The number of organ donations more than doubled in two years in the province, but many Manitobans continue to decline end-of-life donation requests on behalf of family members because they haven't discussed the idea.
Thanks to a mandatory referral policy introduced in 2014 by the Winnipeg Regional Health Authority, donations rose from 35.1 per cent that year to 74.3 per cent in 2016.
"Our target is 90 per cent and beyond and we are working hard with our hospital partners to achieve this goal," Dr. Adrian Robertson, medical director of the Gift of Life program, said in a statement.
The mandatory policy made it routine for medical professionals working in intensive care units and emergency rooms to notify Transplant Manitoba's Gift of Life program about a suitable donor whose family had decided to pull life support.
Dr. Faisal Siddiqui, program director of critical care medicine at the University of Manitoba, said the rise in donations is encouraging, but many families continue to say no to transplants because they don't really know what their dying relative wanted.
According to Gift of Life program, nearly half of the Manitobans who declined organ donation between 2014 and 2016 did so because they weren't clear on their family member's wishes.
"The most important thing is that discussion with your family," Siddiqui said. "People sometimes mention things in passing to their family [but] those kinds memories don't come up at the time when the patient's illness has gotten to a point where there's very little hope of recovery."
Close to 90 per cent of Manitoba families support organ donation when they've discussed the issue and learned about their loved one's wishes, according to Transplant Manitoba.
"Tell your family what you want," Siddiqui said. "At a time when you may not be able to communicate that information to your family, them knowing your wishes helps families understand that they are doing the right thing for you and your wishes."
Under the new policy, a record total of 57 kidneys were transplanted into patients at Winnipeg's Health Sciences Centre last year. Of those, 25 came from living donors and six kidneys came from three donors after cardio-circulatory death — meaning after the heart has stopped beating.
In a move to boost donation rates as much as 25 per cent, former Manitoba health minister Sharon Blady helped push through a separate though related policy in 2016 that allows for organ donation following cardio-circulatory death. That built on previous guidelines that only allowed for organs to be harvested in patients deemed brain dead.
"By offering [donation after cardio-circulatory death] and ensuring the care team and the donation team work together, we are giving Manitobans the right support to decide if donation is an option," Manitoba Health Minister Kelvin Goertzen said in a statement.
Manitobans can declare end of life organ donation wishes on the Sign Up for Life website. That information is then shared with family in the event of a death.
More than 19,000 people are currently registered with the program.
"It's never really a question about convincing people to donate more, it's making sure the people who have that wish, and that desire, to make sure that their wishes are honoured at the end of their life when they are in a situation where they could donate," Siddiqui said.