Why so low?

Saskatchewan citizens can sign up for a donor sticker to put on their health-care card, but even with the sticker the person’s family or next-of-kin can still veto the donation after they die.

According to Canadian Blood Services, the number of registrations overall is relatively low, but it says health-care staff and physicians say "registry information can inform discussions with family members and bring families some relief and comfort when loved ones' wishes are known."

Unlike some other provinces, there is no donor registry in Saskatchewan. Alberta, Ontario and Prince Edward Island have implemented "intent-to-donate" registries where residents can make their wishes known formally.

It’s believed that geography plays a role, with so many small, rural and far-flung communities that don’t have easy access to city hospitals. There’s also the issue of not having a “culture of donation,” something the transplant program attributes to a lack of public education and awareness.

James said there is no way to prove why organ donation rates in Saskatchewan are so low because nobody has ever had the resources to study it.

Doctors Mark James and Stephen Beed both work in Saskatoon hospitals managed by the Saskatchewan Health Authority, which also runs the provincial Saskatchewan Transplant Program out of St. Paul’s Hospital.

Intent to donate not always enough

Stephen Beed said even those who are ready to donate do not always get the opportunity to do so because their cases slip through gaps in the system.

A Dalhousie University critical care professor with a special interest in organ donation, Beed was involved with the development of the organ donation program in Nova Scotia about 13 years ago.

In 2016, N.S. had the highest organ donation rate in the country. He said Saskatchewan is facing challenges now that N.S. was grappling with more than a decade ago.

“Within the health-care community there is a general lack of awareness about organ donation issues. It’s not on the radar screen of most of the medical community [in Saskatchewan],” said Beed.

He said there is an entire generation of medical workers whose education did not cover organ donation in any substantial way, because many schools only added it to courses in the past decade.

For that reason, Beed claims he has seen hospitals miss the chance to retrieve organs.

And chances are rare. In 2016, eight Saskatchewan residents received kidney transplants from a living donor. There were 14 deceased organ donors in the same year.

“I’ve been in the ICU where I’ve had potential donors and it’s like it doesn’t happen, and I go ‘Well, why? That was a huge opportunity lost,’” said Beed.

“So I’ve seen it firsthand here. I knew what the numbers were in Saskatchewan because of my national role. I knew Saskatchewan numbers were very bad, but having worked here I’ve seen how some of the challenges here have led to those bad numbers.”

Meanwhile there are more than 60 people waiting for a kidney transplant, which can be carried out in Saskatchewan. Other types of transplants are facilitated through the program but may require patients to travel to other provinces.

Beed said opportunities for organ donation should be treated with the same urgency as treating someone who was hit by a bus, for example.

“There’s just no way in the world that you’re not taking care of the patient. Doesn’t matter if you’re full, of course you’re taking care of them, and you do because it’s recognized as an absolute priority,” he said.

Sometimes, he said organ donation can be forgotten when emergency doctors are dealing with a catastrophic illness, a complex critical situation and a very distraught family.

He said emergency physicians — “gatekeepers” — need more education to stop possible donations slipping through the cracks.

“They’re the ones that are on the frontline and they see some poor guy that’s had a big stroke,” said Beed.

“They’re the ones that have to recognize, ‘Oh maybe I can’t do anything about a stroke but maybe he could be a donor - I should make a phonecall.’ But if they don’t remember or think about it then the opportunity comes and goes.”