A Life Changing Choice: A liver for Karla: 'I'm healthy. I can move. I can dance!'

EDITOR'S NOTE: This series was produced by veteran CTV Atlantic Anchor & Reporter Bruce Frisko, documenting his sister's successful liver transplant surgery in May of 2022. Karla Frisko found a match in Scott Watson, a co-worker who was inspired to sign up for living donor testing after hearing her story. Although liver transplants are performed across Canada, living donor programs are not available in some provinces.

It's the second weekend of October. With the summer heat largely behind us, and the Saskatchewan harvest mostly complete, Karla Frisko plays host in Regina to the man who saved her life, and his husband.

The occasion is a wedding: our niece Lindsay and her groom, Braden.

It's a big event in our small family, and Karla's well aware she likely wouldn't be here to see it, were it not for Scott Watson.

"Gratefully, I'm here," she said in a pre-wedding interview. "I'm able to finally travel. Leave the province. I'm healthy. I can move. I can dance."

Scott, too, would offer some final thoughts on the process and the experience.

"I would say ‘Don't be afraid,’” he said. "It's not easy. I will never say that this was an easy process, or it was a painless process, but it is a life-changing, life-altering experience for both your recipient and for yourself.”

Liver transplants are performed everywhere in Canada, although pediatric procedures are limited to some larger centres.

According to the Canadian Liver Foundation, the majority of Canadians have access to Living Donor Programs, although B.C.'s is inactive at the moment.

The program is also not available in Quebec or Atlantic Canada.

"The reason we haven't done it here is because we haven't needed it from a volume perspective up to this point in time," said Dr. Scott Livingstone in a post-surgery interview on a cold November day outside the Victoria Building at the QEII Health Sciences Centre in Halifax.

Even with Nova Scotia becoming the first jurisdiction in Canada to adopt presumed consent for organ donation almost two years ago, Livingstone is concerned the number of donors has been dropping off since the pandemic.

Few understand the system better than Livingstone does: he's both a transplant surgeon and a recipient -- he got his third liver in 2019.

"You rarely meet a person who's received an organ who isn't extremely grateful for that gift, and it become a huge part of their personal self-identification -- people who've received a solid organ transplant as well," said Livingstone.

But the need for solid organ transplants is always greater than the supply.

"This is a challenge for most in search of liver transplant options, and that inherently means that for people in marginalized communities, the challenge is even greater," said the Canadian Liver Foundation's Senior Manager of Support and Education Nem Maksimovic in an email.

" I strongly believe that there is a need for more liver transplant programs in Canada, but the real solutions to the challenges are much more complicated and multi-faceted. In order to properly address this issue, you would need to tackle it from many different perspectives: prevention, organ donation, health-care system."

Maksimovic went on to provide the points below:

• Prevention – The best way to reduce the need for a liver transplant is to prevent someone from getting to the stage where they would need a transplant. This is not always possible, and it’s easier said than done, but this is a big step towards reducing the need for liver transplants. This would include prevention of some of the leading forms of chronic liver disease such as hepatitis B, hepatitis C, fatty liver disease, alcohol-related liver disease, etc. The other part of “prevention” is through early diagnosis and treatment of liver disease. Earlier diagnosis and treatment can slow down progression of the disease thereby reducing the need for a liver transplant due to liver failure. Individuals with an autoimmune liver disease, such as your sister with PSC, might be slowed down with early diagnosis and treatment, but progression to liver transplant cannot always be prevented.
   
• Organ donation – Increasing the rate of organ donation in Canada would also be helpful as the need for organ transplants far outpaces the supply of organs. Again, this is another easier said than done scenario. One aspect would entail greater public education (i.e.: address concerns about organ donation, encourage people to register to be an organ donor and have family consent, raising awareness of living organ donation, etc.). Another aspect would be consideration of a change in public policy re: organ donation (i.e. presumed consent legislation approved in Nova Scotia).

For her part, Karla would like to see Nova Scotia's presumed consent legislation greatly expanded.

"In all other Canadian provinces, Canadians must register to donate," she said to me via text message.

"At the end of the day, 90 per cent of Canadians indicate that they want to be an organ donor, but only 30 per cent have actually registered."

"I don’t know why we don’t have presumed consent across the country, or at least a national registry, so that when somebody dies and there are viable organs that can be donated, they go to somebody and they’re not wasted."

In the meantime, during that October weekend in Punnichy, Saskatchewan -- Thanksgiving of course. As we all celebrated Lindsay and Braden, we had another reason to be thankful: Karla was, and continues to be, with us.

Later, as the harvest moon rose in the night sky, Karla shared a dance with Scott, the man who saved her life, and earned our eternal gratitude at the same time.

The priceless gift of a new beginning in a season of thanks.