Four transplant patients tell their story: new organs are life-changing

UHN set a record number of transplants in the last year: 581.

This new record includes the first hand transplant in Canada performed at Toronto Western Hospital in January.

National Organ and Tissue Donation Awareness Week 2016

April 17 – April 23, 2016

Across Ontario, the numbers are equally dramatic:

  • 1,600 people in Ontario are on the waiting list for a transplant
  • Every three days someone in Ontario dies waiting for a transplant
  • 295 is the record number of organ donors in Ontario, reached in 2015
  • One organ donor can save eight lives
  • 29 per cent of Ontarians have registered to be an organ donor
  • To register to be an organ and tissue donor, visit www.beadonor.ca

To mark National Organ and Tissue Donation Awareness Week, the following is happening at UHN:

Toronto Western Hospital

  • Monday April 18, – 12 p.m., 2nd floor auditorium – a pizza lunch and a presentation by tissue recipient Ralph Walker. Walker will speak about his experience of becoming a tissue recipient after surviving third degree burns on over 75 per cent of his body in an accident.
  • Wednesday April 20 and Friday April 22, – 8 a.m. – 3 p.m.: Booths will be set up in front of Shoppers Drug Mart providing information, “beadonor” items and a raffle for items from local businesses.


Princess Margaret Cancer Centre

  • Wednesday April 20, – 10 a.m. – 2 p.m.: an information booth where one can also register to be an organ donor.


Toronto General Hospital

  • Monday April 18 – Friday April 22, – 8 a.m. – 4 p.m. – Information booths will be set up in the in Eaton lobby where one can also register to be an organ donor.
  • Thursday, April 21, – Meet members of the Dragon Boat Team at the booth. They are are all organ recipients and compete in the Toronto International Dragon Boat Race Festival.

Staff and visitors carrying their health cards can register to be an organ and tissue donor at the booths listed above.

Every life saved through a transplant starts with just one click.

Register to be an organ and tissue donor online at www.beadonor.ca

Written by UHN News

KIDNEY TRANSPLANT APP ALLOWS PATIENTS QUICK AND EASY UPDATES

Image of winning team holding Dragons’ Den plaque along with Dr. Atul Humar and Segun Famure

Image of winning team holding Dragons’ Den plaque along with Dr. Atul Humar and Segun Famure

A web-based app to help patients see in seconds where they are in their evaluation process for a kidney transplant has won this year’s Dragons’ Den competition in the Multi-Organ Transplant Program Student Research Training Program (MOTSRTP).

The team expects their app, which can also be used on a Smart phone, to be pilot-tested by staff and patients within the next few months.

The nine-member student team was chosen by the transplant program audience after battling it out with another team who presented an interactive web information hub for those interested in learning more about kidney transplants.

The winners received a plaque and year-long championship “bragging rights.”

“It’s refreshing to hear the innovative ideas of students who go beyond conventional approaches,” says Dr. Joe Kim, Co-Director of the Kidney Transplant Program.

Dragons’ Den: innovation amongst students

“Creating an online patient portal will empower our patients to manage their own heath, and help them become our ‘Partners in Care’ – one of the major goals at UHN.”

My Kidney Path, the winning project, aims to improve the kidney transplant evaluation process by decreasing the time for patients from referral to listing for transplant. Typically, patients can spend from six to 12 months in this pre-transplant phase, with this project aiming to cut this time by half.

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This in turn would allow the program to do more kidney transplants each year. At present, the program does approximately 160 transplant annually.

The team mapped out a new and cost-effective way of standardizing the process in which patient information is entered into and displayed in the transplant data system. This would help both staff and patients get at-a-glance reports and pinpoint exactly what still needs to be done to complete an assessment. Automatic updates can also be generated, along with explanations of tests and medical terms.

“Patients can be more involved and motivated in their own care if they have the information they need at their fingertips,” says team lead Franz Marie Gumabay, a research assistant in the Student Research Training Program. “We want to make it easy for patients.”

Begun in 2011, the annual Dragons’ Den competition in Healthcare Innovation gives students at various levels – from high school to graduate students – opportunities to work as a team to develop research projects with staff and patients and other organizations that significantly improve the experience of patients in the Multi-Organ Transplant Program. Students must apply to the Research Training Program.

