Aging donors, poor donation rates reduce heart transplants

Surgeons are transplanting fewer hearts in Canada, especially among babies and children, because there aren't enough donor organs available, according to a new report.

Data from the Canadian Institute for Health Information show more than 130 adults and children are desperately waiting for new hearts.

Over the last 10 years, 375 Canadians died waiting for a heart transplant.

A lack of donors isn't the only problem, said Dr. Arvind Koshal, director of cardiac surgery at the Alberta Heart Institute.

"There would be definitely situations where organs could be used and are not being used," said Koshal.

He said a heart is usable for only four to six hours, and not all transplant programs are staffed by enough specialists.

Canada's organ donation rate also lags behind other countries. In 2002, 10 per cent of hearts transplanted came from the United States.

The aging donor pool presents another problem, because older hearts aren't small enough for the three dozen or so children who are now waiting for a transplant.

HEART TRANSPLANT SURVIVAL

Between 1996 and 2001, 78 per cent of patients who received a new heart survived at least five years. Ten years ago, the figure was 72 per cent. Source: CIHI

"Sometimes there seems to be a reluctance on the part of medical personnel to approach families ... who are facing a loss of a child, to approach them for consideration of organ donation," said Dr. Lori West, head of the heart transplant program at Toronto's Hospital for Sick Children.

West, who is also a spokesperson for the Heart and Stroke Foundation of Canada, said the reluctance is changing, and many parents are comforted by the chance to donate their child's heart.

More hospitals need a staff member dedicated to talking to family members about organ donation, West said.

On the positive side, the data also show infants who receive a new heart are more likely to survive longer.