One-Year Later: Cornea Donation and Transplantation National Consensus Forum for Improving Access in Canada

March 2021

When the cornea donation and transplantation community met face-to-face in Toronto in February 2020, no one could have predicted the unprecedented year we'd experience. In spite of the challenges COVID-19 caused, the engagement, excitement and momentum generated from the Cornea Donation and Transplantation: National Consensus Forum for Improving Access in Canada continued to build. We are excited to share a snapshot of the progress and advances made over the last 12 months toward realizing the bold and transformative recommendation from this forum. 

From recommendation to action: Establishing the Implementation Committee

As a first step the Ocular Forum Implementation Planning Committee was established. This committee's role is to develop strategies to bring forum recommendations into action. This committee is Chaired by Christine Humphreys, director at Eye Bank of Canada - Ontario Division, and Darrell Lewis, transplant ophthalmologist and assistant professor of ophthalmology at Dalhousie University. See full list of committee members below.

Coming together to address a global pandemic

On March 20, 2020, a meeting of the Canadian eye and tissue donation community was held. The aim of the meeting was to share information and develop a consensus guidance that could be used by provincial donation organizations as well as eye and tissue banks to guide the administration of services during the COVID-19 pandemic. This group met weekly at first and continues to meet monthly to share updates, understand the impact on patients, discuss supply, screening and policy, exchange data and ensure the community stays connected. Together, this group performed a risk assessment on the potential for transmission of COVID-19 through ocular and tissue donors, conducted a security of supply analysis and tracked the status of eye and tissue banks since the pandemic began. This group is committed to continue meeting as we face new challenges and emerging questions related to this global crisis.

• Read more: How Canadian Blood Services supports Canada’s tissue system

Publishing the forum report and publications

In October of 2020, we published the official National Consensus Forum report on our professional education website, along with a feature story.

• Read more: A grieving mother’s journey to help others: Denice Klavano contributed to new plan to improve cornea donation in Canada

Three academic publications from the forum are underway, two of which have been submitted for publication:

• Proceedings of the national consensus forum on corneal transplantation
• Survey data - Canadian demand for and access to corneal transplant care a provincial comparison
• Ocular tissue supply and utilization in Canada

Tackling national governance

One of the key recommendations from the forum was to increase collaboration between provinces, work together to optimize performance and communicate more effectively and with a single community voice. To advance this recommendation, the Implementation Planning Committee took on the challenge of improving and designing a governance model for bringing the eye and tissue community together at the national level. As part of this work, the committee is recommending the creation of the following three new national structures:

The details, membership and terms of reference for these structures are currently in development.

Facilitating and improving interprovincial cornea sharing

Another key recommendation from the forum was to identify mechanisms and opportunities for provinces and eye banks that have the capacity to exceed demand within their current infrastructure to share surplus with other provinces that experience challenges in meeting demand. There was support among forum participants to prioritize interprovincial sharing and cost recovery, not only to promote universal access across Canada but also to enable Canadian need to be met domestically, improve security of supply, and reduce our reliance on international importation.

As a first step, the Forum Implementation Committee launched a national survey to understand the capacity, need and compatibility among programs with respect to the donor and tissue suitability criteria and accreditation standards associated with distribution. Thank you to all the Canadian Eye Banks that completed the survey. The committee is now analyzing the results of the survey and will use this to develop and propose an interprovincial cornea sharing framework and proposal to be presented at the Canadian Opthalmological Society Eye Bank Committee meeting in June 2021. 

Next steps

As we enter year two, the Forum Implementation Planning Committee begins to explore the development of a national data strategy and targeted public education and awareness for eye and tissue donation. If you are interested in engaging in any of these topics or feel there are other topics the Forum Implementation Committee should be addressing, please reach out to share your ideas, feedback and areas of interest. Email: OTDT@blood.ca.