REGINA — Krystal Graham is a Saskatchewan nurse who is on a transplant list waiting for a liver.
When she isn't receiving outpatient hospital care three times a week, she tries to live as normally as she can, staying positive, playing with her three nieces, and avoiding the thought of death.
"I know the risks of being this sick and not getting a transplant in time. I know a young girl who that happened to this past year, and I know that's part of what can happen to me," said Graham, who received her first liver transplant 12 years ago.
"But I don’t think about it too often, because it would drive me crazy."
Avoiding those thoughts became a little more difficult last week when Saskatchewan announced it was halting its organ donation program due to lack of staff and intensive care beds brought on by the province's fourth wave in the COVID-19 pandemic.
Organ donation coordinators are being redeployed to care for COVID-19 patients. That means if registered donors die, their organs will not be available to people who need them.
"It's a scary thing to think about, because you already know you're up against obstacles. This is something that could be totally avoided," Graham said.
Alberta and Saskatchewan fully reopened in the summer about the time their vaccination rates plateaued. Both provinces have begun some form of triage by cancelling surgeries as hospitals fill up with mainly unvaccinated patients and intensive care beds are hard to come by.
Unlike Saskatchewan, Alberta is still providing organ and tissue donation and transplant services, said a spokesperson for Alberta Health Services.
The suspension of Saskatchewan's program will have a ripple effect across Canada, said a professor of medicine at the University of Calgary.
"It affects the entire program," said Dr. Kelly Burak.
Over the last five years, 16 per cent of liver donations in Alberta came from Saskatchewan, said Burak, who spent 20 years as the director of the Southern Alberta Liver Transplant Clinic. Now, he's being pulled away from liver patients to care for infected people on a COVID-19 ward in Calgary.
He said Canada's national organ-sharing policy — which caters to the sickest patients — also relies on livers from Saskatchewan.
"When there’s someone admitted to ICU with acute liver failure, and they’re deemed to be a suitable candidate for liver transplantation, the call goes out (for) a donor organ," said Burak. "And as ICUs fill up, and organ donation becomes more difficult to do, that safety net is not there."
A year ago, Toby Boulet watched as Saskatchewan launched its online registry for organ and tissue donations, partly inspired by his son, Logan, who died in the Humboldt Broncos hockey bus crash in April 2018.
Logan had signed a donor card shortly before the crash and six people were helped when he died.
Boulet, who now advocates for organ donation, said he is devastated to see the program paused.
"This should upset and concern everybody in Saskatchewan," Boulet said.
He said talking about the donation shutdown is the hardest thing he's had to do, because it doesn't just affect his family anymore, but thousands of people on Canada's transplant list.
Latest data from the Canadian Organ Replacement Register says there were 4,352 people waiting for an organ transplant as of December 2019.
"The selfishness of individuals has created a health crisis that is now removing the gift of life. This is an absolute tragedy," Boulet said. "There's another person at the other end waiting."
One of them is Graham.
"I don’t want to be in a negative headspace, but realistically if three months passes, and I go into six months, my mortality rate goes up to 50 per cent," Graham said.
"That's my reality."
This report by The Canadian Press was first published Sept. 27, 2021.
Mickey Djuric, The Canadian Press
