Alberta, Canada, pauses participation in national kidney donor matching program

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https://www.stalbertgazette.com/beyond-local/alberta-pauses-participation-in-national-kidney-donor-matching-program-because-of-surgery-capacity-shortage-8117799

Alberta pauses participation in national kidney donor matching program because of surgery capacity shortage
Patients temporarily pulled from program run by Canadian Blood Services

Carrie Tait

Alberta has partially paused its participation in a national program that matches people in need of a kidney transplant with prospective living donors because a shortage of anesthesiologists is causing a strain in the province’s surgical capacity.
Canadian Blood Services operates the country’s kidney paired donation (KPD) program, which includes a database of transplant candidates and potential donors. CBS uses an algorithm to find potential matches in the registry three times a year. Alberta’s provincial health authority, however, withdrew from the winter matching run, according to the charitable organization.
“Alberta Health Services informed Canadian Blood Services that it will not be participating in the KPD matching cycle in February,” CBS spokesman Paolo Oliveros said in a statement on Monday in response to questions from The Globe and Mail. “The KPD match cycle in February will still proceed as planned with other participating provinces.”
Mr. Oliveros did not answer questions about how many transplant candidates and potential donors were removed from the cycle.
Kerry Williamson, a spokesperson for Alberta Health Services, said potential kidney donors and recipients in the province’s northern transplant program were temporarily removed from the national program because operating room capacity is being squeezed by a shortage of anesthesiologists at the University of Alberta Hospital and the backlog of local and national pairs waiting on Edmonton’s KPD list.
“AHS is experiencing recruitment challenges across the province, and we are actively working to recruit health care professionals,” Mr. Williamson said in a statement. “This is not unique to Alberta and is being experienced nationally and internationally.”
Mr. Williamson said the decision will not affect KPD participants who have already found transplant matches through the program, although he confirmed there is a backlog of donors and recipients currently waiting for surgery.

“Surgeries will proceed for anyone already matched, and living donors will continue to be accepted into the living donor programs, including KPD,” he said in a statement Tuesday.
Kelly Konieczny has been searching for a kidney donor for about four years and has been enrolled in the KPD for about three. She said her transplant co-ordinator called her Jan. 11 with the news – and an explanation.
“We were not going to be put into the February run because of the anesthesiologist shortage,” said Ms. Konieczny, who lives in Mannville, about 170 kilometres east of Edmonton.
Kathy Tachynski, another person hoping to match with a living donor, said she received a call from AHS on Monday, informing her that she would not be in the February matching cycle.
“The reason being is there is a shortage of anesthesiologists,” Ms. Tachynski said. The Edmontonian said she was told transplants from deceased donors are still proceeding.
Alberta Premier Danielle Smith rose to power in part by questioning AHS’s management of the health care system, particularly with respect to the coronavirus pandemic. She believes the health authority is bloated with middle managers who are straining resources and stymieing front-line workers. The United Conservative Party is redesigning Alberta’s health care system and has pledged to cut wait times for operations in part by expanding the use of privately owned surgical centres, where patients receive care at the expense of the provincial government.
The revelation that Alberta pulled back from the KPD program indicates the health care system may be under more stress than previously understood.
Transplant candidates in the KPD program are enrolled alongside people who want to give them a kidney but with whom they are incompatible. The willing donors agree to give up one of their two kidneys to another transplant candidate in the pool, in exchange for their loved one receiving a kidney from someone else. An algorithm then searches for the most suitable matches for the swaps.
Alberta’s decision to opt out, “was kind of startling,” said Ms. Konieczny, who pumps her blood through a dialysis machine at home four times a week. “I was feeling like we were maybe expendable.”
Ms. Konieczny and Ms. Tachynski are among the transplant candidates with the slimmest chances of finding suitable donors because they both have antibodies that would clash with roughly 100 per cent of the population.
“It is not that I will never get a transplant. But my chances of getting one are basically a needle in a haystack,” Ms. Tachynski said.

Sean Delaney, a two-time kidney transplant recipient with two decades of experience working in the organ-donation system, said Alberta’s KPD pause is especially worrisome for highly sensitized patients such as the two women.
Patients develop antibodies from past blood transfusions, pregnancies or organ transplants. They can then spend decades waiting to find a transplant match, he said. Given their slim chances, Mr. Delaney, who has a master’s degree in public health, questions why this cohort was removed from the KPD list.
“Even with low probability, why take them off? That doesn’t make any sense.”
Some decision-makers, he said, consider living transplant surgeries “elective,” a categorization he rejects.
Ms. Tachynski was not told whether other types of surgeries were also frozen in light of the anesthesiologist shortage and the Alberta pause in the KPD program.
“Organ donation, whether it is deceased or living, is life-saving,” she said. If other surgeries are not life-saving, “why are they allowed to go ahead and organ donation is not?”