The story of a New Brunswick teen who died in a car crash last month is exposing the gaps in Canada’s organ-donation system, according to an expert who says the country may be missing out on thousands of desperately needed donations every year.

David Hartell, executive director of the Canadian Donation and Transplantation Research Program, said an estimated 4,000 Canadians who die each year have the potential to become organ donors, but only about 800 end up doing so, despite the fact that 90 per cent of Canadians have expressed support for donation.

He says the case of 16-year-old Avery Astle highlights the sad reality that even families who want to be donors sometimes aren’t given the chance due to a lack of hospital resources, trained personnel or rigorous procedures to prioritize donation.

Astle’s parents told CBC News they’d wanted to donate their sons’ organs and tissues after he died in an April 20 crash but were told nobody from the specialized donation team was available.

The administrative director of the New Brunswick Organ and Tissue Program blamed turnover within the tissue team for creating “gaps in coverage” the day Astle and three friends died after their vehicle veered off a wet, rural road in Miramichi and landed in a ditch filled with icy water.

Nadya Savoie expressed regret that they were not able to provide “the opportunity for donation” to the Astle family, but at the same time warned the situation could persist while it works to train new recruits to its tissue team. The shortage did not affect the organ donation team, she said.

Hartell said the Astle family’s story is a tragic system failure — but it’s one that is all too common.

“Most Canadians think it’s simple, that when you sign your card you become an organ donor, but the reality is that it’s a way more complicated system, and the chance of it actually happening is actually incredibly rare,” he said in a phone interview.

Only a relatively small number of medical circumstances meet the criteria for donation, which Hartell says makes it even more important to make every one count.

But even when those criteria are met — a patient who dies in an intensive care unit of a hospital, on life support, without a major disease or infection preventing them from donating — sometimes the resources aren’t in place to facilitate a transplant. That could be because of a lack of co-ordination between agencies or because overworked doctors are too busy saving other lives to approach grieving families.

“If they don’t call the provincial agency in time, or if they don’t think the family would say yes, of if they make their own judgment call saying that this probably isn’t going to be suitable donor ... then we miss potential donors,” Hartell said.

Hartell says many provinces are making progress on increasing their rates of organ donation by implementing mandatory referrals and programs that teach hospital staff and patients about the benefits of donations. He has particular praise for Nova Scotia, which recently became the first jurisdiction in North America to pass legislation that will mean all adults are presumed to be organ donors unless they opt out.

But he said the Astle case shows that Canada still has far to go.

Hartell said hospitals should have to track how many potential donors die in their intensive care units, and they should be held accountable if they fail to consult families about possible donations.

Raising the rate will also require sufficient funding from the provinces to provide on-site co-ordinators, training and awareness for doctors, and the resources to connect donors, hospitals and recipients in a timely manner.

Loading... Loading... Loading... Loading... Loading... Loading...

Ultimately, he’d like to see a missed opportunity for organ donation be considered what he calls a “never event” — a medical mistake as egregious and rare as amputating the wrong limb or mixing up two newborn babies.

“It’s not something we don’t know the solution to,” he said. “This is a solvable problem, and what it takes are dedicated resources.”

Read more about: