For 10 years, stagnation in the number of cadaveric organ donors has been observed in Quebec. Due to the shortage of nurses, access to intensive care beds is difficult for both donors and transplant patients. This results in significant delays in the transfer of donors, from identifying centres to collection centres, which can contribute to organ loss and prolonged ICU bed occupancy. In addition, the shortage of operating rooms is also contributing to the lengthening of the intensive care bed occupancy period, as well as delaying other surgeries.

To address these issues, the Hôpital du Sacré-Coeur de Montréal has devised a structure that can eliminate delays and improve the retention of organ donors: The regional centre for collection of organs for transplantation. The purpose of this centre is to allow organ donors identified at Hôpital du Sacré-Coeur and surrounding hospitals to be retained and their organs collected at Sacré-Coeur Hospital. Thanks to the creation of an interdisciplinary on-call cover team, it allows two additional intensive care beds to be opened up immediately.

The creation of a cover team, made up of an intensive care practitioner, nurses, anaesthetist, respiratory therapist, pathologist and pathology technician, dedicated to the retention of donors and the collection of organs for transplantation is a very innovative idea, a first in Canada. This practice stands out because of the voluntary nature of the availability of the professionals who take part in it. Indeed, the cover takes place outside of usual work shifts and requires an additional commitment by the various stakeholders.

In order to optimize the number of available organs and retain the donor, an intensive care practitioner and a nurse ensure a constant presence at the bedside. An interdisciplinary cover team facilitates the opening of an additional operating room, to collect organs and analyze biopsies, at a time which is deemed optimal for transplant teams and without impacting on the scheduling of other surgeries. Opening an intensive care bed and an operating room as soon as they are required allows for an unprecedented optimization of the organ donation process in Quebec.

Since the beginning of the project, all potential donors from the referral centres have been accepted for transfer within one hour and 4.5 organs have been collected per donor by the Regional Centre versus 3.5 organs collected for the rest of Quebec.

Thanks to the impressive volunteer involvement of staff and physicians, we firmly believe that this approach is sustainable within our institution. This unifying project brings great pride to the managers, staff and doctors who get involved and even affects all hospital employees. This programme is highly beneficial to society, since it enables more organs to be transplanted and, therefore, allows a larger number of individuals to return to a normal life.

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