CHUM doctor on a mission to convince Quebecers to spare a kidney

When it comes to organ transplants, Quebec is moving in the right direction.The number of people waiting for an organ hita 10-year low atthe end of 2016.

According to numbers from Transplant Quebec, 841 people were on the waiting list compared to the all-time high of 1,264 in 2011. This translates into fewer deaths while waiting for a transplant.

Still, 40 people died last year while waiting for a donor the majority were waiting for a kidney.

Although Quebechas one of the highest organ donation rates in Canada, there remains a problemmost of the donors are deceased. To increase the supply of organs, Quebec is looking to find more living donors.

One man has been tasked with doubling the number of living donors in the province over the next five years MichelPquet is anephrologistat the CentreHospitalierdel'UniversitdeMontral. "I think it's a realistic goal," he said.

"It would bring usto the national average."

Last year, only 56 Quebecers donated a spare kidney, or part of a liver a rate of 6.7 donors per million people. Recent data from the Canadian Institute of Health Information (CIHI) shows the national average is 15 per million.

In British Columbia, it's more than 20.

Why Quebec is lagging

Are Quebecersless generous? According to a report by theFraser Institute,Quebecers give less to charity and volunteer fewer hours than other Canadians.

Quebec had the lowest national average, with 19.3% donating to charity during the 2015 tax period, while Manitoba has the highest at 24.6%.

Many theories try to explain the figures, such as higher taxes andlower incomes. Quebecers are also less religious, and religious people tend to give more to charities.

But none of this explains the low rate of living donors, according to Pquet.

"There's really no cultural reason. The reason is that collectively, doctors and transplant teams have put a lot of effort in deceased donors, and less on living donors. It's a question of where provinces put more effort," he said.

• More living organ donors needed, doctors say

British Columbia had the opposite problem. The provincehas the country's highest rate of living donors, but few deceased aneffort to balance the numbers worked.

"It's possible to have a high rate on both," said Pquet.

"If we put in the effort, we can succeed."

Successful pilot project

In 2009, Pquet tried to increase the number of living donors at the CHUM's Notre-Dame hospital where he works. Heformed a team of surgeons, nurses, psychologists and social workers. Their job was to train health professionals aboutthe benefits of living organ donations.

They also talked about the issue with patients and their families. A critical element was ensuring the safety and health of the donors.

The experiment worked. The hospital went from eight living donors before 2009 to 20 by 2012.

Now Pquet'sjob is to replicate the success at Quebec's five transplant hospitals. For the pastyear, a provincial team that includes past donors and recipients hasbeen working on the project.

Pquet says theyhave another four years to bring the living donor rate to the national average of 15donors per million people.

Why living organs are better

To be a living donor, one must go through a battery of tests both physical and psychological. It'sto ensure the donor is healthy and that the transplant will be done as safely as possible.

As a result, transplants from living donors last longer than those from deceased donorswho often have health problems at the time of death.

Transplants are also cheaper forthe health system than alternatives, like dialysis. In the long term, the savings can totalas much as $50,000 per patient per year, Pquet said.

"But there's a price to pay. You have to put in the effort, hire personnel in large numbers to run the program, and have a nephrologist dedicated to just this," he said.

But Pquetsays the hardest part of his mission has already been accomplished:convincing the government that it'spossible, and to devote staff and resources to the task.