April 16, 2010

Stocking Tissue: Human Tissue Donation Increases in the Winnipeg Health Region

Nineteen year old Dylan Carritt is finally starting to bounce back after a painful knee injury that happened when he was five. A terrible fall from a trampoline left Dylan with a torn PCL (posterior cruciate ligament) on his right knee. For most of his life, Dylan has walked with a limp, plagued by a knee that wasn't properly supported.

"My knee would always pop out if I'd turn quickly like in football," explains Dylan, who now has a new spring in his step thanks to a ligament transplant.

"The doctor told me it was from a donor tissue. I didn't even realize that was possible," says Dylan. "I thought they'd fix it with pins and needles, but to have someone else's body parts in me and to have it work: it's really neat."

Winnipeg surgeons are using a lot more donor tissue like tendons, bone chips and skin, than ever before.

Processed tissue called allografts, are used in a variety of ways. Skin can be used to treat burn patients, bone pieces are shaped to replace spinal discs, bone chips are crushed and mixed into filler for hip surgery and ligaments are transplanted to repair injured shoulders, elbows and knees.

Dr. Peter MacDonald, the head of orthopedics for the Winnipeg Health Region, says he uses allografts on patients who don't have enough of their own tissue or if the patient has already suffered severe trauma.

"There's more pain when you're creating a second operative site and it's a shorter surgery using allograft tissue. It doesn't always make sense robbing Peter to pay Paul," explains MacDonald.

Last year over 700 allografts were used in the Winnipeg Health Region and most of it was recovered by Tissue Bank Manitoba (TBM) from local donors.

"We had 72 tissue donors, that's the second highest number in Canada," says Christopher Snow Director of TBM.

It's a big jump from 2003, Tissue Bank Manitoba's first year, when there were 14 local donors. Snow credits Manitoba's Human Tissue Gift Act that requires all deaths be reported, as well as an efficient death notification system and dedicated tissue transplant coordinators.

In the Winnipeg Health Region, the eye and tissue banks are notified by the hospitals admitting department. Snow says TBM finds out about 95 per cent of all deaths and 80 per cent of those are within one hour of a patients' passing.

"These numbers are just about the envy of all jurisdictions. This way we have a large pool to draw from, and it takes that onus off front line staff," says Snow.

The window of opportunity to recover tissue is only open for 15 to 24 hours. Tissue Bank Manitoba thoroughly screens each case to identify a potential donor. A tissue transplant coordinator then discusses tissue donation with the next of kin and if there is consent, arrangements are made to get an operating room. The tissue is recovered by a four member team from TBM and then sent to a tissue processor to be disinfected and sterilized. Some tissue is cut or shaped based on the surgeon's requirements. It can take three months to a full year for the tissue to be cleaned tested and prepared for transplanting.

Local surgeons use many of the allografts from Winnipeg, but some are distributed to 28 countries around the world as part of a tissue exchange.
"Now we only have to purchase 20 per cent of our tissue requirements. Before TBM was created the Winnipeg Health Region had to purchase 100 per cent," says Snow.

The ability to sterilize, process, freeze or freeze-dry tissue opens up the opportunity for more tissue donations. There have been donors in Winnipeg as young as 15 to upwards of 90 years old.

Snow says that sometimes people rule themselves out, thinking they are ineligible due to a medical condition or disease, but they could still be eligible to donate.

"Just about anybody should consider themselves tissue donors," says Snow.

April 18-25, 2010 is National Organ and Tissue Donor Awareness Week

Learn More

Tissue Bank Manitoba

Transplant Manitoba-Gift of Life Program

Lions Eye Bank

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