Organ and Tissue Donation with Give Life Alberta

Âba Wathtech - Dānít’ádā​

In this episode, Dalton, and Colt travel to Edmonton to speak with Senior Communications advisor Su-Ling Goh, Senior Donation Consultant Corinne Marceau, and Recipient Liver Transplant Coordinator Kelly Gray of Give Life Alberta. They go into detail of the process of organ and tissue donation, dispel common myths surrounding donation, and share their experiences!

Give Life Alberta:

https://www.givelifealberta.ca/

To learn more or listen to past episodes, visit our website at www.g4health.org.

Transcript

0:03

Hello, and welcome to the G4 Talks Health Podcast. For this episode, we traveled up to Edmonton and spoke with Sue Lingo, Kelly Gray, and Corinne Marceau about organ and tissue donation in Alberta. We talked about Give Life Alberta, how one can donate, and what that process looks like, as well as addressing some of the myths surrounding organ and tissue donation. We hope you enjoy this episode. So, my name is Corinne Marceau. I'm a senior donation consultant with Give Life Alberta. Um, and I've been doing that for a couple of years. Prior to that, I was a tissue specialist for almost 13 years. And so my background is in tissue donation. Um now I work for uh Give Life Alberta, kind of what started out as the provincial office, uh, where we do um staff education, hospital development, trying to improve that organ and tissue donation system. And I'm Sue Lingo. I'm the senior communications advisor for Give Life Alberta. I just started uh in 2023 after a very long career in news. Um, but it's it's been so great. I I'm in, you know, my main responsibility is public education and raising awareness, which is so important in donation and transplant. Um, so we do a lot of awareness booths and we'll go and do talks to various groups, and I write stories, which is one of the best parts of my job. Um, and uh we do videos, so it's a really rewarding career. My name's Kelly Gray, and I am the recipient liver transplant coordinator. Um, but I not only do I cover liver transplant, what we do take turns beyond calls, so I cover all organ groups except for kidney. So Gotcha. Yeah. The one thing I thought about uh getting into this was like how do what are we even talking about, right? Um like people hear organ and tissue donation, and then maybe they have a particular idea of what that is, but maybe if we can just break down like what we're talking about in general with like what is an organ, what is considered like maybe eligible for transplant, if that's the right word, or uh don't uh donation rather. And what are tissues, what's classified under that umbrella of that term? Yeah, so um I can speak to that. Um I taught anatomy for many years, so I'll tell you that uh technically uh a tissue is made up of uh similar types of cells united to do a specific function, and then an organ is a collection of different tissues working together to do a function. Um I can't tell you how many exactly are in the body, but I will tell you which of the ones can be donated for transplant. So for organs for solid organ transplantation, we're talking about heart, lungs, liver, kidneys, pancreas, and small bowel. And for tissues, we're talking about um parts of some of the organs in the body that can be used specifically for transplant surgery. So uh examples are from the eyes, corneas, which are essentially the window to the eye for uh sight restoring surgeries, for cornea replacement surgeries. The white of the eye, the sclera, can also be used for traumatic eye injury repair or for glaucoma surgeries, again, to help restore sight. The skin can be used for skin grafts to help severe burn victims. So just a very thin layer of the skin is being used and uh can be considered a life-saving tissue for those experiencing severe burns. The bone and tendon uh can be recovered from the lower limbs and sometimes from the shoulder. And those are used for tumor reconstruction surgeries, joint repair surgeries, restoring function to people, restoring mobility, um things like spinal fusion surgeries. And finally, uh the heart valves can be used. So if the heart is not used for solid organ transplantation or if it's a tissue-only donor, the heart valves, two of those smaller valves can be isolated for pediatric patients who need a heart valve replacement or repair surgeries. So um again, a life-saving tissue there as well. I may be jumping ahead here, but uh uh something you alluded to there. Is there an option to only donate tissues or organs, or is it kind of all lumped together as one? Absolutely. There's actually the option to donate only organs, only tissues, or only certain organs and tissues. So when we do that consent process with uh a patient or their next of kin, uh they can choose which organs or tissues they are comfortable donating. And you know, we explain uh how they will be used and and how they can help recipients in that whole informed consent process. Gotcha. Nice, nice. And also with um the registry, I'm sure we'll get into the registry later, but if you do register your donation decision um online at givelifealberta.ca, you can pick whatever you specifically are comfortable with after you pass away. So there is the option to do that. Aaron Powell Gotcha, gotcha. I guess another terrifying question is like I'm assuming harvesting is probably not the the right word to use. I'm sure this is kind of a you know, maybe a not so positive term that's been kind of picked up in pop culture and whatnot. Um just want to clarify the terms here. So as far as I am aware, recovering is the proper term when you're um recovering uh organs or tissues from someone who has passed that's chosen to donate. Um, and then I'm assuming donor and recipient are the proper terms as well for someone who chooses to give and someone who needs something? Yeah, so the term harvesting has fallen out of fashion. It's quite archaic. You still sometimes hear healthcare workers using it, and part of our education is to, you know, teach them that proper terminology. Um, because recovery is really more reflective of what we do. We're surgically recovering the organs and tissues for transplant. Um and so yeah, it's um uh we the term procurement for organs is also kind of falling out of fashion. So recovery is uh is the proper term. Okay, okay, good. Thanks. I think harvesting and procurement just sort of it's really impersonal, right? And it it implies a lack of respect for for these donors and these families who have who are literally giving the gift of life. And you know, from from what I've seen from our our clinical teams, and I have, you know, had the privilege of following some of them, there is so much respect for donors and their families in our program, and and we w absolutely would not want to convey otherwise. So that's why we don't use those words. It definitely has this uh this or paints this image of something like predatory, right? Or something not so positive. And it's good to hear that. It's it's completely not that, and maybe that's just an artifact of you know, the cultural understanding of it for sure. Um understanding Give Life Alberta as a whole, though, um if say if someone chooses to donate or isn't or someone is in need of uh a transplant, where does Give Life Alberta step in? Like at what point would uh one of you uh be consulting with a client? Is it kind of just at the Yeah, what's the process look like? Yeah, so um it the processes are a bit different for organ and tissue donations. So I'll try and speak to each of those. Um for organ donation, we try to be very clear with the timing of the uh family approach. So uh for an organ donor, the family will not be offered the option of organ donation until there's been a decision to withdraw life support because there is uh, you know, a poor prognosis and you know the family has accepted that there's no meaningful recovery, no meaningful interventions possible uh at this point. So once there has been that decision made to withdraw life sustaining care, then the physician may offer the option of uh organ donation to the family. If they are interested, a donor coordinator will come speak to them and then they can kind of just make their decision. The timing of the physician approach uh to the family is either when there's been a decision to withdraw uh life support or brain death has been determined. So following that conversation with the family, that brain death has been confirmed, uh, then they will talk about organ donations. So ethically, we don't want to be putting the family in a position where they are feeling pressured to donate organs or to withdraw life-saving care so that they can donate organs, that kind of thing. So we're very careful about the timing of that conversation. Um, so it's after the physician makes the family approach that they will make the referral to Give Life Alberta organ donation program that there's a family that is interested in talking about donation for a patient that is potentially eligible. For tissue donation, uh, we will typically get the referral uh after the patient passes away. So uh at that time, the staff will give the tissue specialist or the donor coordinator a call, and uh, we can see if they may be eligible for tissue donation. And then we would do a family approach if the patient may be eligible. At that time, we would check the registry to see if the patient had registered their intents to donate organs and tissues, and we can provide that information to the family. It can help them to make their decision. The other scenario in which we can offer organ and tissue donation is if a patient has decided to proceed with MAID medical assistance and dying. Um, or for a palliative patient, if death is expected, they may want to consent for tissue donation on their own behalf, and we can do that informed consent process with them and their family. Right. Right. I was just thinking, what would the process be? Like if I wanted to sign up for a donation, like what would be the online process? How does that work? So if you are interested in uh donating organs or tissues after you pass away, the main thing that we ask you to do is to register online. So you can do that through givelifealberta.ca. You'll see a little green button there that says um register or update your decision. Um, and then it'll take you to an Alberta health site where you will enter your Alberta Health number. And then you can put in your decision. So let's say I want to register, but you know, I only feel comfortable donating my lungs and my eyes. Um, I can definitely put that in there, or I can choose, you know, I would like to donate anything you need, or I would only like to donate to uh research or that sort of thing. So you can, or maybe I do not want to uh donate at all. You can you can record that decision as well. Uh so that is what the medical team would check once someone is in a position to potentially donate. And then they would check that and they would tell their family what is on there. So, and then it's up to the family to make that final decision. So, another really important thing we like to tell people is talk to your family because they will be in a really horrible place when they are asked this question. They have just lost a loved one, and um we don't want that to be the first time that they have ever thought about donation. Exactly. It's a really difficult decision. Aaron Powell We We actually did some recent engagement around palliative and end-of-life care, and that was something that came up often was like talk to your family. And I'm sure that'll come up again here in our conversation today. Uh just having these conversations ahead of time. And uh maybe there's a cultural stigma around it of like talking about death when you know maybe it's not as close in the future as you think it might be. But it ha like you said, Sue Lang, having that opportunity to talk with your family to say, hey, this is what I'm looking to do, or this is what I would like, instead of putting that pressure uh during a time where there's there's probably not much uh else you want to think about, you know, or there's probably gonna be a lot on your mind and that's uh the big decision to make, right? Um but think thinking again about more of like a myth busting type of thing with something you mentioned earlier. Um when it comes to donating in terms of uh going to a recipient or to research, I'm curious about the research side. I think there's this idea of like donating your body to science. And I think just clarifying what that means in terms of the research and how things will be processed there opposed to donating to a recipient and kind of what the differences are between the two. So when you register, you can choose to register for transplant only or transplant scientific research and medical education. Um and when a family or uh patient themselves is doing an informed consent, they can choose uh, you know, if it's for transplant-only scientific research or also medical education. Um and those are different programs than donating your entire body to uh the anatomical guests program at the University of Alberta Hospital, for example, to the Department of Medicine. So though they're separate programs. Um, our priority is always transplant. So if the organ or tissue cannot be used for transplant, then they may be considered for scientific research, training, and medical education. Uh and these are all research programs uh that have been very carefully vetted and gone through ethics approval prior to us offering that to the family at the time of informed consent. So, for example, for organ donation, you may choose to donate the heart for research if it can't be used for transplant. Um, you could choose to donate pancreas for research on eyelet cells and how to isolate those insulin-producing cells for people who have type 1 diabetes. Um, for corneas, you may, uh if they can't be used for transplant, then we may use them for training staff in developing new ways to process those corneas for different types of surgeries to help more recipients. So uh these are these are all kind of research or training programs within um the university or within the organ or tissue donation program. Oh, I didn't realize there were that many options. Yeah, I thought it was like one or the other, and then that's about it. But that's good to know. Yeah. Great question. Yeah. Thinking more about consent as well, I know you kind of alluded to that. Um when it comes to the process of registering to be a donor, I'm assuming that's the process that some people may be familiar with at like an Alberta registry, getting your driver's license and that sort of thing. Uh that is that the same process? Yes. So basically there are two ways to register. Um, the easier way, I feel, is to go to givelifealberta.ca, like I mentioned. Or you can also do it through a registry when you renew your driver's license. You can ask them to register you for organ and tissue donation. Either way, it's the same registry. So if you did do it through the website, you can tell them I did register. Can you put that little heart on the bottom of your life of my license? Because they do put a little heart that says donor. So if you'd like that, just let them know you registered and they can put that on there for you. You do have to ask for it. But either way, same registry, that's what the medical team would check after someone has passed away. Aaron Powell Looking at the uh what's what's the full title here? I think it's the Alberta Organ and Tissue Act. Aaron Ross Powell The Alberta Human Tissue and Organ Act. Thank you. Is that the full title? Yeah. And it's a it's a long one, yeah. You remember that. I don't think good one. Yeah. I know Dalton's actually read through the full thing, which I commend him for. That's amazing. Yeah, you don't understand. Yeah. As with anything produced at at a higher level, it's a little harder to read if you're uh just getting into it and there's a lot of questions you may have after reading a lengthy document like that. Uh one thing that stood out to me reading it was the automatic referral process. If you can speak to that a little bit and maybe try to explain what that actually is. Because I I think if you were reading it quickly, some people may that may read that as automatic consent, which I I know isn't is not a thing. Right. The difference there, yeah. But just clarifying the two and what that referral process looks like and you know how consent is still involved at that. Yeah. We went with mandatory referral, um, which is not the same as like an opt-out legislation. Um so mandatory referral just means that every patient death in Alberta must be considered for organ and tissue donation. And if the patient is eligible, referred to an organ or tissue donation program, or if they're not uh eligible, a note be made in the patient's medical record so that we know that they were at least considered. This referral just means that the option of organ or tissue donation will be offered to the family or the patient in the case of a palliative patient. So the uh informed consent process will proceed uh after the patient is referred to the organ or tissue donation program and they are found to be eligible. Also, at the time that we