bc transplant update d...transplant.bc.ca bc transplant bc transplant update leanne appleton,...
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BC Transplant
BC Transplant Update
Leanne Appleton, Provincial Executive Director Dr. David Landsberg, Physician Lead, Transplantation
BC Kidney Days October 5, 2017
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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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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
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Work underway across the continuum of care
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transplant.bc.ca/medications
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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.
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Public awareness and partnerships
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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%
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BCT Referrals (2012-2016)
124
180 178
321
437
0
100
200
300
400
500
2012 2013 2014 2015 2016
Referrals
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Poll question!
What is the growth in transplants since 2012?
a. 12%
b. 27%
c. 38%
d. 45%
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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
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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!
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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
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# 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
per m
illio
n po
pula
tion
British Columbia
Canada
All donors
Year
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Deceased Kidney Donors
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
07 08 09 10 11 12 13 14 15 16
Perc
ent
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
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Kidney transplants by donor type
All
0
50
100
150
200
250
300
07 08 09 10 11 12 13 14 15 16
Num
ber
of T
rans
plan
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
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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.
Mon
ths
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Wait times by blood type and age
0
20
40
60
80
100
120
140
2012 2013 2014 2015 2016
Mon
ths
AABBO
0
20
40
60
80
100
120
140
2012 2013 2014 2015 2016
Mon
ths
AABBO
Recipient age < 60 Recipient age >= 60
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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
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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
Perc
ent
Year
5+ yr4-<5 yr3-<4 yr2-<3 yr1-<2 yr<1 Year
Proportion of people waiting for 2+ years has decreased
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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
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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
Num
ber
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
per m
illio
n po
pula
tion
British Columbia
Canada
Donor per million population
Year
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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
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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
Perc
ent
Patient survival
0 1 2 3 4 5 6 7 8 9 10
Transplants - - all
Deceased donor
Living donor
Graft Survival
Years post-transplant
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Transplant First
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Transplant First
Videos for recipients and donors • English • Mandarin Chinese • Punjabi* • Cantonese*
* Coming soon
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BC Transplant