Trainee Spotlight: Katya Loban
We are thrilled to congratulate Katya Loban on her outstanding achievements! Katya will be presenting three abstracts at upcoming conferences: the Canadian Association for Health Services and Policy Research (CAHSPR) 2023 Conference, to be held in Montreal from May 29-31, 2023, and the American Transplant Congress, to be held in San Diego from June 3-7, 2023.
At the CAHSPR conference, Katya will be giving an oral presentation on living kidney donation entitled: “Thank you for your kidney, good-bye.”: The Canadian living kidney donor perspective. At the American Transplant Congress, she will participate in an oral presentation entitled “Are We Providing Optimal Care, Information, and Support to Living Kidney Donors? A Qualitative Study.” In addition, Katya will present a poster on “What I Desire from My Family Physician: The Living Kidney Donor Perspective.“
These presentations at such prestigious conferences are a testament to Katya’s hard work, dedication, and expertise in the field of healthcare. We applaud her achievements and look forward to hearing the valuable insights she will undoubtedly contribute.
Congratulations, Katya!
About Katya Loban
Katya Loban is a health services researcher. She is a postdoctoral fellow at the Research Institute of the McGill University Health Centre and the Department of Medicine of McGill University, working under the supervision of Dr. Shaifali Sandal. Katya is also a trainee with the Canadian Donation and Transplantation Research Program (CDTRP). Katya holds a PhD in Family Medicine and Primary Care, an LLM in International Dispute Resolution and an MA in Organization Development. She has 14 years of professional experience in the areas of international project management and research administration. Katya’s areas of interest include multi-stakeholder partnerships, inter-professional collaboration, the organizational aspects of health care and medical law and ethics. The aim of her current postdoctoral project is to explore the integration of primary care into the living donation trajectory, to optimize the care of living kidney donors.
Abstract for the Canadian Association for Health Services and Policy Research (CAHSPR) 2023 Conference
“Thank you for your kidney, good-bye.”: The Canadian living kidney donor perspective
K. Loban, J-T. Robert, P. Nugus, C. Rodriguez, S. Sandal
Background and objectives: Living donor kidney transplantation saves the Canadian healthcare system millions of dollars in averted dialysis costs, is the best treatment for kidney failure, and helps to narrow the persistent gap between the demand and supply of organs. Evidence suggests that this process is fraught with challenges for living kidney donors (LKDs). We aimed to obtain the perspectives of LKDs on their healthcare throughout the donation trajectory, with a focus on the role of primary care.
Approach: This was a qualitative descriptive study, entailing 49 semi-structured interviews with LKDs. Adult male and female participants who spoke English or French and donated their kidney to someone they knew or anyone in need prior to 2020 were recruited via social media and email rosters from seven transplant jurisdictions in Canada. Interviews were conducted in person or via zoom. Interview questions related to perceived gaps in the provision of information on donation, experiences pre- and post-donation and the coordination of care among different healthcare providers. Data were analyzed using inductive content analysis.
Results: LKD care lies at the intersection of primary and transplant care. Our analysis revealed: 1) variability in health information provision, 2) poor coordination between levels of care, and 3) gaps in post-donation care accessibility and comprehensiveness. Post-donation, most donors were under the care of their family physicians, some had limited annual follow-ups with transplant teams, and a minority of donors lacked access to care altogether. Many donors felt abandoned by the transplant teams. Those LKDs who felt “healthy” perceived follow-up by family physicians as acceptable, although many noted significant gaps in the knowledge of family physicians regarding LKD care. A key challenge identified was a lack of ongoing support for mental health
Conclusion: This study suggests that in Canada, a country with universal health care, LKDs have unmet needs. Its results underscore the need for stronger integrative models of primary and tertiary care, with the living donor at their core. In addition, targeted medical education initiatives for primary care practitioners are needed.
Abstracts for the American Transplant Congress
Are we providing optimal care, information, and support to living kidney donors? A qualitative study
K. Loban, J-T. Robert, H. Badenoch, A. Bugeja, P. Nugus, C. Rodriguez, S. Sandal
Purpose: Living kidney donors (LKDs) experience several challenges when pursuing donation and their follow-up care is suboptimal. Data from the US have demonstrated that many centers are not in compliance with the Organ Procurement and Transplantation Network/United Network for Organ Sharing mandated follow-up of LKDs and that lack of health insurance may play a role. Thus, we wanted to explore the experiences and needs of LKDs in Canada as they transition through the five phases of their donation trajectory.
Methods: This was a pan-Canadian qualitative descriptive study, entailing 49 semi-structured interviews with LKDs who were recruited via social media or email rosters. Data were analyzed using inductive thematic analysis.
Results: Participants reported: 1) unmet health information needs prior to donation, 2) poor coordination and lack of continuity between primary care and transplant teams, 3) inconsistency in post-donation care protocols, 4) challenges with access to care post-donation, and 5) suboptimal long-term follow-up. Post-donation most donors were under the care of their family physicians, some had annual follow-ups with transplant teams exclusively for monitoring remaining kidney function, and a minority of donors lacked access to care altogether. Many donors often felt abandoned by the transplant teams post-donation, particularly in light of very intense screening and evaluation leading to surgery. Those LKDs who felt “healthy” perceived follow-up by family physicians as acceptable, although many noted significant gaps in the knowledge of family physicians regarding donor care. A key challenge identified by nearly all donors was a lack of ongoing support for mental health.
Conclusions: We report that even in a country with universal health care, LKDs have unmet needs. Our data can inform targeted multi-disciplinary interventions to improve care coordination, facilitate early detection of problem symptoms and enhance the experiences of LKDs which would, ultimately, lead to better short- and long-term patient outcomes.
