Humboldt’s ‘Logan Effect’ bolsters Canada’s dismal organ donations

The impact has been so profound that they are calling it the “Logan Effect.”

Logan Boulet, a Humboldt Broncos’ defenceman, suffered traumatic brain injuries in the April 6 bus crash that left 16 dead and 13 injured.

Because he had registered as an organ donor on his 21st birthday, just weeks before his death, his heart, lungs, liver and kidneys were all donated and transplanted into others, with his grieving family’s blessing.

Mr. Boulet’s gesture was one of the small glimmers of hope that emerged in the grim story that left the country grief-stricken.

The junior hockey player was hailed as a hero.

He has also inspired action. In the past 10 days, thousands upon thousands of Canadians have registered as organ donors.

The uptick has been greatest in Saskatchewan (the site of the crash) and Alberta (Mr. Boulet was a native of Lethbridge), and the influx of new donors has been especially strong among young people aged 16 to 24 (the age group of most of those who died in the crash).

The challenge now is to keep that momentum going. Canada has a pretty dismal rate of organ donation and, as a result, long wait lists for transplants.

Polls consistently show that close to 90 per cent of Canadians support organ donation but only about 20 per cent have actually registered as organ donors.

Why is there such a disconnect between intentions and action?

There are many potential reasons – or perhaps excuses is the more appropriate term.

We tend to be a bit squeamish about death, even thinking about it. There’s a generalized “it won’t happen to me” attitude that often leads to people not bothering to register as donors.

The horrific Humboldt crash shocked many out of that complacency.

There are about 280,000 deaths in Canada annually. A 2014 study found that there just over 3,000 potential donors – only about one per cent of deaths.

That makes it all the more important that everyone sign a donor card – we can’t afford to miss any potential donors, because each one is an opportunity to save lives.

Yet, miss them we do.

In 2016, the most recent year for which detailed data are available, there were 758 deceased donors. That’s not a great conversion rate; three in four potential donors are lost.

The main reason is because people don’t register as donors. While the rules are slightly different in every province and territory, the process only takes about three minutes. The Canadian Transplant Society has compiled information from all the jurisdictions on its website.

The laws in Canada are such that next of kin can veto organ donation, even for those who have registered. That happens surprisingly often: In about one in five cases where family members are approached, they refuse.

Making these decisions in a time of grief is difficult. Mr. Boulet and his family had “the talk” where he informed his parents of his wishes, and they did him, and the country, a great honour by following through.

The public discussion of organ donation that has resulted has also revived the notion of presumed consent – assuming that everyone will be an organ donor unless they opt out.

Countries with presumed-consent laws have higher transplant rates, but they also have better organized transplant systems.

This issue is not going to be resolved by legislation alone; it’s going to require culture change, within hospitals and in society more generally.

That change is happening. The number of organ donors has increased by 56 per cent in the past decade – to 758 in 2016, up from 485 in 2007.

But the need is also growing.

There were 2,906 solid organs transplanted in 2016 – 1,731 kidneys, 579 livers, 302 lungs, 202 hearts, and 92 pancreases – according to the Canadian Organ Replacement Registry. (Donors can also donate bones, tendons, cornea, skin and veins, but there are no precise data for those donations.)

There were also 4,469 people waiting for transplants – 3,421 for kidneys, 433 for a liver, 261 for a lung, 189 for a heart and 165 for a pancreas.

Many of the kidney patients require dialysis, which can mean visits to the hospital several times a week. For the end-stage liver, lung and heart patients, a transplant is the only treatment; they often die on the wait list.

Mr. Boulet’s gesture means six fewer people will die as a direct result of his donation and, in the future, countless others will have better lives due to the Logan effect.