Dialysis, organ donation examined

11-year-old Sarah Marshall, the world's youngest multi-organ recipient wowed this audience with her story of receiving "The Gift of Life" and her message of the importance of organ donation. "This is very important to me, as I am one of the lucky people who received that gift", she said.

From Northumberland Today in Ontario, Canada:

"With only a few days' life expectancy left at the age of five months 24 days, she transferred to the London children's hospital for the transplant of a stomach, pancreas, liver and bowel."

For someone ill with kidney failure, having treatment facilities close by means so much. And for those eligible for a kidney transplant, an organ donation represents the gift of life.

The Northumberland Hills Hospital Caring For Generations Society spring lecture examined these related issues recently, with a dialysis professional and the world's youngest multi-organ transplant recipient.

Committee chair Louise Stevenson had her own brush with dialysis, past and present. Back in 1963, in Saint John, New Brunswick, her mother was diagnosed with kidney failure and became the first dialysis patient in the Maritimes (and one of the few in Canada). Unfortunately, she died not long after her first treatment. Within six months, her brother also died from kidney failure.

Today, her son's kidney transplant has failed and he is in the dialysis unit at Northumberland Hills Hospital.

The procedure purifies the blood when the kidneys can no longer do so, usually three days a week for three to four hours a shot. The machine handles 250 millilitres of blood at a time, dialysis-unit director Kathleen Fair explained, and the average man with normal kidneys has about five litres of blood in his body.

Before Peterborough began offering the service in 2001, Ms. Fair said, patients had to travel to Oshawa or Kingston. The local service operates as a satellite of the Peterborough Regional Renal Program. Ross Memorial Hospital in Lindsay became its second satellite a year ago.

Dialysis became available in Port Hope in 2002. When the new hospital opened the following year, its 16 patients transferred over. The roster has grown to 45 patients, serviced during two shifts six days a week.

The leading causes of kidney failure are diabetes (it is estimated five to 10 per cent of diabetics will experience kidney problems) and hypertension. The list also includes other cardiovascular disease, congenital disease, obstructions (like kidney stones and prostate enlargement), infections and over-use of pain medication.

The hospital's 16 Fresenius 2008K machines are worth $32,000 each, and each has a life span of seven to 10 years. Twelve are in service at any one time, each uniquely programmed for each individual patient.

"Our team is unique in that the level of our autonomy is quite high," Ms. Fair said.

The team consists of a dedicated and specialized group of nurses - "the best team I have ever worked with," Ms. Fair declared - plus specially trained attendants and clerks, with a Peterborough nephrologist visiting twice a month. The team is also enriched by a multidisciplinary crew that includes social workers, dietitians, technologists and pharmacists.

The team has really come through for neighboring dialysis patients, such as several times when Peterborough had more procedures than it could handle and last year during the fire at Lakeridge hospital. In a 48-hour period, she said, Northumberland Hills took 30 Lakeridge patients and performed 42 extra treatments.

Only a few patients fit the criteria to be put on a waiting list for transplants, she said, yielding the floor to an expert in that department. Boosted by a step-stool to see over the lectern, helping to adjust the microphone expertly, 11-year-old Sarah Marshall briefly shared her story.

The Grade 5 student at Terry Fox Public School in Cobourg holds the Guiness Book of World Records entry for youngest multi-organ transplant recipient in the world.

"I wear this green ribbon, as it is the symbol for giving the gift of life," she said of the small pin on her brown sweater. "This is very important to me, as I am one of the lucky people who received that gift.

"The number of students in my school is almost the same number of people in Ontario waiting for a liver transplant."

Born five weeks early at four pounds 12 ounces, she took her time in pronouncing the medical condition that threatened her life and confined her to the Hospital for Sick Children in Toronto. With only a few days' life expectancy left at the age of five months 24 days, she transferred to the London children's hospital for the transplant of a stomach, pancreas, liver and bowel.

"It was the first pediatric multi-organ transplant in Canada, and I am the youngest in the world for that," Sarah said.

She made her first trip home at the age of 10 months.

"Although I had some challenges along the way, I am very lucky," Sarah told the appreciative audience. "I have had the chance to help organizations like the Children's Miracle Network, which helps raise money for all the children's hospitals across Canada and the U.S. I have also got to help with teaching people about organ donations because, without organ donations, people like me would not have a second chance at life."

Sarah and her mother Cindy brought along a supply of organ-donor cards and applications for an organ-donor sticker to affix to the red-and-white health cards some citizens still have.

Mrs. Marshall also expressed gratification that 240 secondary schools across the province (including three in the local area) will have an organ-donation curriculum in the fall.

"It's aimed at Grade 11 and 12, because that's where they felt students would be most comfortable with the topic and I speaking with their families," she explained.

That last part is so important, she added, because the next-of-kin always have final say over whether organ donations will be allowed. Therefore, it is vital to let your family members know your wishes and ask that they honour them.

"Even if you have a signed card, if your family is not comfortable with the topic, it's not going to happen," Mrs. Marshall said.

Age is not a factor, she stated. The oldest known donor for a tissue transplant was 102 - a 90-year-old was the oldest known organ donor. "Not all transplants work," she allowed. "But even for families I know who have gained five, six, seven years, it really does make a difference."

Hospital president and chief executive officer Joan Ross said that organs are harvested by hospitals that specialize in the procedure, and that eyes are harvested locally.

Committee member Shirley Johnson recalled how Dr. Bob Scott used to go into seniors' homes after a death to encourage eye donation.

"It meant sight for so many people who would not have had the operation," Ms. Johnston said. "It doesn't matter what age you are."

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network
For other Canadian provinces click here

In the United States, be sure to find out how to register in your state at ShareYourLife.org or Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation