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INSIGHTS: UHN’s Award in Transplant Innovation Obscures Two Deeper Challenges: Organ Donation and Technology Commercialization

By Ross Wallace, Principal at Santis Health

The Toronto Star recently published an important and compelling article marking the news that Toronto’s University Health Network (UHN) was now North America’s largest adult organ transplant program. UHN performed 639 transplants last year, besting California counterparts at UCLA Medical Center and the University of California San Francisco Medical Center.

UHN’s accomplishment can be attributed to two distinct but interrelated factors: an unparalleled transplant team, led by Dr. Atul Humar (lead of the Multi-Organ Transplant Program at UHN) and Dr. Shaf Keshavjee (UHN’s surgeon-in-chief) and a cutting-edge technology platform which was developed by UHN itself.

The “Toronto Ex Vivo Lung Perfusion System” (Toronto EVLP) allows lungs to be preserved outside the body for up to 24 hours and dramatically increasing the number of organs available to patients – leading to a transformational change in UHN’s approach to organ transplantation. The impact of organ perfusion is already being felt well beyond the borders of UHN, as seen in the American Society of Transplantation’s decision to recognize the system with its AST Innovation Award.

Although UHN deserves serious kudos as this continent’s leading transplant centre, the Star’s article misses two key elements to the story that deserve a deeper dive. First, the challenges impeding Canada’ goal of creating a new generation of global biomedical companies; and second, the challenge to Canadian’s health care system of insufficient organ donation.

Let’s look at commercialization first: the Toronto EVLP System is being commercialized by XOR Labs, a start-up company spun out of UHN. Despite the cutting-edge technology and the global market opportunity – XOR estimates many thousands of patients around the world could benefit from a lung transplant – XOR remains relatively invisible to the broader public. Although Toronto is home to many of Canada’s most technologically advanced medtech companies, companies like XOR need more sources of early-stage capital. That’s why there’s so much interest in the $50M joint Ontario-Quebec life sciences venture fund recently announced in both provinces’ budgets, but this amount only scratches the surface of the need faced by XOR and its peers.

Shifting to the health system, the supply of donated organs continues to dramatically lag demand. According to the Canadian Institute for Health Information (CIHI), there were 758 deceased donors in Canada in 2016 – or 20.9 donors per million population. Although the donor rate has increased by 42% in the last decade, there are still more than 4300 Canadians on the wait lists for kidney, liver, heart or lung transplants. And polling data shows more than though 90% of Canadians support organ donation, only about 20% have consented to donate. Ex vivo organ perfusion is groundbreaking technology, but its impact is still being felt at the margins of a problem that requires a change in behaviour from thousands of individual Canadians. One recent cause for optimism actually stems from the tragic accident that claimed the lives of 16 members of the Humboldt Broncos hockey players. One of the players who died was Logan Boulet, whose donated organs found their way into six other Canadians in dire need of transplants – and whose inspiring and generous example has caused organ donation registration to spike across the country in response.

UHN should be justifiably proud of not only its spot at the top of the continent’s list of top transplant teams but also the impressiveness of its innovation.

I’m looking forward to the day when the Network can be equally proud of the emerging superstar medtech company taking that same technology into the world, and maximizing the impact of the live-saving decisions made by Logan Boulet and those he inspires.