receive a referral, the donor coordinator or the tissue specialist will check the registry to see if they have registered their decision to donate. And we won't actually approach the families of patients who have um, you know, decided to donate only organs and they're not uh eligible or um we won't approach them about tissue donation in that case. Um, we won't approach them if they have registered for, you know, to donate only their heart if they're not eligible to donate their heart. Um so we will check that registry. Um but the the registry itself, just because you have registered your decision to donate, um, that doesn't take the place of an informed consent. So for our purposes, um, you know, if to to meet our regulations, we we do need an informed consent where we've provided all of the information that the family needs about uh what the process is, what kind of tests we do, what the process looks like after the donation has happened in order for the next of kin or the patient themselves to make an informed decision. So just going to the motor vehicle registry and and signing up uh online doesn't count as an informed consent for our purposes. Yeah, it's good to know. Yeah. It's really good to know. Yeah. Thinking more about the family as well, like getting the consent from the family. I know there's a very detailed structure about who is contacted first or who can give consent. If you can speak to like the hierarchy more or less and kind of explain uh what that process looks like on who to contact when, if this person doesn't answer the phone. So I'm assuming a lot of this has to be very timely. You don't have a very small window to deal with this, and then getting people on the phone may be a little tricky sometimes. Um yeah, if you can just kind of elaborate on that a little bit more. Spouse or sibling. I remember we're seeing that in the act to Yeah. So um the donor coordinator or the tissue specialist is responsible for reading that act and determining who the legal next of kin is. But we often in practice will have the conversation about organ donation and sometimes organ and tissue donation with the whole family. Um so it's up to the family who they would like in the room for that conversation. Um, and ideally there would be consensus among the family before we do that legal consent with the next of kin. Um so it in practice it's often a family decision. Um but yes, we will determine who the legal next of kin is and uh and do the informed consent with them. But other family members could serve as a witness for that consent or could be present during the medical and social history questionnaire. Um so uh, you know, we we do try and involve the family whenever possible. Do you want to do I think your mention in was it Nova Scotia? Oh, yes, that certain places have the uh mandatory um or they have the consent. I think we uh do have different provinces are at a different rate when it comes to that. I think it's important, yeah, to outline that the conversation we're having today obviously applies to Alberta and Albertans and uh everyone that falls under the Alberta jurisdiction, but it it is different elsewhere. Um part of the research I did getting into this podcast for this discussion today was uh listening to a different podcast um on the East Coast, and they were talking about the different structure out there. I believe it is in Nova Scotia, how they have an opt-out system where by default everyone more or less is consenting, and then you have to go through the process. So to withdraw your consent, I'm sure it's uh that comes with its own challenges there. But yeah, I did want to reiterate that it is like Alberta specific here that we're talking about. Kind of getting more into the matching process, though, I'll maybe turn over this way. Um, how does the matching process work? Again, like under the umbrella that this all has to be done in a very short matter of time. Right. So it's matched based on medical compatibility. All right. So that's gonna be your blood type, um, tissue compatibility, size. Um, of course, they're gonna be looking at in some programs how long they've been waiting on the wait list. Um, for liver transplants, it's based on acuity, right? The sickest person is gonna get the transplant first. Yeah. How do you determine who is the most sick or who's in the most need of the liver? Yeah. So this is of course determined by a team. We have each program, each like the lung transplant program, heart transplant program, each team. It's not one guy saying, Oh, it's not, it's not based on one person's decision. We have multidisciplinary teams that are involved with every patient who's on each list. Their medical acuity is determined by that. In liver transplant, they're given a score, and it's called a MELD sodium score or a MELD 3.0 score. And it's based on their blood work. And what MELD stands for is model of end stage liver disease. So what it does is it gives us an indication of mortality or passing away within a three-month period of time. Oh, wow. Yeah. So the highest score is going to be at the top of the list. Oh, gotcha. And the list is constantly moving. So in liver transplant, it's not based on how long you've been on the list. It doesn't work like that. So someone can come in who is sicker than everyone else will be at the very top of the list. So it's very fluid. Yeah. Yeah. But I know that in kidney transplant, it's based on time on the wait list, right? And so you'll move up as your time goes on. Yeah. So it's based on acuity. Nice. Dalton and I were discussing on the way up here how it works in terms of. Of like age and how age factors in, and like other things that could impact someone's ability to donate or receive a donation. And we were throwing out some random hypotheticals in the car of like, well, what if someone's like 20 and then the only eligible person to give a heart is like 75 or that sort of thing? And maybe you can shed some light on how that actually works, or if there's some rules or guidelines in place, or if there's anything to consider there. I know that from a recipient side that the physicians look, of course, at very, very in-depth into every um offer that is made from the donor side and trying to figure out who it would be best compatible with. Um, of course, they're gonna try to accept organs that are gonna be the most successful. That's what we want at the end of the day, is for success, right? On the be on behalf of the recipient to put them through probably the biggest operation they'll have in their whole life to make sure that the outcome is successful. And that's kind of the goal of all of them. Um, I know that, and correct me if I'm wrong, that we have accepted offers of all ages up into like late 70s, 80s. Tissue is different, but for solid organ transplant, we do get quite old. They will match it, of course, trying to match it as best they can. And of course, pediatrics will make sure they go to the pediatrics. Yeah, yeah. I was curious about that. Yeah. Like if someone's like like if you have a child, for example, that's in need of an organ or tissue donation. Um, yeah, is there like an acceptable range? Is kind of as long as it works and it's compatible. Well, I can speak for liver transplant for sure. Um, with pediatrics, uh, we they they are given extra points as well to can be competitive on the transplant list. So that kind of yeah, we'll kind of make sure that they're kind of standing out on the list. Of course, we're doing the same criteria. So we're looking at acuity, you know, which which child is in need of it more or the most at the time when we do get the offer, and then compatibility in regards to size, right? Blood type. That's what we're matching in liver. I assume that most surgeries of any scale like this would be risky or have some sort of inherent risk with them. But is there anything that is less risky or some like more common uh transplants or uh things that recipients are, I guess, less at risk for or particular types of organs or tissues? Um I would say there are definitely a lot of uh tissue transplant surgeries that are fairly low risk. Um so uh, you know, if you are receiving uh skin grafts because you have a severe burn, your risk is definitely from the complications of the severe burn and the the skin graft is is gonna save your life. It's also just a temporary covering. So that skin graft is not gonna be incorporated into your own skin. Um very, very low risk. In terms of cornea transplant surgeries, uh, they are fairly low risk and happen all the time. They're very common surgeries. I would say for things like uh, you know, a spinal fusion surgery where bone is being used as a packing material, or something like uh a joint repair surgery where you're receiving an ACL tendon from a donor, those are kind of lower risk in some ways than using the patient's own tendon to do that surgery or um using that person's own bone to do the surgery, because then they're, you know, having to heal from having their own tendon or bone recovered as well as the surgery that they've just had. Right. It's almost two things to be healing from. Yeah. I was just thinking, is there like a um, do you see like the most common? Yeah. So uh we send out about 5,000 tissues per year provincially for transplant. And a lot of those are um, I'm just gonna say we send out corneas every week for cornea replacement surgeries. So that's one of our most common ones. Um, and the other class of surgeries that are very common are um joint reconstruction, joint repair, all of those orthopedic surgeries, anything to do with bones or tendons, a lot of the products that we make and send out every day uh to surgeons are used for uh those types of orthopedic surgeries. What about organs? Um, is it kidneys that are the most yeah, kidneys for sure, because of course with every organ donor, we get two kidneys, right? And so it does increase that. Um, but yeah, so kidneys, livers, and lungs uh are we do probably the most of solid organ transplants. Um hearts are right up there. Uh we do eyelet transplants, of course, for our type one diabetics, which is pretty amazing. And those numbers are creeping up too. And kidney pancreas transplants. So yeah. And multivisceral, which is the small bowel, liver, stomach altogether. Yeah. And we do a couple of those too a year. Yeah. I'm curious how like one uh donor could impact like many people or how many people one donor could impact. Getting into uh the research again was uh listening to this podcast and they were explaining how uh one set of eyes that was donated impacted up to four people, but they said it could impact up to ten, and how multiple parts of the same organ could be um provided to individuals that it's not just like one set of eyes goes to one set of one person. Uh could you speak a little bit more to that and how it can impact more than like one person? You're telling me that on the drive, and I'm like, there's there's no way. The math doesn't add up. It's impossible. I can speak to tissue. And the reason uh that we say that uh one eye donor can help up to 12 people is because you do have two corneas, and each of those corneas can only go for one transplant surgery, so can only help two people restore sight. But if you if those corneas are not used for a cornea replacement surgery, they can be used as a patch graft. Um, and the sclera, the white of the eye, can also be used for um traumatic eye injury repair, patch grafts, glaucoma surgeries, that kind of thing. So we've recently increased the number of uh grafts that we're making from a single eye because there's been an increase in demand for the sclera for glaucoma surgeries, for example. So one eye donor can help up to 12 people. In my opinion, it's not about the numbers. Um, if one person goes to restore site for two people with their corneas, that's huge. Um and I will say a lot of families are floored when they receive a letter saying um your loved one was able to donate uh eyes, bone and tendons, skin, and heart valves and helped 75 recipients. And so many, many recipients can be helped with these tissues. Um and we like to say that uh a single organ donor can save up to eight lives. Again, if that donor only goes to help one person with their liver, that's a huge that's such a huge contribution. That's really cool at the communication, like the hear back and you're like, you could see like, wow, you really affect somebody's life. That's good. Is there a follow-up process like that where someone could be like, hey, like I want to know what happens to my loved one afterwards and like can I connect with those people? Is there something available? Yeah, no, with solid organ transplants, we encourage all of our recipients to write their donor family's letters afterwards. I mean, they're not very specific. We do kind of keep it general at first, and then we make sure that the donor family does receive those letters. Um, of course, you know, it's a big thank you. And once the kind of dust settles after a surgery like that, and our recipients can kind of wrap their heads around what's happened, they're so grateful. And yeah. So every organ donor family and every tissue donor family receives a follow-up letter for tissue donation about two weeks following the recovery. We'll send a letter saying which tissues were recovered. Um, and by that time, we usually know if the uh corneas were sent out for surgery. So we can let them know that, you know, there were already two recipients. Um, so we follow up with every donor family. Uh, every organ donor family also receives a letter saying, you know, what organs were recovered. Um, and they usually receive an update as well as to how many recipients uh received uh organs and just some general information, as you said, um, just in an anonymous way, who was helped and how they're doing. And then the donor family does have the option then to say, I would like to know more. Um so they can write to their recipients. Um, they can request uh once the donor family has written to the recipients and the recipients have written back, they then have the option to meet. So if both sides would like to, um, and you know, the the donation program will kind of act as the go-between, making sure that everybody's comfortable receiving those uh communications. But if they would like, they can, uh after they exchange one letter each, they can arrange to meet. It really helps to see the impact when you receive a recipient letter or when you receive a donor family letter and you forward those on and to hear that response. It's uh it's really rewarding and it makes the difficult work um a little bit easier. Can I just say um I'll just share a quick story? So I've had the privilege of being at two of those meetings now where the donor family was able to um talk to one of their loved ones' recipients. Uh one was a virtual call. It always starts with a virtual call or whatever both people are comfortable with, right? So uh I was on one with a Zoom uh with a mom who had donated her her son's organs, and she got to meet the lady who got his lungs. And so that was obviously really emotional. And then I also got to be at a meeting uh where they met in person for the very first time. So uh you can actually see that story on our website. We were so honored that they were comfortable enough to have us there. We we did a little video and we wrote a little story about it with uh a mom, her name was Verna. She donated her daughter Brandy's uh organs 30 years ago. Brandy's liver went to and Brandy was five, went to another little girl whose name is Hillary. And so 30 years later, Hillary managed to find Verna through Give Life Alberta. And they coordinated a meeting, so they both wanted to meet. Uh so they met up at uh Hillary's house. And Hillary's, you know, she's she's 35 or 36 now. She's pregnant. Um, so she was expecting her first child at the time. She has since had a little boy. Um so she just really wanted to thank Verna and say, you know, thank you for my life and thank you for my baby's life and everything you've given me. And obviously it meant so much to Verna. There were a lot of tears. And uh, you know, it's just this is just one of those things that happens in donation and transplant and the difference it can make for one person and their family and generations to come. I think that really connects to a lot of the the work that we've done in the past around end of life and palliative care. Uh we've really tried to hone in on the perspectives of not only the Satina people, but also the Yithka nations. And a lot of the feedback we got when we started asking some of the elders and participants and some of the engagements was like uh they were saying that death is a process and it's not final. That was the one sort of commonality amongst all the different family understandings and cultural differences was that it's it's ongoing. And the cultural view more or less is that you know your time here on earth is temporary, but you know, you you pass on and it's uh it's another stage in the process, right? So I think seeing that life continue on in that way, I think, is definitely beautiful, right? Yeah, and then I was just thinking around like the uh making sure like if people have like their their own beliefs on preserving um when