Communique: March 2025

Update on Interprovincial Organ Sharing of Hearts for High-Status Recipients Program

On Oct. 12, 2023, the Interprovincial Organ Sharing of Hearts for High-Status Recipients (IPOS HSH) program was officially launched with heart allocation and offers being facilitated through the Canadian Transplant Registry (CTR) for medically urgent and highly sensitized heart patients. Within the first year of the IPOS HSH program’s operation, 36 heart transplants were facilitated through the program, 30 of which went to medically urgent recipients and six were allocated to highly sensitized recipients.

Up-to-date statistics can now be accessed through the HSH dashboard on Canadian Blood Services’ professional education website. Statistics are updated daily. A summary of the IPOS HSH program’s first year in operation is now available: First Anniversary Summary Activity sheet.

It has been an honour to witness the dedication of this community in providing the best possible care for heart transplant patients. The IPOS HSH program would not have been possible without your hard work. On behalf of Canadian Blood Services, we would like to sincerely thank you all for your continued commitment, diligence, perseverance and collaboration.

Expansion of the Interprovincial Organ Sharing of Kidneys

Since 2013, highly sensitized kidney patients have benefited from the interprovincial sharing of kidneys facilitated through the Canadian Transplant Registry (CTR) and with the collaboration of donation and transplant programs across the country. On Dec. 4, 2024, a new version of CTR (version 5.6) was released with the Interprovincial Organ Sharing of Kidneys (IPOS Kidney) expansion functionality enabled in the CTR.

This update included functionality to support expansion of eligibility criteria for specific kidney patient groups, aimed at increasing their likelihood of receiving a kidney transplant. Additional criteria will impact participation of non-sensitized pediatric kidney patients and may enable the participation of pre-emptive kidney patients. In addition, the hardest to match kidney patients with a calculated panel reactive antibody (cPRA) of ≥ 99.0% could potentially gain further opportunities for transplant through Willing to Cross (WTC).

The IPOS HSH program is not expected to be impacted by this expansion. Highlighted below are a few of the changes that will be implemented:

One Decimal cPRA:

IPOS Kidney expansion policies will introduce a cPRA with one decimal precision to support the WTC program allocation. In the CTR, recipient cPRA values are specific to the type of organ request and will only be at one decimal precision for IPOS Kidney eligible recipients. As such an adjusted and unadjusted cPRA maybe calculated for these patients. The adjusted cPRA is the cPRA after Willing to Cross antibodies are removed and is relevant for the current allocation, if the offer requires Willing to Cross to be used. The unadjusted cPRA is the cPRA with no Willing to Cross antibodies.

IPOS HSH allocation policies do not include Willing to Cross at this time and HSH recipients are not expected to be affected by this change. IPOS HSH recipients will continue to display the cPRA without a decimal.

For more information on the IPOS Kidney expansion please refer to the program website found here.

Updating Transplant Status

We understand there are competing priorities during an allocation. A gentle reminder to please enter in the CTR the date and time the offer was actually accepted or declined. This data provides important information on the allocation process and the opportunity to improve the efficiency of this process as the IPOS HSH program continues to evolve.

For any questions or concerns, please contact listing.allocation@blood.ca.