Tissue donations could double under new N.S. law, says physician

The medical director of Nova Scotia's tissue bank expects his department could see more than double the current number of donations when Nova Scotia changes its organ and tissue laws.

On Monday, the province is implementing a new presumed consent system. It means all adults will be considered organ and tissue donors unless they register to opt out.

Nova Scotia's organ and tissue law will exempt children and those who do not have the capacity to understand the law. It also doesn't include people who have lived in the province for less than a year.

Those who do not want to be donors can use the opt-out registry, and their families will have a say when decisions are being made at the time of death. 

While organ donation is commonly understood, Dr. Michael Gross hopes people will take the time to understand what it means to donate tissue.

Gross said many families are scared or intimidated by the thought.

"The whole system is set up to respect the donor," he said. "One of the things people are scared of is that the body is not going to be looking normal."

He said they have worked with funeral home directors to make sure that they reconstruct bodies after donation.

"You are making a difference, but you are not destroying the overall form of the body," said Gross.

Donations lead to 'life-saving' operations

The list of possible tissue donations includes corneas, skin, tendons, heart valves and bone. Gross believes more people would be open to the process if they knew how each donation could help others.

"It's actually a life-saving operation to put a new heart valve in a child that's undergoing surgery for a cardiac anomaly."

Right now, 150 people in Atlantic Canada are waiting for cornea transplants. That wait can take a year and a half.

"The people who receive corneal transplants can see again, they can drive again, they can read the newspapers," said Gross.

Skin is used for grafts, but it's also now being transformed into a collagen product that can be used in rebuilding tendons.

There were 978 tissue grafts in Nova Scotia in 2020. To give that context, Nova Scotia Health says one patient with serious burns can need up to 100 skin grafts.

Bone donations can help people who have been in accidents, they can be used in breast reconstruction, and they can help rebuild someone's jaw.

"You would be amazed," said Gross. "One person who donates their tissues and we take everything, can affect about 100 other different people. And this is the way it goes."

Currently 200 tissue donors a year

The need for tissue donation is significant. Gross said the department currently has about 200 donors a year, but once the new law is in effect, he expects it could be as many as 500.

Unlike organs, he said, tissues can be donated 24 hours after death.

"So there's time for your family to say 'we would like our loved one to donate tissues' or with presumed legislation, anybody who is eligible is able to donate their tissues can automatically which is a big thing."

Tissue donors need to be under 70 years old, said Gross, and can't have infections or cancers. He says in 25 years in the department, they have never had a problem with safety.

"People need to know that we do an awful lot of screening," he said. "We examine the donor's records. We do a lot of questioning."

Gross said the department is also in the process of developing a way to donate placenta at some point in the future. Overall, he said donating is an important part of helping families through the grieving process.

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