they pass, that's respected in the process you have. It sounds pretty good in that you just because the family the family's gonna be involved in that, so in those decision making. Maybe people are initially scared. They don't want um their body to be um referred when they want the family to have their wishes and beliefs. But I I personally know a lot of uh First Nations donors too. So I'm like when you think about it like that, you know, about the next generations ahead, then it does kind of align. Yeah. Um I was speaking with uh an older Den A man at the Misercordia hospital at Edmonton recently. Um, and uh he was there visiting little mother. And uh he said, um, you know, a lot of people want their body to be buried whole, to be returned to the earth whole. And he said, but they may not realize that they could help someone. Um and so, you know, our job in doing a family approach to offer them the option of organ and tissue donation is not to convince them to donate, it's to offer everyone the option equitably in a culturally safe way so that they can make the decision. And if it's something that they do want, we can honor those end-of-life wishes. I'm so glad you brought that up. We some of our initial uh kind of probing with some in individuals in the nation saying, hey, like we're gonna talk about this, like what do you think about it? Like what's the vibe basically on organ and tissue donation? And that was kind of the the moral of the story we got was that you the view was that we were given the gift of life uh to be here temporarily. And I'm not saying it speaks for anybody or speaks for everybody in terms of a First Nations perspective, but we return back home to creator in some way. And I think the there's that inherent tension there where okay, well, you have to be buried whole or you have to be uh whole when you return back home, right? Um but I think, yeah, highlighting that you can pass on that life and you can make a great impact while you're still around here, yeah, definitely. Aaron Powell Yeah. And I think that increasingly uh people have someone in their family or in their community who's in need of a transplant, and kind of that may shift their focus. They may change their mind about organ and tissue donation once they have that experience of someone who is in need of a transplant or who receives a transplant. True. Yeah. Kind of going back a couple minutes ago ago, I was starting to think more about the eligibility and what would make somebody eligible or what makes them ineligible. And maybe if you can kind of give some explanations about like what would make somebody eligible for a particular type of transplant, or if there's a particular medical condition that they could have that would make them ineligible for that particular tissue or organ. Most of our solid organ transplants are life-saving, right? And so these are usually people who are in end-stage organ failure, right? And so what'll happen is they'll be referred to us from their specialist, and we'll, of course, work them up extensively to make sure that the risks of a transplant don't outweigh the benefits. Because at the end of the day, we want success for the patient, of course, and also for the donor and their family, right? We want success all around. So we also want to make sure that these recipients have all the tools in place that they need to take care of this organ as well, right? And so we also take a look and in a psychosocial perspective as well to make sure that that's set up for success. Yeah. And we do have national guidelines across the whole country in regards to this. Yep. So in regards to addictions and mental health, um, we make sure that it is standard across the whole country because again, our interest is for the recipient's best like well-being. So that's kind of our ultimate goal. So, you know, whether it be issues with coping and we're using substances and that sort of stuff, perhaps we need to look further into that. And we are here to help with that. But again, it is about outcome and success with a really scarce resource, right? Like we don't have enough organs for the people who need them. We don't. And I have people who are dying on my list all the time because we don't find them an organ in time. Like in liver transplant, we have a really great multidisciplinary team, right? With addictions counselors and social workers who are here to help, of course. Right. Yeah. And if there aren't a candidate, it's not like we close the door completely. We don't. They do an addictions treatment program, they obtain a period of abstinence, they show compliance with our medical team. We open up that evaluation super fast and they can be listed. Yeah. It's just about success. Yeah. And um, it sounds like, yeah, that we're gonna have bigger uh numbers now of uh opportunities now that these legislations are in place. So hopefully that's the same. Yeah, yeah. And our guidelines are, I think, are fair and and again national. So yeah. Yeah. Hopefully more referrals, right, to the program and just giving people the option. Um, there's zero pressure, of course, on anyone to, but just we just want to make sure that if someone actually does want to donate, um, you know, that that they are given that choice. And we don't want to take that away from them. Uh, just to expand on Kelly's point, uh, right now in Alberta, there are over 500 people who are waiting specifically for a life-saving organ. So I cannot imagine what that wait would be like. Many people will wait years. Um, many will never receive that organ. Just uh last year in 2025, we had 53 people die who were on that wait list. So it's just it's really important if you are ever interested in in becoming a donor to just make that really clear. Even though it is very optimistic to know that you know one person can impact like many people, I think it is important to reiterate that there is still a need 100% to have more donors, right? Like, you know, even just driving around down in Calgary, I saw a billboard, I think it was last week, uh someone was advertising that they needed a kidney. And yeah, just I thought about that for a second. I thought, well, if if I was ever in that position where you know I knew things were not gonna look good for me if I didn't get this transplant, I would be doing everything I could to try to get my hand in in whatever I can to talk to anybody, say, hey, I need this. Um and yeah, if the wait list is is long and there's no one available uh to donate, yeah, I can see how that can get quite desperate, especially when it comes to you know very dire circumstances. So it's good to know that you know many people can be affected uh in a positive way when they choose to donate. But uh yeah, just reiterating that there's still a great need to have uh more donors register as well. Yeah, there are thousands of people on the wait list for tissue transplants as well, which can be life-changing. Um there are uh, you know, many people on the wait list for cornea transplants. Um, you know, about 10 years ago, the wait list was about two years, and we were able to reduce that to about seven months for a cornea replacement surgery, um, just with uh trying to increase the number of people that were approached and offered the option uh to donate corneas. Um so even people with uh chronic medical conditions um or active cancer may still be eligible to donate corneas, and that has really helped to reduce our wait lists in Alberta. Uh thinking about timing and being on the wait list, is there like a check-in process while you're waiting on the wait list to say like, okay, well, is your condition worse? Is it getting better? Like can you move up or down while you're already on the wait list or is it pretty static as you're sitting? No, it's it's very, very fluid. Right, right. Right. Especially with us when we're they're given like a score based on their blood work. So they're consistently getting or constantly getting blood work done and they're closely followed by their specialists, right? And to make sure that again, the risks of the transplant don't outweigh the benefits. And that's constantly on people's minds, right? Because yeah, you know, some people do get too sick and at that point we're like they they wouldn't qualify for a transplant because it would do more harm than good at that point. Yeah. How long are we talking? Like if say if someone chooses to donate, unfortunately they pass. Um, what does that time frame look like to you know re-recover the organs or tissues that they've chosen to donate with like I'm assuming this is I'm assuming hours maybe? Um, great question. So um it may be longer than you're thinking. Okay. So uh I'll start with uh tissue donation. So tissue donation, we do have um we say that the ideal time to contact a family is within um, you know, three to six hours after death so that we can get hold of the family, so that we can give them a chance to think about it or discuss with other family members if they want to do so before they make their decision. So we are asking hospital staff to refer as soon as possible after death to give us time to um, you know, review the medical history, contact the family, do the informed consent, do the medical and social history questionnaire, arrange for transport. If they're from a distant or a rural site, the sooner we get that referral, the sooner we can arrange that transport, the better. Um, so often rural sites will assume that their patients can't be tissue donors because of the timelines. Um, I will say that uh we do have, you know, up to 15 hours, roughly, um, to start the tissue recovery. So um if you know a patient really wants to donate their tissues and they're from High Prairie, we will do our best to make sure that they're transported to um the University of Alberta Hospital in that case, um, so that we can uh recover those tissues. And then we will arrange uh for that patient to be transported back to the funeral home that the family has chosen. So we do have some time to offer the family. Uh, you know, we'll inform them of the timelines, we'll arrange for a time to call them back, we'll give them some time if they need it. We're not trying to push them into anything. Um, we will give them as much time as we can. Um, and, you know, ideally, we will recover eyes as soon as possible so that the corneas have the best outcome for the recipient that we can possibly get. But um, you know, if it's a if it's a heart valve donor, if it's a pediatric patient and the mother really wants to donate her baby's heart valves, we will do everything we can to start that recovery within 24 hours to make it successful. Um, and so um, you know, for organ donation, um yes, there is a lot of time pressure. It takes about 24 to 48 hours to uh place all of the organs, to find recipients for those organs, to arrange for the recovery, to arrange the OR, to arrange the recipients. It's logistically, it's hugely complex. Um, and so the family does have some time to make. The decision from the time they consent, they have time to spend with their loved one until they're taken to the OR. They will be informed throughout the whole process so that they know what the what the timelines are. If the family has any special requests to speed up or delay the OR times, uh our staff will do the best that they can to accommodate that. So from the time that brain death is determined or there's been a decision to withdraw life support, there's some time. We're not going to rush any families into anything. If they need time to discuss, uh, we will give them that time. I assume like communication is the biggest part at the level where you're trying to make sure people know what's going on, what their options are. Um what are some challenges with that? Like when communicating only uh well communicating overall organ and tissue donation and trying to raise awareness of the whole program with Give Life Alberta, is there any sort of um roadblocks that you've encountered, whether it's a I'm assuming stigma is probably one of the bigger ones? Well, I'll start off with public education and raising awareness. There are of course all kinds of challenges when it comes to that, right? I think, like you said, stigma. Who wants to think or talk about death? Right? It's it's I get it. That's that's not something you want to talk about. If, you know, if you you're gonna talk to your family, you don't want them to have to think about when you're gone. And you don't want to have to think about when your loved ones are gone. Um so one of our main goals in at Give Life Alberta is just to normalize those discussions. We actually released uh an ad campaign uh a couple of years ago, and the tagline is however you tell them, your family needs to know. And and it was kind of a lighthearted current campaign because we don't think that it actually has to be a really dark, you know, really serious discussion. You can just let your family know in a way that they're going to remember. So some of the ads will have like a cake on it that's I saw that one. Yeah. Did you see it? Yeah, mom, I'm a donor. Yeah, I'm a donor. Or, you know, one of the videos is this family playing charades, and mom acts out, you know, that she's an organ donor, and then that's how she tells them, right? So uh make it memorable. Um, we have all kinds of videos and stuff on our website as well, givelifealberta.ca. If anyone wants to just watch one of those videos with their family, like look at this amazing story of this recipient who was going to pass away and now they have this whole life ahead of them. So we we figure, you know, people can sort of talk about it that way. Uh other challenges are just misinformation that's out there. And this is why we are so grateful to be on this podcast today. We really appreciate the opportunity to just clear up some of that misinformation and and have you ask us any questions that you might be interested in. And that's why we do a lot of awareness booths um, you know, in public places, and we're always up for a talk. If anyone wants us to come talk to their group, we're more than happy to do that. So yeah. Get over that uh the taboo or the uh stigma, right? Absolutely. Yeah, and I already kind of start hearing some of my friends talk about it, like even outside of health, outside of G4 Health, you could start to see it kind of go through the grapevine. Oh, really? So something's working. Yeah. Oh, that's so awesome. And then, you know, let your uh let your family know or stuff like that. So would you have any recommendations on like how to frame that conversation or how to have those conversations with loved ones? I mean, it almost depends on your culture. It depends on your family, it depends on your personality. Um, I know in my family we talk about death all the time. I'm from a big rural community. We all know people that have passed away, you know, weekly. My mom is telling me on the phone, oh, do you know who has cancer, or do you know who passed away? Um, so it's something that we've always talked about. It's it's something, you know, death is is part of life, and that's something that's openly chatted about in our family. Not all families are like that. Um, so I think it's important to gauge what your family is comfortable with, um, how to bring up that conversation. Maybe it's something that gets very detailed, maybe it's not. Maybe it's something that's very peripheral, um, because not everybody wants to think of these terrible circumstances in which they would have to make that decision. Um, but I know that a lot of our families who have had to make this really difficult decision are so thankful that they had the conversation with their loved one before they passed. Um, so especially if, you know, it's um the death of a teenager, um, you know, the the mother and the father um are usually, in my experience, um, extremely comforted and find it to be a much easier decision if they, you know, son or daughter had come home and said, Hey, I heard about this. I I think I want to be a donor. And, you know, having that conversation can be the difference between making that process uh an easy decision or making that process something that is is a struggle and truly painful. Maybe making a cake is probably the best move. Yeah. Not necessarily for everybody, right? Yeah, but uh definitely would make it memorable. So Dalton would not be able to express himself in a cake. I'll buy a cake though. Yeah, yeah. Yeah, there you go. You can buy one. Yeah, we have um, you know, I don't know if you're familiar with the case of Logan Boulet. He yeah, he died in in uh a bus crash. Uh uh he was a humble Bronco, he was a hockey player. Yes. So and that was in 2018. And uh he and and uh a number of those uh players and staff passed away. But Logan was the only one who became eligible for donation. And part of that was because his parents knew that Logan wanted to be a donor. He was a young man, 21 years old. But he, you know, just a few months before had mentioned, hey, by the way, I would like to be a donor. And because his mom knew that, she actually asked the staff at the hospital if Logan could be a donor. And it gave them so much peace to know that Logan had helped people in the end and that perhaps he had not passed away for for no reason. Right. Just to make a tiny bit of sense of that horrible tragedy. Yep, yeah, the peace of mind. Exactly. Something we've seen a lot in various uh ways throughout our work is the differences between the different generations. You know, I I've I've heard us uh Dalton and I on The Nation be referred to as like the sandwich generation because we have influence over like the the Gen Alpha and like the younger generations below us, but we're also the ones teaching our elders, our parents, about technology and new things in the world. So we have this communication going up and down both ways. And it sometimes it is challenging because some of the older people in our communities, they are um they have their own reasons for the believing the way that the things that they do and believing in those things in the way that they do. Um and actually just kind of recently I was speaking to my dad about this because I I had this conversation with my mom. I kind of spurred out of um an Instagram reel of all things. We saw this post, it's like, ah, talk to your parents, like understand what they want. Um, kind of the same idea of like you don't want to be caught not knowing, then and worrying about, okay, well, is this what they actually wanted when they passed? Or you know, what if they wanted something different and uh just not having to worry about that? So I asked my mom, we had a really frank, open conversation, and my mom's very laid back, so it was definitely approachable, right? But my dad, a little bit more traditional, um, I had to approach it in a different way. And I was like, Well, I've been thinking about this, and like I tried to frame it in a way where I'm like, okay, we're not in public, where it's like, we can talk about this, make sure it's comfortable, make sure he's cool. And I asked him, I was like, hey, I talked to mom about this. Um, this is what she told me, and I wanted to ask you the same thing. And he's like, huh. Okay. And he got out of the car and he went and bought some lottery tickets, and we never talked about it again. You know, so I think it is important to also know that like sometimes people maybe not be ready for that conversation. And kind of on that, uh when my mom and I first had this conversation, I brought it up to her and she was caught off guard, but she was she was cool about it. And she's like, Well, you know, I d I don't know yet. Let me let me think about it a little a little longer. And it was maybe two or three weeks later, I was having dinner with her. She's like, you know what, I thought about that question again. And you know, I really gave it some thought. And she had a couple clarifying questions about like what would bring me value when she passes. She's like, Would this be a value to you? Like, would you come visit? Or you know, varying uh ideas. Um we had a great conversation about it. I think just revisiting it. And maybe if the first time you talk to somebody about it and it doesn't go well or uh you don't really feel like you got anywhere, you know, but maybe try again or touch base again in a different situation or a different scenario, different environment, and try to get an answer from there, or just kind of keep consistent with it, but you know, don't be like, okay, let's talk about it now. You know, it's really pushing it, you know, still being respectful, of course. And I think what you say about generations is is very accurate. I think a lot of younger people will sign up at the registry or sign up online and then not talk to their family about their wishes. I would much rather that they bring it up with their family than I have to bring it up as a tissue specialist or a donor coordinator has to bring it up, maybe kind of uh bringing it up, as you said, in an offhand way, letting them be you know, giving them some time to digest is still a much gentler approach than them being blindsided by, oh, hey, did you know your loved one had registered their intents to donate organs and tissues and this is the first time they've thought about it? Aaron Powell I was gonna ask about that as well. If if that situation ever occurs where the individual chooses to be a donor and they pass and their family does not know, um, what does that process look like in terms of consent if the family's like, actually, no, we don't like this, you know, whether it's cultural or whatever it may be, is there uh another consideration there with the family if the family doesn't want that, or is it strictly going by the individual's wishes? Yeah, so um that's a kind of a complex question. But um, in practice, if a uh person has registered their intents to donate organs and tissues, we provide that information to the family. Um, the family still needs to do the informed consent and they can decline. So um and there's kind of two parts to the rationale behind that. Uh we trust that the family will know what is in the best interest of the person at the time that they pass away or at the time that they're being considered for organ and tissue donation. Um, you know, maybe they registered at a motor vehicle registry or online. That's not an informed consent. Maybe they didn't kind of appreciate everything that is involved in organ and tissue donation. You know, maybe they changed their minds since they registered and we trust the family to know that. So we trust the next of kin to know what is in the best interest of the patient at the time that it comes to make that decision. The other um part of that is we're not gonna traumatize any family members by pulling their loved one away and taking them to the OR for organ and tissue donation recovery if that's not something that they're comfortable with. And it's if it's not something that they can accept at a time where they're grieving and they are and they're suffering a loss. So um that's why, again, it's important to talk to your family about your wishes. Yeah. Yeah. And I was just thinking about some of the some of our cultures, it's like you gotta you have a few days where you kind of have to get get the ball rolling with um uh burial. So that makes sense. It's it's pretty timely, which is good to know that you can still incorporate the family's wishes and if they were a donor, they could still honor both. If I may, one thing I've learned since since I started this job um a couple of years ago is uh just noticing the amount of respect in these programs for the donors and the donor families. These um, you know, donation teams will bend over backwards to try to accommodate families who have, you know, certain requests or certain needs. Um it's it's really amazing to see. Um, another thing that that I love about this program is once someone, you know, once a family has agreed and their loved one goes to the OR for recovery of their organs, the medical team in there does a moment of silence. So everyone will bow their heads and they'll say a little bit about this donor and the lives they are about to save. And uh it's it's just a really beautiful thing to know that uh, you know, if if your loved one is is going to be a donor, that the amount of respect in those programs is huge. Trevor Burrus, Jr. I'm glad you reiterated that because I think it's there's still that negative idea of like, all right, well, it's this whole process and you know, and going back to that the negative language of like harvesting, and I think it's really trying to get away from that, like there is that whole respect and the process there, and it's not we're not trying to pressure anybody into doing anything. And there's that whole uh consent process as well, right? I will hit you with another complicated one though. Um us getting into this and kind of sharing that we will be speaking with Give Life Alberta, uh, we got some questions from the community, and some of them were like a little uh we had to be like, well, okay, what are you trying to ask by this, right? But one that came up often um was if you can choose who you can donate to, or um like one particular one uh was if you could choose to donate to another First Nations person. And we did do some preliminary research and we kind of got uh some mixed answers about how that works. Um but if you can shed some light on that. Um I'm assuming the answer is no, you can't specify, oh, okay, they give it to this person, you know, but um kind of what control do you have um as a donor to say, okay, well, I want it to go to somebody. So we don't match based on ethnicity. Of course, we don't have enough organ donors to make that call, right? Um so we do, like Rice said, we do match based on medical compatibility, is what we do. Um, with our live donor program, of