented at the forum by stimulating presentations by experts from national and international jurisdictions where living organ donation is currently practiced.

Introduction

To develop recommendations, participants worked in small groups guided by worksheets that provided an overview of the subject, a summary of Canadian and international practice and of existing recommendations. Following these deliberations, the Forum Recommendations Group (a multidisciplinary group representative of forum stakeholders) met to review the results of these discussions and develop consensus recommendations. These were returned to plenary for further clarification and discussion. The forum process resulted in recommendations on the following aspects of living donation:

a. Risks and benefits of living donation related to informing the donor and to organ-specific medical/surgical risks for kidney, liver and lung transplantation.
b. Psychosocial considerations affecting living donors.
c. Long-term follow-up of living organ donors.
d. Legal and ethical challenges related to consent.
e. Economic implications of living donation related to out-of-pocket expenses and loss of income.

The full report and recommendations from "Enhancing Living Donation - A Canadian Forum (2006) are available upon request

PDF copies of the report and recommendations including background documents are available by request. Submit a request by sending an email to OTDT@blood.ca, please include the title and use the subject line: PDF Document Request.

Background documents

A Review of the Economic Implications of Living Organ Donor Donation: Donor Perspectives and Policy Considerations
Environmental Scan of Live Organ Donation Programs
Living Donor Liver Transplantation Overview
Living Organ Donation: Consent Challenges
Medical Risks of Becoming a Living Kidney Donor – What is known and what needs to be known
Psychosocial Aspects of Living Organ Donation
The Risks of Living Lung Donation