By ANDRÉ PICARD
The plan to revamp Canada's organ donation system is "pitifully inadequate" and a "national disgrace" says one of the world's leading transplant specialists.
Phil Halloran, editor-in-chief of the American Journal of Transplantation, said the new system - which was announced on Tuesday by provincial health ministers - was designed by bureaucrats without adequate consultation from the public or transplant specialists.
"People are dying because of the inadequacy of our current transplant system so why aren't we reaching out to find the best solution? Why is this being done secretly in the smoke-filled backrooms?" Dr. Halloran said yesterday in an interview from Sydney, where he is attending the World Transplant Congress.
He is also critical of the fact that Canadian Blood Services has been charged with overseeing a national transplant system and that a stand-alone agency was not created, as is the case in Australia, Britain and the U.S.
"Imagine if they asked a bunch of transplant people to run the blood transfusion system. That would be laughable," said Dr. Halloran, who is also director of the Alberta Transplant Applied Genomics Centre in Edmonton.
He added that the $35-million investment in revamping the organ donor system is paltry.
By contrast, Britain recently invested the equivalent of $200-million and Australia $150-million.
"This is a joke. But it's not a joke for the Canadians who are dying," he said.
Lori West, an internationally renowned pediatric cardiac surgeon and president of the Canadian Society of Transplantation, said she shares some of those concerns, but prefers to see the announcement as a big improvement over what currently exists and the foundation for building a new system.
"This is clearly a major step forward toward providing comprehensive organ transplant services to Canadians," she said in an interview from Sydney.
Dr. West added that a consultative meeting planned for September should focus on looking beyond the bureaucratic structures and determining how the organ donation and transplantation system can be improved coast to coast.
"A nationally cohesive approach is crucial," she said.
Graham Sher, CEO of Canadian Blood Services, anticipated some of the criticism. "There are questions - and appropriately so - about what this new system will be," he said.
Dr. Sher said CBS has expertise in information technology and in managing the complex system required to collect and deliver blood to hospitals around the country, functions that are similar to those required for a good organ donation and transplant system.
"We don't see blood and organs as similar products because they're not. But there is a service delivery model in place that can be taken advantage of to improve the organ donor system," he said.
"This is in no way, shape or form a power grab," Dr. Sher said.
The starting point of the new system will be the creation of new electronic registries to facilitate the sharing of organs between provinces and to make it easier for individuals to donate. CBS will also launch education campaigns to promote organ donation and undertake other initiatives, but only after consultations with provincial transplant agencies, transplant specialists and patients, he said.
Bill Barrable, executive director of B.C. Transplant, said CBS has the potential to vastly improve the organ donor system in Canada by complementing and co-ordinating the work of provincial transplant agencies.
But it is essential for CBS to remain focused on specific tasks and to be "clear and transparent" with the public, transplant surgeons and provincial agencies alike, he said.
At the end of 2007, there were 4,195 Canadians awaiting organ transplants, according to the Canadian Organ Replacement Register. By contrast, only 2,188 transplants were performed during the last year.
A report prepared last year by Dr. Halloran estimated that as many as 1,200 Canadians a year were dying because of bureaucratic shortcomings and mismanagement in the organ donor system.
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