Transplant Digest newsletter - Spring/Summer 2019

Transplant Digest

A N R T SPL Y E N

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Spring/Summer 2019, Issue No. 26

Years

1969-2019

y r a s r e v i n An

Congratulations!

In this issue Editor’s Desk • Half Century of success • Long Term Health after Kidney Donation • Recommended vaccines • Reflection on the 30 years • Patient Connect and Learn • Through the years • Messages

Transplant Digest 1 Spring/Summer 2019, Issue No. 26

From the Editor’s Desk Welcome to the Spring-Summer 2019 issue of Transplant Digest. As the weather turns warmer, our thoughts turn to spending more time outdoors, perhaps with greater leisure activity and travel thrown in. The most important goal of kidney transplantation is to improve the lives of patients with kidney failure. At the core of achieving this goal is greater knowledge about transplantation itself; what goes into the selection process, what is involved in surgery, what transplant medications are all about, and what are the things to watch for after the transplant, to name just a few. We hope that Transplant Digest helps fulfill this core need of transplant donors and recipients to some degree.

The content in this issue of Transplant Digest is a bit different from previous issues with few medical articles included. The St. Michael’s Kidney Transplant Program is celebrating its 50th Anniversary in 2019.

Several activities are planned over the course of this year. This is a time to look back with fondness at our past successes, reflect on what we have learned from our failures, honour our pioneers, and boldly visualize our future. No matter what your particular connection to kidney transplantation might be, or for how long, we cordially invite you to celebrate along with us.

WELCOME SPRING...

Dr. Ramesh Prasad, Editor

St. Michael’s Hospital KidneyTransplant Program (across the hospital) 61 Queen Street 9th Floor Toronto, Ontario, M5C 2T2 Phone: (416) 867-3665 Please send your comments or suggestions of topics for future publication to: jayomam@smh.ca Disclaimer Note: Views presented in this newsletter are those of the writers and do not necessarily reflect those of St. Michael’s Hospital or the University of Toronto. Subject matter should not be construed as specific medical advice and may not be relevant. For all questions related to your own health please contact your health care provider.

Contact Information Dr. Ramesh Prasad – Editor Meriam Jayoma-Austria, RN, BScN, CNeph(C) – Newsletter Coordinator 2

Half a century of success for the Kidney Transplant Program

By Ana Gajic The newspaper pages are faded but the stories shine through: two strangers become connected after each receiving a kidney from a deceased donor in 1979; a woman donates her kidney to a sister and marks the 300th transplant at St. Michael’s Hospital in 1984; a brother travels from Vietnam to Canada in the ‘90s to save his sibling’s life with a kidney transplant.

These are just a few of the stories the Kidney Transplant Program at St. Michael’s has seen over its 50-year journey.

Now, to celebrate half a century of success, the program is launching a campaign called #MyTXanniversary to encourage more people to register as organ donors and highlight its patients and staff by sharing stories of their own transplant anniversaries.

“We have grown to be one of the largest kidney transplant programs in Canada,” said Dr. Jeff Zaltzman, a nephrologist who has worked with the program since the early 1990s. “Despite that, we never take a transplant for granted, even after doing it for 50 years. Every transplant is a unique experience and story for that individual and we always remember that.”

Transplant reunites brothers image: In the early 90s, a young man from Vietnam traveled to Canada to donate a kidney to his brother. Not only did he give him the gift of life, but it was the first time the two had seen each other since their childhood.

The road to 50 years Though the program is now one of the largest in the country, it started with humble roots. Fifty years ago, St. Michael’s successfully completed Canada’s first heart transplant, but kidney transplantation was the only organ transplant program that stuck.

When Maureen Connelly, a registered nurse in the program, first started to care for transplant patients in the late 1970s, the surgery was considered a risky

Celebrating a year with new kidneys: In 1979, two strangers become connected through transplant at St. Michael’s: one deceased donor had donated each kidney to one of them.

last resort. Now, transplant is considered the preferred treatment option for those with end stage kidney disease.

Connelly has watched the program grow from about 200 patients in the early 1980s to nearly 2,000 today.

Transplant today Since the program’s launch in 1969, the science and medicine behind transplant surgery has grown and improved. Opportunities for donors and recipients have also increased through the work of the Trillium Gift of Life Network (TGLN), making it possible to expand potential donor pools for patients.

Continued on page 4

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Half a century of success story from page 3

“We’ve had a lot of progress in terms of the antirejection medication, treatment of infection, and the technology of immunological surveillance to identify risk factors for rejection,” Dr. Zaltzman said.

“We are transplanting patients who are older and sicker with donors who are older and we’ve adapted to that process.”

One unique opportunity St. Michael’s offers is the outof-country donation option. This program has yielded donors from countries such as Vietnam, Pakistan, India, the Philippines, Australia, Myanmar, the United Kingdom, the United States, Malaysia and Sudan. This speaks to the diverse patient population the program at St. Michael’s serves in Toronto.

The National Kidney Paired Donation Program has also offered many St. Michael’s patients the gift of life.

Through it, connections are made with two separate but willing donors who are each unable to donate to their intended recipients due to incompatibility. The willing donors are matched so that each recipient can receive a kidney with a compatible blood type. The National Registry is managed by Canadian Blood Services.

And most recently, the Kidney Transplant Program has been able to combat incompatibility barriers through a protocol called Blood-Type (ABO) Incompatible Direct Kidney Transplantation. With this option, new technology has allowed patients who meet the right criteria to receive a transplant from a donor who does not have the same blood type as them.

“The success of transplant has allowed us to look after patients who no one would have imagined transplanting even 15 years ago,” Dr. Zaltzman said.

In addition to the options available to patients, both Dr. Zaltzman and Dana Whitham, the clinical leader manager of the Kidney Transplant Program, note that its culture of excellence, camaraderie and collaboration with patients makes it special.

“Last year we created the tag line, ‘People Transplanting People,’ and I do really feel that it summarizes our team and what we bring to our patients,” Whitham said.

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The need for donors Despite the advancements in kidney transplantation over the past 50 years, more than 1,100 people in Ontario are waiting for a kidney transplant.

“People don’t think about their kidneys until it becomes a problem because many don’t understand that it’s a chronic illness,” Connelly said. “But the impact is quite devastating — it can affect people’s social and financial circumstances more than many other chronic diseases.”

She encourages everyone to at least consider registering to become an organ donor.

“The likelihood of actually needing a transplant is probably about 10 to 15 times greater than ever being an organ donor,” Dr. Zaltzman said. “It’s important to check your status as an organ donor online and make sure your family knows what your wishes are. In a time of tragedy, being able to donate a loved one’s organs is often something a family can hold onto as a fulfillment and meaning despite loss.”

Looking forward As the Transplant Program continues to grow at St. Michael’s, the team sees a bright future. Whitham hopes to see the program continue to deliver patient-centred care to its community.

“Our vision is to provide the best patient experience possible,” she said. “That means a smooth flow in clinic, with experienced clinicians who take the time to empower and educate our patients. One of the ways I see us achieving that goal is to elevate our education platform and extend our reach beyond St. Michael’s walls.”

For Dr. Ramesh Prasad, the director of the Kidney Transplant Program, the first 50 years are a solid foundation for the program to build on.

“I am extremely proud of the team and the culture we’ve built here together over the past 50 years, and I am both humbled and honoured to be part of it,” he said.

“With continued developments in organ donation and the collaboration of our new partners through Unity Health Toronto, I look forward to an even brighter future in transplant medicine through world-class patient care and cutting-edge research.”

Long-term Health after Kidney Donation

By Dr. Ramesh Prasad We are always seeking living kidney donors for our patients with kidney failure. The health of these patients is improved, often almost immediately after the transplant.

This improvement motivates many donors to donate.

Transplant patients are followed for many years after their transplant to ensure that the transplanted organ continues to function well and the recipient stays healthy. The donor is followed only for a few months, however, perhaps with one or two check-ups. The donor is then “released� from the transplant program, and all further follow-up is left to the donor along with their family physician. As a result there is a gap in knowledge about what happens to donors many years after their transplant. In the last decade many researchers have tried to gather more long-term data about donors. These data are needed both to reassure donors and recipients about the safety of living kidney donation, and also to better select living donors in the future. Most living organ donors are kidney donors, so Donor Medicine greatly interests Nephrologists.

Donor follow-up is important because their health consequences need to be fully known and there is a moral-ethical obligation to appropriately counsel future donors. At a recent meeting of nephrologists from around the world, it was discussed that donors seen less-thanannually pre-donation were also less seen post-donation.

Single men and those with no college education were especially at risk for not being seen regularly after their kidney donation, most likely because they could not be traced, or did not want to come for follow-up.

Another concern for donors is expense. In Canada, out-of-pocket costs are about $1254, not including lost productivity costs due to time away from work. Costs were especially high in spousal and directed donors.

A third concern is the quality of life in donors. Some donors experience significant fatigue after donation, and this can affect both physical and mental quality of life. Postdonation fatigue is predicted by young age, fatigue before

donation, and worse overall functioning, highlighting the need for taking a good pre-donation history. Sobering was that 14% experienced regret about donating 12 months later. There are clearly some donors who do not do well post-donation, and we need to do a better job and finding out in advance who these donors are.

What is the risk of donors getting kidney failure and needing dialysis or a transplant themselves? About 120,000 American living kidney donors contributed 218 cases of kidney failure by 11 years after donation. A higher risk for kidney failure was seen in men, those with a higher body mass index, and low kidney function to begin with. A higher risk was also seen in siblings, twins, and those with low socioeconomic status. Fortunately, however, the absolute risk of kidney failure remains low for everybody, well under 1 percent.

Should donors be smoking? Kidney function after donation was lower in smokers compared to nonsmokers, about 64 versus 67% of normal, and at 6 months after donation the risk of low kidney function defined as less than 60 percent was higher in smokers.

Therefore, it is important for donors to seriously consider stopping smoking as soon as possible.

Finally, in a study combining many studies (called a meta-analysis) comparing over 100,000 living donors to over 100,000 non-donors, there was no higher risk of mortality, heart disease, hypertension, diabetes, or psychosocial conditions. Diastolic blood pressure was higher by 1.5 mmHg, eGFR was lower, and the risk of kidney failure somewhat higher but still very low at less than 0.1 percent. The risk of preeclampsia from pregnancy was about double that of non-donors but again still under 1 percent. There was no increase in any other pregnancy complications.

In conclusion, kidney donation remains a safe procedure, as long as donors are carefully selected and they receive medical attention when needed. There are some changes to the body from donation, but these rarely affect overall health. More research on donors is of course needed. This is the least we can offer these wonderful people.

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Recommended Vaccines for Adult Candidates and Recipients of Kidney Transplant Post-Transplant

Vaccine

Pre Transplant

Haemophilus influenza type b (Hib)

Recommended

Recommended

Meningococcal quadrivalent conjugate

Routine use

Routine use

Hepatitis B

Recommended

Recommended

Human Papilloma Virus (HPV)

Routine use

Routine use

Tetanus

Routine use

Routine use

Diphtheria

Routine use

Routine use

Pertussis

Routine use

Routine use

Pneumococcal conjugate 13-valent

Recommended

Recommended

Pneumococcal polysaccharide

Recommended

Recommended

Polio (inactivated)

Routine use

Routine use

Influenza (inactivated)

Recommended (annually)

Recommended (annually)

(if not completed pre-transplant)

Recommended Live vaccines *Must be administered no sooner than 4 weeks pre-transplant Varicella

Recommended

Not recommended

Measles-mumps-rubella (MMR)

Recommended

Not recommended

Routine use

Not recommended

Routine use

Not recommended

Rotavirus Herpes Zoster Live Vaccine (Zostavax ) ®

*Smallpox vaccine is contraindicated both pre- and post- transplant

Common Questions Regarding Pre-Transplant Vaccines When should I receive the vaccines before my transplant?

Inactivated vaccines should be given at least 2 weeks before transplantation to optimize their effects. Live attenuated vaccines (eg. MMR, MMRV, varicella, zoster, rotavirus) should be given at least 4 weeks prior to transplantation to reduce the risk of disease caused by the vaccine strain.

Are these vaccines publically funded?

Most vaccines are publically funded. Full list with eligibility criteria can be found here: http://www.health.gov.on.ca/en/pro/programs/ immunization/docs/immunization_schedule.pdf

Who should be administering these vaccines?

Vaccines should be administered by your family doctor.

If you are on hemodialysis, your hemodialysis unit may provide you with the Hepatitis B vaccine.

Use only if indicated •

Japanese encephalitis

•

Rabies

•

Typhoid (inactivated)

•

Hepatitis A

•

Cholera/ETEC Traveller’s Diarrhea Vaccine (Dukoral®)

•

Influenza (live vaccine) – only pre-transplant

– BCG (live vaccine) – contraindicated unless potential benefit outweighs risk (only pre-transplant) – Yellow Fever (live vaccine) – only pre-tranplant

References: https://www.canada.ca/en/public-health/services/publications/healthy-living/ canadian-immunization-guide-part-3-vaccination-specific-populations/page-8-immunization-immunocompromised-persons.html#a22 http://www.health.gov.on.ca/en/pro/programs/immunization/docs/immunization_schedule.pdf

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Reflections on 30 years with the Transplant Program

By Maureen Connelly, BScN, RN Living Kidney Donor Coordinator

the surgery and the immunosuppression we used to give were doing extremely well.

I’ve seen the post transplant patient population grow from 250 patients to close to 2,000 patients. Our program is one of the biggest transplant programs in Canada and we are all very proud of that.

There have been a lot of exciting changes in the 30 years I have worked in the transplant clinic.

Transplant outcomes have improved dramatically, in part with improved surgical techniques and improved immunosuppressive drugs that we can tailor to the individual patient needs.

We have a lot of program 1sts that we are reflecting back on as we celebrate our 50th anniversary since the 1st kidney transplant was performed here in 1969.

Maureen Connelly

The first kidney transplant patients I looked after as a young nurse were in the late 1970’s when transplantation was relatively new. They were cared for in the acute care unit, and in isolation for six weeks. The outcomes were often quite poor with many transplants not working. It was really those early pioneers of transplant who were brave enough to consider it an option that paved the way for us to be able to learn from those experiences and be able to improve outcomes.

I clearly remember being on a night shift caring for a transplant recipient who was dying. I was so frustrated and said to one of the medical residents,” I don’t know why anyone would want a kidney transplant.” The resident just said very calmly, “You need to go to the transplant clinic to see how many patients are doing well with their transplants.”

That always stuck in the back of my mind. Years later I left the emergency trauma unit to work in the kidney transplant clinic. I saw the resident was right. The patients we saw in clinic who survived

We are the first program in Ontario and the second in Canada to offer laparoscopic or “key- hole” surgery to living kidney donors. This has allowed our living donors to have shorter hospital stays and faster return to work opportunities. Now we have one of the largest living kidney donor programs in Canada; another feat my living donor clinic colleagues and I are very proud of.

Years ago, donors were deemed ineligible to donate to their intended recipient if they were blood type incompatible or immune system incompatible. That has significantly changed. St. Michael’s was one of two transplant programs in Canada to be the 1st to pioneer the living kidney donor paired exchange program in partnership with Toronto General Hospital. Now the program is offered at every transplant program in Canada and the database matching registry is managed

by Canadian Blood Services. Paired exchange is when two separate but willing donors are each unable to donate to their intended recipients due to blood group (ABO) incompatibility or because of incompatibility of cross match blood testing. In this program the willing donors are matched with the other’s respective recipient so that each recipient can receive a kidney with a compatible living donor.

Continued on page 8

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Reflections on 30 years story from page 8

We are the first transplant program in North America to offer living donor kidney transplants with a blood type incompatible donor using a special treatment in advance of the transplant. It does require more intensive preparation for the transplant candidate including treatments with a special filter called Glycosorb. ™ The research on this option has shown promising results.

The courage with which our transplant recipients live meaningful lives while managing their ongoing kidney care is an inspiration to me. The kindness and generosity of our living kidney donors never fails to astound me.

The patients, my colleagues and the ever evolving landscape of transplantation keep me excited to come to work every day.

Patients celebrate St. Michael’s 50 year anniversary at special session of Connect & Learn

On April 26, approximately 100 post-transplant patients and family members gathered for a special session of Connect & Learn. Connect & Learn is an event series for post-transplant patients and their families to learn about transplant and network with other kidney recipients an event series hosted biannually. On April 26, attendees shared songs, photos, videos, dances and more to reflect the positive impact of transplant on their lives.

To find out more, visit www.stmichaelshospital.com/transplant/connectlearn.

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Through the Years...

Celebrating a year with new kidneys: In 1979, two strangers become connected through transplant at St. Michael’s: one deceased donor had donated each kidney to one of them.

She gets 300th photo: The Kidney Transplant program at St. Michael’s celebrates its 300th transplant when a woman donates her kidney to her sister in 1984.

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Through the Years...

Renal Transplant Team 1983

L to R: Family member, Mary Murphy,RN, Colleen Samalasingh of Etobicoke (500th kidney transplant recipient at St. Michael’s Hospital), Dr. Edward Cole and Maureen Connelly,RN

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Through the Years...

Canada’s First Kidney Paired Donation: St. Michael’s Hospital and Toronto General Hospital; 2006.

The first Transplant Digest Newsletter, 2006

Galo Meliton, RN providing information to dialysis staff at SMH, 2006.

SMH Transplant Program’s 40th anniversary. Dr. Prasad with other Medical Staff from SMH and UHN.

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Dr. Lee first surgeon in Canada doing the autotransplant on a damaged kidney using a robotic surgery at St. Michael’s Hospital, 2015.

Staff enjoying the experience in the simulation lab at Li Ka Shing Knowledge Institute, 2012.

Mina Kashani,RN and Fernanda Shamy, RN (Simulation Centre Lab at Li Ka Shing), 2012.

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Through the Years...

World Kidney Day 2019 Lucy Chen, BScPhm, PharmD, Care & Transitions Facilitator – Kidney Transplant/Diabetes

World Kidney Day 2009 L-R: Jenny Huckle,RN; Jill Campbell (Diabetes Comprehensive Care Program Director); Meriam JayomaAustria, RN and Thelma Carino, RN

Staff joining the Living Donor Appreciation Night 2015

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Dr. Jeff Zaltzman in 2015

Clinical and Research Staff 2019 1st row: Meriam Jayoma-Austria, RN; Dr. Darren Yuen; Galo Meliton,RN; Dr. Ramesh Prasad; Lucy Chen, PharmD; Dr. Michael Ordon and Michelle Gabriel, RN 2nd row: Francine Kwee, BscPhm; Weiqiu Yuan (Research); Maureen Connelly, RN; Kevin Bradley, RN; Sarah Mattok, RN; Dr. Ken Pace; Michelle Nash (Research Program Manager) and Suela Cela, MSW 3rd row: Niki Dacouris (IT); Dr. Jeff Zaltzman; Lindita Rapi (Research) and Dana Whitham (Transplant Program Manager)

Clerical and Admin Staff 2019 1st row: Michelle Gottwald, Ethlyne Courtney, Lynn Doak 2nd row: Mary Leger, Susie Par, Mona Udit, Katelande Lee, Patricia Zambri 3rd row: Camille Russell, Erin Irving, Elizabeth Couto, Orlene Bailey, Luisa Petruzzo-Kwok, Sheila Buencamino, Anna Mendoza, Marketa Schoralkova, Kamisha Richards

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Messages...

To be a partner of the SMH Transplant Program is to be given a gift. Whether a patient, family or allied health partner – we have all reaped tremendous benefits. Hundreds upon hundreds of lives have been saved and families given years upon years together because of the transplant program at SMH. We at Trillium Gift of Life Network (TGLN) have learned from SMH, we have been led by SMH, and we continue to be guided by all those at SMH who are and have long been the brilliant champions of donation and transplant. On behalf of all at TGLN – hearty congratulations on your 50th anniversary.

Wishing you many many more!

It is a great honour and pleasure to be part of the 50th Anniversary celebrations of the Kidney Transplant Program at St. Michael’s Hospital.

This program was built on the shoulders of clinical giants. During my 19 years at St. Michael’s so far, I have seen the program evolve further as a modern, innovative, and friendly place to work. I genuinely believe that the program always provides the best possible care that kidney transplant recipients and donors can expect anywhere in the world. We are people transplanting people.

Ramesh Prasad MBBS, MSc, MA, PhD, FRCPC, FACP, FASN, FASH, FAST Professor of Medicine, University of Toronto Director, Kidney Transplant Program, St. Michael’s Hospital

Ronnie Gavsie President and CEO Trillium Gift of Life Network

Congratulations to the Kidney Transplant Program!

Thank you for 50th years of dedication and service to our patients and for your knowledge and expertise in kidney transplant giving our patients with end stage kidney disease a life altering option. We are all very proud of this significant milestone in St. Michael’s history of providing exemplary and compassionate care to the patients we serve!

Sonya Canzian

Vice President Clinical Programs Chief Nursing & Health Disciplines Officer St. Michael’s Hospital and St. Joseph’s Health Centre Unity Health Toronto

We are very proud of the kidney transplant program at St. Michael’s Hospital and the tremendous impact it has had on the lives of our patients and families over the last 50 years. The staff and physicians in the program are true ambassadors for the mission and values of our hospital.

Dr. Thomas G. Parker Executive Vice President, Medical Affairs and Clinical Programs Unity Health Toronto

The fiftieth anniversary of the renal transplant program at St. Michael’s Hospital is a tremendous achievement! It demonstrate what we can accomplish when we work together: dialysis centres, progressive renal disease clinics, nephrologists, urologists (kidney transplant surgeons), nurses, social workers, dieticians, pharmacists, administrative staff, Trillium Gift of Life, and of course our tremendous kidney donors and transplant recipients!

Fifty years have seen enormous changes in immunosuppression drugs, transplant life span, and patient care, and St. Michael’s has been at the forefront of these changes. Just to name a few, these include: 1. The first laparoscopic donor nephrectomy program starting in 2000: this allowed donation surgery to be less painful with faster recovery times 2. An expansion in decease donor kidney transplants due to donation after cardiac death 3. ABO blood group incompatible transplants 4. A local, and now a national paired-exchange program 5. The first robotic-assisted renal autotransplant in Canada Kenneth Pace, MD, MSc, FRCSC Chair, St. Michael’s Hospital Medical Services Organization Vice Chief of Surgery Head, Division of Urology Researcher, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital

Congratulations to the Kidney Transplant Program for reaching an incredible milestone! From its humble beginnings to now being one of the largest and most respected transplant programs in country, it has been an incredible journey. A lot of things have changed in 50th years but what’s been maintained is the program’s reputation in providing high quality patient care. This program has transformed so many lives and it’s only the beginning. Cheers and here’s to another 50 years of excellence!

Jonathan Fetros Program Director Diabetes Comprehensive Care St. Michael’s Hospital Unity Health Toronto

‘Some things get better with age’ as the saying goes, and that is absolutely true of our transplant program. Our team continuously strives to improve. We aim to improve the experience of our patients. We look for ways to be innovative and efficient. We are thrilled to share our anniversary with all of you this year and want to thank each and every one of you for helping us age so well!

Dana Whitham, RD MSc Clinical Leader Manager Centre for Diabetes and Endocrinology Kidney Transplant Program Ophthalmology Clinics St. Michael’s Hospital Unity Health Toronto

Messages...

Congratulations to the Nephrologists, associated Physicians and Staff of the Renal Transplant Team at St Michael’s Hospital for 50 years of amazing achievements in scientific advancements and patient care providing hope and a new lease on life for many fortunate individuals and their families!

With gratitude and many thanks for over twenty years of unwavering partnership and collaboration with the Scarborough Regional Nephrology Program and its patients who have immeasurably benefited from our relationship.

The Nephrologists and Staff of the Scarborough Regional Nephrology Program

Congratulations on such an amazing milestone!

This is a great moment to reflect on all the lives this program has positively impacted. I am proud to say that I am a member of this program and to have the privilege of working with such a dedicated, compassionate, and expert team.

Happy anniversary – I’m looking forward to the next 50th years!

Art Jerome (AJ) Lopez, RN, MN/MHSc, CHE Clinical Leader Manager – Nursing Resource Team; Nephrology and Urology Inpatient Unit; and ENT Clinic St. Michael’s Hospital Unity Health Toronto

Wow !!! Half a Century for St. Michael’s Kidney Transplant Program.

Congratulations to the current Team and all those who contributed to the program’s success over the past 50th years. You have made a difference in the lives of so many.

Celebrate with pride.

Elizabeth (Liz) Anderson Clinical Leader Manager Multi-Care Kidney Clinic Home and Satellite Dialysis Clinics, St. Michael’s Hospital

FOCUS T H E C A M PA I G N F O R S T. M I C H A E L’ S T R A N S P L A N T AND KIDNEY CARE CENTRE

IMAGINE IF THE WORLD-CLASS CARE YOU R E C E I V E AT S T. M I C H A E L’ S H O S P I TA L C O U L D B E M AT C H E D B Y A N E W S TAT E- O F -T H E- A R T FA C I L I T Y.

THAT ’S THE PLAN. We are launching a $7 million fundraising campaign to build a physical space that provides greater comfort to our patients and enables us to invest in research that will stop kidney disease from impacting any more lives.

We have the rare opportunity to build a new facility on the eighth floor.

With your support, we will create the centre that our patients deserve.

Please join us.

416.864.5000 | stmichaelsfoundation.com

Integrity

Innovation

Partnership

Education

OUR VISION

Collaboration

Best options.

Best outcomes.

Best experience.

Dedication Â

Quality

Leadership

People Transplanting People Thank you to all our health care partners!!!

Kidney Transplant Program People transplanting people