Experts say the Canadian organ transplant system may be a model for the U.S. system, which is currently being challenged after a federal judge permitted two dying children to temporarily jump ahead on an adult transplant list.
All candidates for donor organs in Canada, whether they are children or adults, are added to the same list. In the U.S., however, some jurisdictions maintain separate lists: one for children under the age of 12, and another for everyone else.
But now the cases of Sarah Murnaghan, 10, and Javier Acosta, 11, are challenging U.S. transplant rules, which state that children in need of a lung transplant under the age of 12 must wait for pediatric lungs to become available -- a rarity.
The policy is in place to account for the specific medical needs of younger children, as adult lungs arenât always a good fit for them, Dr. John Roberts of the Organ Procurement and Transplantation Network said.
U.S. children needing lung transplants can also be placed at the end of the adult transplant list, but they remain behind adults who arenât as critically ill.
But on Wednesday a U.S. District Judge ordered a 10-day suspension of the rules for Murnaghan, so she could be moved up the adult waiting list. The ruling came after Murnaghanâs family filed a lawsuit arguing that their daughter should have the same access to organ donations that adults do.
One day later, after his family filed a similar suit, Acosta was also moved up the adult waiting list.
Murnaghan, 10, was born with cystic fibrosis. After three months waiting in a Philadelphia hospital for a suitable donation, her family says she will soon die without new lungs.
âI used to go to school before I got oxygen,â Murnaghan said from her hospital bed, wiping away tears.
Murnaghanâs parents said their daughter should have access to adult lungs and that the current rules are unfair.
âThe stakes donât get any higher than this for my child. She is 10-years-old, she has weeks to live. She is struggling and fighting with each breath,â her mother said.
Dr. Stuart Sweet of the United Network for Organ Sharing said the system isnât perfect.
âIt tugs at my heart. Itâs not a perfect system, there is no perfect system,â he said. âItâs the best we can do right now.â
Canadaâs transplant lists donât separate adults, children
Experts say a case like Murnaghanâs or Acostaâs would never happen in Canada, because there is a single transplant list which is ordered according to need -- and children are considered a priority.
Ronnie Gavsie, president of the Gift of Life Network, told ŰÎŰ´ŤĂ˝ that the Canadian system is working.
âWe have a list where the most medically needy person, who has been on the wait list the longest, will be the first to get the organ, regardless of age,â she said.
Dr. Gary Levy, director of the multi-organ transplant program at Torontoâs University Health Network, said in a telephone interview that the Canadian medical community has come to the agreement that children are a priority.
âWe believe children come first,â he said. âWe consulted widely ⌠we believe children are a priority.â
Levy added that age should not be a factor, as adult lungs can be modified to fit a smaller childâs body.
He gave the example of Helene Campbell -- the famous Ottawa resident who successfully underwent a double lung transplant in 2012.
In the meantime Murnaghanâs parents are hoping their daughter will get a new set of lungs soon, as the court order only lasts for 10 days. But at least now they have hope.
âIâm not going for easy. Iâm just going for possible,â Sarah Murnaghan said.
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip