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  • transplant.bc.ca

    BC Transplant

    BC Transplant Update

    Leanne Appleton, Provincial Executive Director Dr. David Landsberg, Physician Lead, Transplantation

    BC Kidney Days October 5, 2017

  • transplant.bc.ca

    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.

  • transplant.bc.ca

    BCT Operational Goals

    Increase organ donation

    Reduce the number of patients on the transplant wait list

    Improve how we deliver care to patients and donor families

  • transplant.bc.ca

    Work underway across the continuum of care

  • transplant.bc.ca

    transplant.bc.ca/medications

  • transplant.bc.ca

    Work underway across the continuum of care

    “In a time of great sadness and grief, we are able to provide a silver lining to families by facilitating what becomes the gift of life.” “I have the privilege to work with real life heroes— people and families who are going through some of the most difficult times of their lives and yet are still so thoughtful, generous, and intent on helping others.

  • transplant.bc.ca

    Public awareness and partnerships

  • transplant.bc.ca

    Poll question!

    From 2014-2016, what was the growth in deceased donor referrals from hospitals to BC Transplant?

    a. 15%

    b. 84%

    c. 145%

    d. 192%

  • transplant.bc.ca

    BCT Referrals (2012-2016)

    124

    180 178

    321

    437

    0

    100

    200

    300

    400

    500

    2012 2013 2014 2015 2016

    Referrals

  • transplant.bc.ca

    Poll question!

    What is the growth in transplants since 2012?

    a. 12%

    b. 27%

    c. 38%

    d. 45%

  • transplant.bc.ca

    Number of transplants is increasing

    306

    95

    326

    422 423

    70 67 69 95 97 90

    130 107 113 95

    0

    50

    100

    150

    200

    250

    300

    350

    400

    450

    2012 2013 2014 2015 2016

    Transplants Deceased donors Living donors

  • transplant.bc.ca

    Donation and Transplant Stats

    2015 2016 2017 (to Oct 1) Heart 19 28 16

    Kidney – deceased donor 161 173 181

    Kidney – living donor 110 95 70

    Liver – deceased donor 76 74 61

    Liver – living donor 3 0 0

    Liver-Kidney 3 1 0

    Pancreas, pancreas-kidney, pancreas islet

    15 12 4

    Lung 35 40 43

    TOTAL 422 423 376

    Exceeded 2016!

    Exceeded 2016!

  • transplant.bc.ca

    Summary of Stats – October 1, 2017

    99 deceased donors

    66 living donors

    376 transplanted

    4,544 patients followed post transplant

    ≈ 625 people in BC currently waiting for transplant

    1,157,735 people have registered their decision for organ donation

  • transplant.bc.ca

  • transplant.bc.ca

    # of deceased donors is climbing

    07 08 09 10 11 12 13 14 15 16

    British Columbia

    Kidney donors

    0

    2

    4

    6

    8

    10

    12

    14

    16

    18

    20

    22

    07 08 09 10 11 12 13 14 15 16

    pe r m

    ill io

    n po

    pu la

    tio n

    British Columbia

    Canada

    All donors

    Year

  • transplant.bc.ca

    Deceased Kidney Donors

    0%

    10%

    20%

    30%

    40%

    50%

    60%

    70%

    80%

    90%

    100%

    07 08 09 10 11 12 13 14 15 16

    Pe rc

    en t

    Other

    Aboriginal

    Asian Indian

    Asian

    Caucasian

    Race

    07 08 09 10 11 12 13 14 15 16

    A

    AB

    B

    O

    Blood type

    Distribution of deceased kidney donors Deceased kidney donors with at least one kidney used for transplant in BC in the given year. Kidney donors from OOP are included.

    Year

  • transplant.bc.ca

    Kidney transplants by donor type

    All

    0

    50

    100

    150

    200

    250

    300

    07 08 09 10 11 12 13 14 15 16

    N um

    be r

    of T

    ra ns

    pl an

    t

    Year

    Total kidney transplants by donor type Patients received a kidney during the given year, including multi-organ transplants and pediatrics.

    Deceased Donor

    Living Donor

  • transplant.bc.ca

    Wait times by blood type

    0

    20

    40

    60

    80

    100

    120

    2009 2010 2011 2012 2013 2014 2015 2016

    Wait times by blood type

    A AB B O

    Median wait time (in months) from dialysis to transplant for adult deceased donor kidney transplants by blood type (first kidney transplant) Adult patients received a deceased donor kidney in the given year. Simultaneous multi- organ transplants and retransplants are excluded.

    M on

    th s

  • transplant.bc.ca

    Wait times by blood type and age

    0

    20

    40

    60

    80

    100

    120

    140

    2012 2013 2014 2015 2016

    M on

    th s

    A AB B O

    0

    20

    40

    60

    80

    100

    120

    140

    2012 2013 2014 2015 2016

    M on

    th s

    A AB B O

    Recipient age < 60 Recipient age >= 60

  • transplant.bc.ca

    Most patients are transplanted within 5 years of listing

    40% of patients waitlisted in 2000 were transplanted within 5 years with ~35% still waiting after 5 years 80% of patients waitlisted in 2011 were transplanted within 5 years with ~ 7% still waiting after 5 years

    0%

    10%

    20%

    30%

    40%

    50%

    60%

    70%

    80%

    90%

    100%

    02 03 04 05 06 07 08 09 10 11

    Status: 5 years on wait list

    Died

    Removed

    Transplanted - DD

    Transplanted - LD

    Transplanted - OOC

    Waiting

  • transplant.bc.ca

    How long do people spend on the kidney wait list?

    0%

    10%

    20%

    30%

    40%

    50%

    60%

    70%

    80%

    90%

    100%

    07 08 09 10 11 12 13 14 15 16

    Pe rc

    en t

    Year

    5+ yr 4-

  • transplant.bc.ca

    HSP Transplants in BC

    Year Out-of-Province Donor BC Donor Total

    2014 2 2 4 2015 10 2 12 2016 11 7 18 2017 (Sep 30) 10 3 13 Total 33 14 47

  • transplant.bc.ca

    Living Kidney Donation – BC still leads the country

    0

    10

    20

    30

    40

    50

    60

    70

    80

    07 08 09 10 11 12 13 14 15 16

    Nu m

    be r

    Donor type

    Biologically Related

    Biologically Unrelated

    Paired Donation

    0

    5

    10

    15

    20

    25

    30

    07 08 09 10 11 12 13 14 15 16

    pe r m

    ill io

    n po

    pu la

    tio n

    British Columbia

    Canada

    Donor per million population

    Year

  • transplant.bc.ca

    Poll question!

    What kind of transplant has the best outcomes for a person whose kidneys have failed?

    a. A pre-emptive living donor kidney transplant (before dialysis)

    b. A living donor kidney transplant after starting dialysis

    c. A deceased donor kidney transplant

  • transplant.bc.ca

    Patient and graft survival

    Patient and graft survival among first kidney transplants, by donor type Patients who received a kidney in BC from 2000 to 2015, including pediatrics. Simultaneous multi-organ transplants and retransplants are excluded.

    50%

    55%

    60%

    65%

    70%

    75%

    80%

    85%

    90%

    95%

    100%

    0 1 2 3 4 5 6 7 8 9 10

    Pe rc

    en t

    Patient survival

    0 1 2 3 4 5 6 7 8 9 10

    Transplants - - all

    Deceased donor

    Living donor

    Graft Survival

    Years post-transplant

  • transplant.bc.ca

    Transplant First

  • transplant.bc.ca

    Transplant First

    Videos for recipients and donors • English • Mandarin Chinese • Punjabi* • Cantonese*

    * Coming soon

  • transplant.bc.ca

    BC Transplant

    BC Transplant BC Transplant BCT Operational Goals Work underway across the continuum of care transplant.bc.ca/medications Work underway across the continuum of care Public awareness and partnerships Poll question! BCT Referrals (2012-2016) Poll question! Number of transplants is increasing Donation and Transplant Stats Summary of Stats – October 1, 2017 Slide Number 14 # of deceased donors is climbing Deceased Kidney Donors Kidney transplants by donor type Wait times by blood type Wait times by blood type and age Most patients a