Héma-Québec soon to be the only distributor of human tissues in the province

The logo for Hema Quebec is seen at a clinic Thursday, November 29, 2012 in Montreal. (Ryan Remiorz, The Canadian Press)

In addition to having a monopoly on blood products in the province, Héma-Québec will soon be the sole distributor of human tissues for all Quebec hospitals.

It will add this new string to its bow in December 2024.

The Health and Social Services Ministry granted the mandate, and hospitals have already been notified that Héma-Québec will soon be solely responsible for tissue distribution. The organization has been involved in tissue harvesting and processing since 2001.

Some hospitals contact Héma-Québec to place their orders, or turn elsewhere if the organization is unable to supply the tissue requested. In other cases, hospitals have the task of identifying suppliers and negotiating with them to obtain supplies.

Approximately 50-60 per cent of all tissues used in Quebec's hospital network come from donors harvested and prepared by Héma-Québec. The rest comes from suppliers outside Quebec, mainly on the American market.

Starting in December, "hospitals will no longer have to look left and right" for the tissues they need. Héma-Québec will be responsible for identifying suppliers and ensuring product quality and safety.

The primary aim of centralizing distribution is to ensure complete traceability of all human tissues used in hospitals, as has already been done for several years for blood products.

"In terms of the obvious impact on patients, there won't be any, except that they'll be able to be reassured that the tissues used for a transplant have been validated, that they come from a reliable source and that the quality will be there," said Marc Germain, vice-president, Medical Affairs and Innovation at Héma-Québec. "And if there is a quality issue, Héma-Québec will be there to conduct the necessary investigations to identify the source of the problem and correct the situation if necessary."

Human tissues do not have the same requirements as organs.

Unlike organs, they must not be harvested while the heart is still beating or immediately after cardiac circulation has stopped.

"We have up to 24 hours after cessation of vital functions to harvest tissue," says Germain. "Nor do we have to worry about rejection by the recipient, because the tissues are not very vascularized. There is some immune reaction, but it's nowhere near what we see with organs."

This means that there is a much larger pool of potential donors for human tissues than for organs. Around 30-50 per cent of deceased people can provide suitable tissue for a transplant, compared with 1.5 per cent for organs, Germain said.

When it comes to human tissues, the most widely used in the health-care network are corneas - which were very rarely transplanted in Quebec ten years ago. The others are skins, which save the lives of burn victims; bones, which are often used in orthopaedic surgery for hip replacements; among other things; tendons, mainly used in sports medicine, as well as heart and lung valves.

There is no waiting list problem for the majority of human tissues, with the exception of pulmonary valves, which are increasingly used by surgeons who are abandoning artificial valves for all sorts of advantages.

"We have begun to identify American suppliers who may have surplus pulmonary valves to supply the Quebec network," said Germain. "If there is a wait (for tissue), it has more to do with the fact that it takes up space in the operating room, but it's not because there's a shortage of tissue that this type of surgery is generally delayed."

This report by The Canadian Press was first published in French on April 26, 2024.

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