University Health Network (UHN) innovations, strong living donor programs, along with increased numbers of deceased donors in Ontario and generous philanthropic gifts have contributed to making the Multi-Organ Transplant Program the largest adult transplant program in North America.
UHN’s Multi-Organ Transplant Program reached a milestone of completing 639 adult transplants in 2017.
Based on U.S. Organ Procurement and Transplantation Network and UHN’s own data as of March 01, 2018, UHN’s Multi-Organ Transplant Program ranked first in volume, with UCLA Medical Center performing 607 adult transplants, and the University of California San Francisco Medical Center performing 601 adult transplants in 2017.
“This propels us into the ranks of the top transplant programs internationally, as we now strive to become the top transplant program in the world,” says Dr. Atul Humar, Medical Director of the Multi-Organ Transplant Program, located at Toronto General Hospital (TGH), UHN. “It is not just the experience we have in doing so many transplants, our outcomes are equal to or exceed international standards even though we take on some of the most complex cases.”
There was an increase in numbers of procedures in all organ groups, but especially in lung, liver and kidney transplants. The lung transplant program – now the largest in the world – performed 167 transplants, with about one-third of them due to the innovative Toronto Ex Vivo Lung Perfusion System. This system for high-risk donor lungs, a world-first pioneered at TGH, UHN in 2008, assesses, improves and treats donor lungs, making many more available for transplant. This program is now expanding to other organs.
“This work opens the door for a variety of therapies that could potentially be applied to repair various injuries in other donor organs to improve the safety and outcomes of transplants. We are well on the way to becoming the world’s first Ex Vivo Organ Repair Centre which uses sophisticated molecular and cellular repair techniques to further improve transplant outcomes,” says Dr. Humar.
In 2017, TGH performed 195 liver transplants, of which 39 were living donor liver transplants, making this the largest in North America. The kidney program performed 202 transplants, with 64 of them being living donor kidney transplants, and an additional 19 kidney-pancreas transplants to the 202 kidney-only transplants, making this the largest kidney transplant program in Canada.
The Multi-Organ transplant Program also performed 21 pancreas, 34 heart and one small bowel transplant for the final total of 639 adult transplants.
“Living donation is an important part of our program because it’s a way to ensure patients get a transplant when they need it, without waiting for long periods of time or dying while they wait,” says Dr. Humar. In Ontario, at any point in time, there are 1,500 patients waiting for an organ transplant, and someone dies every three days while waiting.
Dr. Humar also notes that the criteria for accepting organs such as kidneys for transplantation have been expanded to include organs from “extended criteria” donors, typically those who are older than 60, or who have hypertension or diabetes, with excellent results. One innovative clinical trial at UHN demonstrated good results with using organs from donors with hepatitis C, removing the virus with the latest drug regimen within 12 weeks.
“We’re pushing the boundaries, using organs from donors that 10 years ago we could not have used,” says Dr. Humar, “and yet our results are equal to or better than international benchmarks.”
The complexity and collaboration within UHN’s Multi-Organ Transplant Program allows its world-leading team to translate research into clinical treatments efficiently and quickly, with a direct and strong impact on the lives of our patients.
More than $63 million has been raised by Toronto General & Western Hospital Foundation, mainly in the past five years. Brian Porter, Chair of UHN’s Board of Trustees, and Megan Porter, are Honorary Co-Chairs of the Live On Campaign, which seeks to raise $100 million in support of UHN’s Multi-Organ Transplant Program (uhnliveon.ca).
“Our work and ability to recruit the best talent can be accomplished only with strong philanthropic support, says Dr. Humar. “We rely upon the vision and generosity of our benefactors to help us find life-saving treatments and cures for some of the most devastating chronic diseases.”