Supervised by Segun Famure, Co-Director of the MOTSRTP, both projects this year were so well received by staff they will continue after the competition. Both developed innovative ways in which to engage and educate patients about the benefits of receiving a kidney transplant from the Multi Organ Transplant Program at TGH.

The Kidney Path project was developed as part of a Master’s Research Project by Sonia Seto, a student in the Biomedical Communications Program at the University of Toronto. ​

 

Written by UHN News

Principles in Immunology Course

Dear colleagues and program directors,

On Saturday April 9th, 2016  the Toronto Transplant Institute will be offering the Principles in Immunology Course.

We wish to extend an invitation to your fellows, trainees, and other colleagues to participate in these sessions.

The purpose of this event is to provide participants with a solid foundation in immunologic principles that are most relevant to the study of clinical transplantation.  The target audience consists primarily of advanced clinical and research trainees, practicing physicians and allied health clinicians.

There is no cost to register however limited seating is available.   Online live webcast option is available to those located outside the Greater Toronto Area.

To view the schedule and to register for this course, please go to  https://piicourse.eventbrite.ca

Please forward this information along to anyone you think might be interested.

Thank you,

Dr. Michael McDonald, MD, FRCPC
Director of Education for the UHN Multi-Organ Transplant Program
Director of Education Toronto Transplant Institute

CANADA’S FIRST UPPER LIMB TRANSPLANT PERFORMED AT UHN

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Getting to the last few steps of the procedure, surgeons (including Dr. Steven McCabe, second from the left) attach the muscles and plan how to suture the skin. (Photo: UHN)​

Dr. Steven McCabe was part of the surgical team that performed the world’s first hand transplant in 1999 in Louisville, Kentucky.

Fast forward 17 years and Dr. McCabe has made the possibility of hand transplants in Canada a reality, leading a multi-disciplinary team of experts to complete the country’s first transplant of the upper limb.

The team at Toronto Western Hospital (TWH) successfully attached the hand and forearm from a donor to a patient who had lost her arm below the elbow in an accident several years ago.

“We are very proud to have successfully performed this forearm and hand transplant procedure,” said Dr. McCabe, Director of TWH’s Hand and Upper Extremity Transplant Program.

“This is a tremendous accomplishment involving many people across several programs, and we are excited to make this treatment possible and available for patients who would benefit from it.”

The procedure lasted approximately 14 hours and involved 18 surgeons of a variety of different surgical disciplines from a number of hospitals.

IMG_9781

To protect the privacy and confidentiality of the patient, the donor and their families, the hospital will not be releasing the date of the surgery or any possible identifying details.

“It’s another milestone for our program,” says Dr. Atul Humar, Director of UHN’s Multi-Organ Transplant Program. “With this Canadian first, we are entering another era in transplantation.

“This kind of effort requires not only the expertise of a diverse surgical, medical, and rehabilitation team at UHN, but also a life-changing gift by a tissue and organ donor and his or her family.”

Continue reading

High School Outreach Initiative (HSOI)

Dear Colleagues:

Happy New Year!  Hope everyone had some quality time with loved ones during the holiday break.  As we embark on a new year, I thought it would be opportune to provide a brief update about an important outreach initiative on behalf of the Toronto Transplant Institute, the High School Outreach Initiative (HSOI).

Many of you may already know that the High School Outreach Initiative (HSOI) started 5 years ago as a unique partnership with Trillium-Gift-of-Life Network (TGLN) and  Health Care Professionals (HCP’s) from the Toronto Transplant Institute (Sick Kids, UHN, St. Mike’s) towards an overall objective of  providing education and awareness of transplantation and organ donation to youth in Toronto high schools. The overarching goal is to increase donor registration in the Greater Toronto Area.  Since the initiative began, 265 presentations have been provided to more than 17,000 GTA high school students.

I am writing now to ensure that you all knew that the HSOI is still going strong – and to let you know how you can support this initiative!

First off –  this year we welcome a new coordinator from the Toronto Transplant Institute – Anna Cocco – who will be working with us to quarterback all invitations and speaking opportunities at High Schools in the GTA.  We know that with Anna’s energy and proximity to us all within the Transplant programs, the opportunities to capitalize on all your expertise will be enhanced.

1) How you can support this initiative – Volunteer to be a HSOI Speaker in 2016!

HCP’s participate as Guest Speakers in classroom presentations and assemblies at secondary schools in the Toronto District School Board (TDSB) or Toronto Catholic District School Board (TCDSB). In previous years TGLN attended the presentations, starting this year they will not be attending presentations, the HCP presenters will now provide information on donation in a newly designed presentation. An organ recipient or donor family will also attend to take part in the presentation, sharing their story, which is an integral aspect of the presentation.

Anyone interested in participating as an HCP presenter will receive training on the 25 minute presentation. Your commitment may be 1-2 presentations over a year, which may require ½ day of your time.

If you are interested in participating, please advise Anna Cocco for tracking – anna.cocco@uhn.ca

2) Promote the Initiative to Teachers you know:

We continue to target all Toronto public and Catholic high schools and in doing so we hope to utilize as many Health Care Professional (HCP) volunteers as possible.   Everyone’s help is appreciated in trying to bring the program to new schools in the GTA.  Please find attached a healthcare professional letter that we encourage you to share with any teacher and school contacts you have.

Please contact me if you have any questions related to this important initiative.

Thank you,

Vicky Ng

Chair, HSOI Steering Committee

 

Triple transplant teen doing well after rare surgery

​​​​​​ Image of Reid lifting weights Triple transplant recipient Reid Wylie makes regular visits to Toronto General Hospital to go through a post-operative workout routine. (Photo: UHN)

​A unique triple transplant has transformed the life of a 19-year-old Cystic Fibrosis patient who can now walk without an oxygen tank, exercise, eat full meals, and plan for the future.

Just two weeks after his life-saving three-organ transplant, Reid Wylie was walking around the transplant unit at Toronto General Hospital (TGH), inhaling and exhaling without coughing, and diligently keeping up his breathing exercises to expand his lungs.

“For the first time, when I walk, my legs are more tired than my lungs,” says a smiling and shy Reid, who was diagnosed with Cystic Fibrosis at age two.

Being sick made Cystic Fibrosis patient Reid Wylie feel like there was no light in his future. His triple transplant has changed that. (Video: UHNToronto YouTube)

​​​Reid received a world-first transplant combining double lungs, liver, and a pancreas in the summer of 2015. The procedure took 17 hours, with 15 staff which included: surgeons, surgical fellows, anesthesiologists, operating room nurses and healthcare specialists in the use of the heart-lung machine during surgery.

A novel combination

Since 1990, the Multi–Organ Transplant Program at TGH has performed nine lung-liver transplants, but has never combined those with another organ – until Reid’s triple transplant.

Cystic Fibrosis (CF), a chronic, genetic disease, affects many organs, including the lungs, the digestive system, liver and the pancreas. This results in improper digestion of food, as well as a breakdown of pancreatic tissue, leading to diabetes.

When medical management alone can no longer maintain the health of a person living with CF, transplantation, although not a cure, can improve a person’s quality of life.

Since his diagnosis, Reid has had to take three to five enzyme pills with meals and snacks to digest his food, and insulin to control his diabetes.  Draining about three cups of sticky mucus from his lungs, by clapping his chest and coughing, had to be done daily. His condition worsened this summer, and Reid was hospitalized with severe lung infection.

Respirologist Dr. Cecilia Chaparro, who treats CF patients at TGH and St. Michael’s Hospital after they become transplant patients, has been treating Reid for about two-and- a-half years, with TGH transplant liver specialist Dr. Nazia Selzner.

Both agreed that a unique three-organ transplant offered Reid the best possibility of leading a more normal life.

“CF patients like Reid are a remarkable group of people, who live and enjoy their lives despite the limitations of their disease,” says Dr. Chaparro. “They live fully because they don’t know how long they have.

“The disease is unpredictable.”

Dr. Cecilia Chaparro comments on the unique opportunities Toronto General Hospital’s Multi-Organ Transplant Program can offer patients. (Video: UHNToronto)

“We all felt that Reid was ready for a transplant,” adds Dr. Selzner, “He was very ill, able to walk only with oxygen, and both his lungs and liver were failing quickly.

“Despite that, he was motivated, courageous and never complained.”

Dr. Shaf Keshavjee, Director of the Toronto Lung Transplant Program – the largest lung transplant program in the world – notes that the risk for performing lung transplants on CF patients has improved significantly since 1988, when the first one in the world was done at TGH.

“The question for our team was, ‘Can we help CF patients even more by curing their diabetes and liver disease?'” says Dr. Keshavjee, who is also the University Health Network (UHN) Surgeon-in-Chief.

“Each transplant has risks, but to do all three at the same time takes dedicated, skilful teams in the Operating Room and in the care of the patient afterwards.

“It’s a medical tour de force, a huge accomplishment.”

Image of Reid doing breathing exercises
Reid performs post-operative breathing exercises in his room prior to discharge from TGH. (Photo: UHN)

“Cystic Fibrosis Canada is proud to have supported innovations in transplantation processes at TGH,” says Norma Beauchamp, President and CEO of Cystic Fibrosis Canada. ”

“The world-class results have contributed to improving surgical rates for Canadians with CF, and are giving Reid a second chance at life.”

A ‘technically challenging’ surgery

The double-lung transplant was performed first by a team led by Dr. Tom Waddell, Head of Thoracic Surgery at UHN, as this was the most urgent procedure. Lung transplants are always emergency surgeries, never elective. It took about 10 hours, longer than most.

Dr. Waddell describes it as “technically challenging” due to the inflammation of the lungs and the extra time it took to control the bleeding. He especially praises anesthesiologist Dr. Karen McCrae and the anesthesia team for their skill in keeping the patient stable by managing his blood pressure, breathing and circulation “minute by minute” while the surgeons worked.

Image of Reid walking outside his Toronto home
Less than two months after his triple-transplant, Reid was back home and able to go for a walk around his neighbourhood, something impossible before the surgery.
(Photo: UHN)

Dr. Mark Cattral, Director of Pancreas Transplantation Program at UHN, led the team that transplanted the liver and pancreas as a whole unit. He received the nod from the anesthesia team to proceed after a careful assessment of Reid’s vital signs – blood pressure, heart rate, oxygen levels – as stable enough to undergo another seven-hour transplant.

One of the crucial moments in that transplant was when the surgeons unclamped the blood vessels to the transplanted liver to restore blood flow throughout the body. That sudden rush can cause instability in the heart.

“This is the part that gives us grey hair,” says Dr. Cattral. “That’s when things can go wrong. Your eyes are on the monitors, watching the blood pressure, activity of the heart. In the first few moments, you sense how things are going to go. Patients can have a heart attack at this stage.

“In this case, Reid sailed right through it. The organs ‘pinked up’ nicely, very quickly. In a surgeon’s world, that’s what we are looking for. I was quite happy with how it all worked out. ”

‘The benefit exceeded the risk’

Although performing both the liver and pancreas transplant at the same time was a challenge, Dr. Cattral points out that the transplant program performs 45 pancreas or pancreas/kidney transplants a year, making it the second largest in North America. The liver transplant program performs about 150 transplants from deceased and living donors a year, making it one of the largest in North America.

“We were taking on added risks by combining the two transplants, but the benefit of doing both exceeded that risk,” says Dr. Cattral, adding that the transplant has changed Reid’s life completely.

“He really needed a break, and he got one with the help of a generous donor and our excellent lung, liver and pancreas teams.”

Toni Emerson, Reid’s mom, smiles every time she talks about the progress her son has made. His blood oxygen levels are now usually 99 per cent when he exercises – well within the normal range – and he has gained five kilograms, or 11 pounds, in seven weeks.


Toni Emerson, Reid’s mother, reflects on the decision to go through with transplant despite the risks. (Video: UHNToronto YouTube)

​​”As a family we will always be grateful to that wonderful person and his or her family who made the decision to donate three organs to our son,” she says. “They gave Reid his life back.”

The Multi-Organ Transplant Program at TGH is the largest in Canada and within the top five in North America, performing more than 500 solid organ transplans a year – more than half of all transplants in Ontario – and providing lifelong follow-up care to almost 5,000 patients.

For more information about CF, please visit www.cysticfibrosis.ca

 

Written by: UHN News