course, um you can donate to your loved ones that way, right? So we do have the live donor program with our liver transplant as well as kidney. Um, so if you have a loved one who is sick and needs a transplant, of course, your family members can come forward and donate. It's kind of fascinating with liver transplants. They can donate 60 to 70 percent of your liver to your loved one. And your liver and the liver, that piece that goes into your loved one will regenerate to full size in 30 days. Wow. That's great. So that's spectacular. Yeah, it's very cool. Yeah. So we do see that, you know, quite common. There is some benefits, um, of course, being genetically compatible, which we do see with our live donor program where parents will donate to their children, right? So there is some benefits to that, of course. But in regards to ethnicity, we don't have the amount of organs that we need to match. Yeah, it just goes to the sickest person, right? The person who needs it most. Yeah. So for organ donation, um, directed donation is not possible for deceased donors, but for living donation, um, you know, uh for kidney and liver, um, a person can donate those organs when they're still alive. Um, and, you know, even if they're not a match for their loved one, they could donate in a paired or a chain of donation so that they could donate to someone who is a match. That person's loved one can donate to someone else who is a match, and then that person's loved one could donate to theirs. Wow. We have that in the kidney transplant program. Yeah, which is pretty fascinating. And sometimes it'll trigger this chain of surgeries all across Canada, right? Like it's really cool when that can happen. Do you ever see a um overlap between other provinces as well, or is it mainly like donors only in Alberta? So a live donor, they actually can work up live donors out of country and overseas, which is pretty amazing. We've seen that with our liver transplant program where they can do most of the workup for the donor in another country and then bring them here for the surgery, which is pretty amazing. I'm still stuck on the regenerating in 30 days. It's pretty amazing. Hey, the liver's pretty cool. Yeah, it is, it's probably the most forgiving organ in the body. Yeah, except when it becomes sick. Yeah, and it becomes scarred, then it's unable to regenerate at that point. Yeah. I always thought about like, all right, well, if you can live with like uh, you know, one kidney and like half a liver, it's like, what are we doing with the full one anyway? Yeah, no, it'll it'll grow into the space. Yeah, it's pretty amazing. That's why in in living donation, there's a saying, share your spare. Right. So if you are a really healthy person and and you can match with you do have a spare kidney in the little spare part of your liver. So and you know, you talked about what would I do if I was in the situation where I needed an organ. Um my suggestion is if you find yourself in that situation, one of the first things you should do is call the Living Donor Program. Um, they can really help with reaching out to your social circle and your and your family to try and find people who are willing to get tested to see if they're a match. Um, and they can be contacted through our website. What does that testing process look like? Is it like how involved is it? Maybe put you on the spot. Yeah, for liver transplant, it's quite extensive. Yeah, I can speak to that for sure. Um, of course, it is a very big operation and we need to make sure that the donor who is well continued to be well post-post-transplant, right? We don't want to put them at any undue risk, right? And of course, it is a risky surgery because we are taking a large portion of it. So the workup is quite extensive. We need to make sure the heart is strong enough to get them through it. Like, because it is an amazing gift to be able, yeah, to be a live donor to someone who needs it. And saying that, like our like I was saying, we have people who are dying on our wait list. And so live donors, of course, are helping with that. So family members and friends who come forward. Thinking more about like technology and stuff and how things have changed over the past little while. How has the program through Give Life Alberta changed over time in terms of um communications and how the strategies have either increased uh donors or you know affected the the wait list and the times? We're always making improvements in transplant, right? That has, you know, pushed us forward and has allowed us to use donors we haven't been able to use before, right? So we do have um, you know, medications now that have allowed us to use donors who are hepatitis positive, right? Which is pretty amazing. So that has broadened our donor pool for sure. So, you know, we are able to take someone who does have hepatitis C and use their organs, their heart, their lungs, their liver and kidneys, I believe, um, and successfully transplant someone, give them those medications and clear the hepatitis C. We also do have technology such as the Organox and ex vivo for lungs. And what they are is like um machines that are simulate a body. So they're able to put the liver or the lungs on these machines and has allowed us to use organs that weren't transplantable before. Organ transplants is very innovative. We constantly have research going on that has, you know, increased our chances of our recipient survival, as well as again, utilizing organs that we weren't able to use before. And it's continuing daily, the amount of research going on even at the University of Alberta Hospital alone. What was that technology and the organox? We have the organox for liver transplants. Yeah. So again, it's a technology that simulates a body, and then we're able to, you know, treat livers that weren't able to be transplanted before. And that's kind of like an intermediary step to like make sure things are good before. Right. And yeah. And so allows us that again, organs that are marginal and they're not sure if they can use in transplants, we're able to kind of treat and observe and let them heal a bit. Yeah, a little bit. And yeah, that's kind of a good way to put it. Yeah. And then they can use it in the inner person. Yeah. Isn't that cool? It's amazing. Yeah. Yeah. Yeah. Well, just keeping an eye on time as well. Uh just kind of maybe starting to wrap up here. If you have any actionable items for the listeners, obviously register to be a donor if you're if you're uh if you're cool with that. And then that's something that uh have the conversations. Is there anything else that you'd like to point out for any listeners? You know, if you have any healthcare workers listening, um one thing that I like to say when I'm doing any kind of staff education about organ and tissue donation is don't assume you know the family's wishes. Um let's give them the opportunity to make that decision for themselves. Um, let's give everybody equitably the option to donate organs and tissues. Aaron Powell Really focus on having like initial conversations to say, hey, what's going on? What's this topic? You know, let's just talk about it and allowing an opportunity in the future to follow up and be like, hey, we got some more questions. The the ones we think about on the drive home, those will probably be in a future episode where we can sit down again and be like, hey, like we thought some more of some more stuff, or our community engaged with that episode in a great way. They had some more follow-up questions. And our whole role with G4 Health is to be the connector between the community and the system, uh, whether that's you know, provincial, federal, and you know, provide our communities a voice, whether it's one person or it's a family, whatever it is, and kind of make sure that the information is flowing both ways. So definitely probably be hearing from us again in the future. And we look forward to it. Yeah, fantastic. Thank you. And one thing if if I could mention to your listeners, you know, if anyone ever has any questions about organ donation, tissue donation, transplant, um, we are open books. There are no secrets uh in our programs. So um, if you want to email or or call us, you can find all that information on givelifealberta.ca and and we'll do our best to answer any questions they might have. Amazing. Thank you. CSGUS, Ish Nish. Thank you for listening to this episode on organ and tissue donation in Alberta. For more information on G4 Health and our previous G4 Tox Health podcasts, check out our website, ww.g4health.org. Follow us on Facebook at G4 Health and Instagram at g4 underscore health. Nani is dunning.