Héma-Québec's role : from referral to transplanting

Héma-Québec is responsible for supplying human tissues to the hospitals in Quebec’s health care system. This means that the team ensures the smooth operation of the donor qualification activities and the human tissue collecting, processing, and distributing activities, all in keeping with the strictest quality standards in order to provide safe grafts and reduce the risk associated with communicable diseases.

1. Referral

As part of its activities involving human tissues, Héma-Québec must raise health care workers’ awareness of the importance of identifying and referring potential donors. These recommendations are paramount to more definitely ensuring an adequate supply.

Section 204.1 of the AHSSS, facilitating organ and tissue donations, provides that the director of professional services of an institution operating a general and specialized hospital, when informed of the recent death of a potential organ or tissue donor, must diligently identify him/her, refer him/her, and send any necessary medical information about that person to Héma-Québec.

Therefore, the role of the health care staff at every institution is to be sure to identify potential tissue donors and refer them to Héma-Québec. Your contribution is vital.

To assist you in this process, Héma-Québec has made tools available to give you some independence in the identification and referral process.

View identification and recommendation tools

2. Consent

Once you have referred a potential donor to Héma-Québec, they do the usual checks in the consent registries of the Régie de l’assurance maladie du Québec (RAMQ) and the Chambre des notaires du Québec (CNQ).

After both registries have been checked, the hospital staff will be informed by phone of the presence or absence of consent or refusal.

If a refusal exists in the CNQ’s register, the process ends. If a consent exists in the registries, the responsible person at the hospital informs the family that a member of Héma-Québec’s team will contact them. If there is no consent in the registries, the responsible person at the hospital presents the family with the donation option and offers the support of a member of Héma-Québec’s team. If the family refuses, the process ends. If the family consents, the responsible person at the hospital informs the family that Héma-Québec will contact them.

The donor qualification process is initiated as soon as the family gives its consents to human tissue donation.

3. Qualification

Héma-Québec continues to meet the highest standards in order to provide safe grafts and reduce the risk associated with communicable diseases. Its donor qualification process consists of:

• a medical/social questionnaire to be filled out along with the loved ones;
• a review of the medical record;
• the hemodilution calculation;
• a physical examination;
• screening tests for communicable diseases;
• a full technical review by the medical director and the quality assurance staff.

4. Collection

The collecting is done in facilities specially designed for this purpose, at Héma-Québec or in a hospital operating room. It is carried out in keeping with strict procedures and in compliance with Health Canada’s standards and with the standards of the various recognized regulatory agencies.

Héma-Québec has an operating room specially laid out for collecting human tissues (cleanroom classified as ISO 8 under ISO 14644-1).

5. Processing and preservation

Control of bacterial contamination

Strict measures are applied to minimize the risk of bacterial contamination:

• aseptic collection;
• bacteriological tests;
• preparation of the tissues in “cleanrooms”;
• final decontamination of musculoskeletal tissues through irradiation;
• antibiotic soaking of valve and skin grafts;
• preservation methods for maintaining tissue asepsis.

Asepsie

The processing of human tissue is done entirely in Héma-Québec’s laboratories. The products are processes in cleanrooms (classified as ISO 5 and ISO 7), in an environment where the air quality is strictly controlled, so as to minimize the risk of bacterial contamination.

Decontamination

All products are subjected to a decontamination phase. Musculoskeletal products undergo a final gamma-ray irradiation treatment. Valve and skin products are soaked in a solution containing antibiotics.

6. Distribution

Héma-Québec takes all measures necessary to ship products as soon as possible, regardless of the circumstances. Depending on the preservation conditions required, products are sent frozen, at room temperature, or by cryogenic container. As such, grafts are sent to the health care professionals who will use them as required and in the manner prescribed, under optimal safe conditions.

As of December 2, 2024, Héma-Québec will act as the sole distributor of human tissues for all the needs of the Quebec health care system. .