Looking back at 50 years of organ transplants in B.C.

This year marks 50 years since the first organ transplant in B.C. and much has changed in the medical world since then.

“One of the significant advances has been our ability to do a better job of matching,” said Dr. David Landsberg, the provincial medical director with B.C. Transplant Services and the director of kidney transplantation at St. Paul’s Hospital.

“Today we’re way more sophisticated, so our ability to identify compatible donors is better. So if you get a transplant, it’s much more likely that you’ll go through the process without having rejection and ultimately have a longer-term success.”

One Penticton resident can speak firsthand to the changes he has seen in the transplant processes over the years. David Folstad was diagnosed with kidney disease at the age of 19 and is currently on the waitlist for his this third kidney.

“I had my first transplant in 1986, and that failed miserably and I nearly died at the Vancouver General Hospital,” said Folstad.

“I was in the hospital for five months that year, so that transplant was removed and I was lucky enough to get another in July of 1987.”

His second kidney lasted Folstad until September of this year, meaning he was able to go roughly 30 years without the need for dialysis, a means of filtering blood for those with low-functioning kidneys. Dr. Landsberg speculates that Folstad’s first transplant failure may be the result of early rejection and says the odds of this happening with transplants today are significantly lower.

“We’ve also been able to advance our ability to accept kidneys from donors we may have turned away 10 or 15 years ago because they were older or the kidney may have had a particular issue,” said Dr. Landsberg.

“Today with our matching techniques, we’re able to put the right kidney into the right patient and get good success for that patient with that particular kidney that before we wouldn’t be able to use.”

Dr. Landsberg noted that in terms of organ transplants, potential kidney recipients have the longest waitlist, but this is hard to compare against potential recipients waiting for other organs as dialysis allows kidney recipients to live a long time. Those in need of a heart transplant, for example, would die without the surgery.

“You can accumulate lots of patients on dialysis that you can’t accumulate with other diseases like liver failure or lung failure,” said Dr. Landsberg. “We are also facing a sort of epidemic of diabetes and high blood pressure, and those are two leading causes of kidney failure. So even though our number of donors has gone up significantly (over the years), the number of recipients has gone up.”

For Folstad, there is no telling when or if he’ll receive another transplant.

He said that because his body has built up antibodies over the years, he only has a two per cent chance of finding a donor match.

“Two per cent is better than nothing, and there are people in Penticton who had a lower success rate than that who have found a donor,” said Folstad. “Penticton is an amazing community for the number of volunteers who get involved.”

Dr. Landsberg said B.C. Transplant services has also increased its efforts in communicating with and educating the public about becoming organ donors over the years.

“We have always put a lot of effort into promoting deceased donations, but our success of being able to get that message out has increased significantly lately,” said Dr. Landsberg. “Our registry has been a big factor, the fact that you can register at Services BC has been a factor. We’ve also recently developed a lot of information about living donations for the public, all of it is accessible on our website.”

Dr. Landsberg said it’s more beneficial to receive an organ from a living donor, but many people have misconceptions about what their life would be like post-donation. He said there are risks with every surgery, but they are always assessed beforehand to make sure they are minimal.

“A lot of people worry that it means they’d have to stop doing the things that they like to do, especially recreational activities,” said Dr. Landsberg. “It’s a pretty straightforward surgery, people heal quickly and are able to get back to living a very normal life.

I tell people that if they think they couldn’t lead a normal life, then they shouldn’t donate.”

In terms of after-life donations, Dr. Landsberg said it’s important to note that the donor can specify before death which organs they’d like to donate. When it comes time to remove the organs, their body “is treated with dignity, in an operating room, similar to what would be done on a live patient.”

“With a deceased donation you have two kidneys, a heart, two lungs, a liver and a pancreas, and even with small bowel transplants, you could potentially benefit eight or nine people,” said Dr. Landsberg.

Even with increased matching abilities, no organ is 100 per cent a match for its recipient so anti-rejection is necessary to ensure the transplant is a success.

Dr. Landsberg said there have been numerous improvements to these medications, also increasing the likelihood of a successful surgery and recovery process.

“When we first started, our kidney transplants, for example, were between 40 and 50 per cent success rates for the first year. Transplants results were not good,” said Landsberg. “These days, 95 per cent of people get through the first year. So we’ve seen a dramatic improvement in success over 50 years.”

Dr. Landsberg said while these statistics are comforting, there is still no guarantee of success and the medical community still has a ways to go. He noted that some recipients are hard to match, and while the number of donors is increasing there are still long waitlists.

“However it’s going, I think that the future that transplant surgeons and B.C. Transplant Services wants is one without waiting lists,” said Folstad. “Where lives are being saved, instead of counting the people who die waiting and get rid of the uncertainty. I think that there’s hope for the future and B.C. Transplant is part of that with the evolution and accumulation of knowledge and being able to share it with hospitals and surgeons around the world.”

To report a typo, email: editor@pentictonwesternnews.com.

Jordyn Thomson | Reporter

JordynThomson