Toronto hospital network requires organ transplant patients to be fully vaccinated with COVID-19

Avis Favaro and Nicole Bogart, CTV News

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Toronto, OntarioCTV network) — Canada’s largest transplant center has set a precedent policy that requires patients to be fully vaccinated with COVID-19 in order to be eligible for life-saving organ transplants.

Carefully discussed by doctors at the University Health Network (UHN) in Toronto, this decision will affect approximately 4,300 Canadians waiting for donor organs to become available and those who follow.

“From a medical point of view, we all felt very strongly that this was necessary, so there has been much debate about the best way to develop this policy,” said UHN. Dr. Aturfmar, director of the Azimera Transplant Center, told CTV National News.

“It was actually a very complicated discussion. We had ethical opinions. There were opinions from medical leaders and experts in this area.”

Organ transplant recipients face the unique risks posed by COVID-19.

Although any type of surgery puts stress on the patient’s immune system and makes them more susceptible to viruses like COVID-19, organ transplant recipients thanks to a strong regime of rejection inhibitors that need to be taken. And it carries an even greater risk. It suppresses their immune system and prevents their bodies from rejecting new organs.

Not only will these patients’ immune systems be compromised, but they will also be at increased risk of complications and death from COVID-19.

“Whenever possible, there is enough research to support that vaccination of individuals before transplantation is the best behaviour,” reads UHN’s statement on the decision.

“Like other medical requirements, COVID-19 vaccination helps ensure the best possible results for patients.”

According to statistics provided by UHN, unvaccinated patients are 12% more at risk of organ rejection and 30% more likely to die of COVID-19. According to Humar, the risk of wasting valuable resources is too great.

“Remember that organs are a really scarce resource. It was donated by another person. And really, we have to make every effort to make sure our patients are successful. No, but we also need to make sure that the organs are well cared for, “he said.

The policy is not exaggerated when considering the stringent requirements that patients must already meet in order to be listed for transplantation.

“You can’t drink aggressively and be listed for liver transplants. You can’t smoke aggressively and be listed for lung transplants. This is actually the same kind,” Humar explained. ..

And while it may be the first of its kind in Canada, that requirement has already sparked a life-and-death debate in the United States.

Leilani Rutari, a Colorado woman, was denied a life-saving kidney transplant because she said she was a Christian reborn with stage 5 kidney disease and did not agree to be vaccinated for religious reasons.

Rutari, who was lining up his donor, says both she and the donor have been removed from the transplant list.

“I feel a bit like my transplant is being held hostage, and there is only one decision I have left,” she told CTV National News.

UHN’s policy came into effect only on Friday, but Humar says hospitals have taken great care of people who may hesitate to get the vaccine, including an educational process to help people understand the vaccine.

“The good news is that very few patients refuse vaccination,” he said. “After proper education, understanding the nature of the transplant and the risks associated with immunosuppression, most people agree that they will actually be vaccinated.

Mode Labelage, an expert in health inequalities and policy analysis at Laval University, ensures that such policies do not judge people’s decisions, but that already overkill medical resources are used effectively. Say that.

“From the perspective of wanting to use our health care resources … it makes sense to request vaccines to assign them to patients who are most likely to benefit from them,” she told CTV National News. Told.

“It’s not about making value decisions about people’s lifestyles, habits, etc., but about their ability to benefit from interventions.”

It is unknown how many hospitals have enacted transplant vaccination policies in North America.

The American Hospital Association, which represents about 5,000 hospitals, healthcare systems and networks in the United States, told the Associated Press that there was no data to share on this issue. However, many porting programs state that patients are required to be vaccinated with COVID-19 due to a weakened immune system.

Humar acknowledges that this is a new area for healthcare providers. It is up to the individual porting program to decide what is best for the patient.

“Sure, many other programs take this very seriously,” he said.

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