“What I desire from my family physician”: the living kidney donor perspective
K. Loban, J-T. Robert, H. Badenoch, P. Nugus, C. Rodriguez, S. Sandal
Purpose: In the US, transplant centers are mandated by the Organ Procurement and Transplantation Network (OPTN) to follow living kidney donors (LKDs) for two years after donation, yet a majority of LKDs are lost to follow-up. LKDs are healthy individuals whose main health care contact prior to and after donation are primary care practitioners, such as family physicians (FPs). Better engagement of FPs can inform improved compliance with the OPTN policy as well as optimal long-term care of LKDs. We aimed to obtain the perspectives of LKDs on the role of FPs pre- and post-donation.
Methods: This was a pan-Canadian qualitative descriptive study that aimed to obtain the perspectives of LKDs. We chose Canada as the setting for this study as lack of insurance is not a major barrier to access care. We conducted 49 semi-structured interviews with LKDs who were recruited via social media or email rosters. Data were analyzed using thematic analysis.
Results: Having a FP was a prerequisite for being a LKD for most transplant programs. Post-donation, most LKDs were under the care of their FPs. In practice, the role of FPs was confined to occasional pre-donation physical screening and limited long-term follow-up. Participants reported poor coordination between primary and transplant care and significant gaps in the knowledge of FPs regarding living donation and long-term donor care. A few stated that their FPs implicitly or explicitly discouraged donation. Desired roles for FPs included health information brokerage, mental health support and long-term kidney function monitoring. Some illustrative quotes are highlighted in Table 1.
Conclusions: We have identified several opportunities for improving long-term donor follow-up and care much beyond the two-year mandate from the OPTN. Given that LKDs are generally under the care of a FP pre- and post-donation, targeted medical education initiatives and stronger integrative models of primary and tertiary care are needed.
ity of Alberta and has received training in patient-oriented research through the University of Calgary’s PACER (Patient and Community Engagement Research) Program. He is the Patient, Family, and Donor Partnerships & Education Manager with the Canadian Donation and Transplantation Research Program. In this role, Manuel builds relationships patient partners with investigators and strengthens capacity among CDTRP patient partners.
Anders Billström 
Gareth Wiltshire
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Sherrie Logan 
born and raised in Edmonton, AB. With a degree in Music Performance (saxophone performance) and Education, Lindsey has taught for over a decade in the Edmonton Public School system. When she is not teaching, she is very involved in the music community, performing in the Edmonton Winds, conducting her own community ensemble (The Beer League Band) and on numerous musical boards across the province. For the past 5 years, Lindsey has had to take a break from teaching after having her amazing son, George. Maternity leave did not goes as expected as George was diagnosed with Dilated Cardiomyopathy at 5 months old and required 2 heart transplants before the age of 4. During this time, Lindsey has also began to dedicate her time building and expanding her charity: Big Gifts for Little Lives, where they raise money to fund Pediatric Heart Transplant research at the Stollery.
Dr. Caigan Du is a scientist at the Vancouver Coastal Health Research Institute and an assistant professor in the Department of Urologic Sciences at the University of British Columbia. He received a Ph.D. degree in Biochemistry in UK and postdoctoral training in Immunology in USA. He is interested in the pathogenesis of kidney ischemia-reperfusion injury and transplant rejection, and molecular control of urinary malignancies. He has been studying the impact of kidney donor-derived factors on renal allograft rejection, and the molecular pathways of kidney injury and regeneration in experimental models. He is also interested in developing medical solution including drugs made from natural compounds for all kinds of health problems, including immune disorders, organ preservation, kidney failure and urinary cancer. He is the PI of many grant supports from the Kidney Foundation of Canada and the Canadian Institutes of Health Research.
Heather Badenoch is a non-directed living liver donor and communications strategist. As the president of Village PR, she provides strategic communications direction and training to not-for-profit clients in community and health. An active transplant volunteer, Heather helps transplant candidates find living donors by running their public appeals, small and large, pro-bono. She also mentors potential living donors on the path to living donation. Heather is a volunteer with the UHN Centre for Living Organ Donation and the Canadian Donation and Transplant Research Program. She and her spouse adopt rescue dogs and volunteer together with Community Veterinary Outreach, a group providing free veterinary care to the pets of people who are homeless.
Sean Dicks is a clinical psychologist who has 20 years’ experience supporting both families of organ donors and transplant recipients. While it is rare for him to have contact with a donor family and recipient linked to the same organ donation-transplantation event, his contact with families who have lived experience with organ donation on the one hand, and patients who have received transplants on the other hand has provided opportunities to explore how their journeys become linked when they attempt to make sense of and find meaning in their respective crises.
Terri Hansen-Gardiner is a Cree speaking Metis woman from Northern Saskatchewan as well as a 10 year Breast Cancer Survivor. Her tireless spirit and dedication to her community is undeniable. Terri is a cancer survivor who travels around the province to provide assistance, information, and support to Indigenous patients who are trying to access and navigate the cancer care system.
Dr. Golnaz Karoubi is Assistant Scientist at the Toronto General HospitalResearch Institute and principal investigator in the Latner Thoracic Research Labs. She currently holds an Assistant Professor appointment in the department of Laboratory Medicine and Pathobiology and a cross-appointment in the department of Mechanical and Industrial Engineering at the University of Toronto. Dr. Karoubi received her PhD in Applied Science and Engineering at the University of Toronto and joined the Lung Regenerative Medicine Program in the Department of Clinical Research in Berne University, Switzerland for a post-doctoral research fellowship. She stayed on as a Group Leader in 2008 to direct the basic and transitional science as related to Cancer Stem Cell and Lung Regenerative Medicine in the Department of Biomedical Research at the University of Berne until 2012. In early 2012, she joined the team of Dr. Tom Waddell at the Toronto General Hospital Research Institute as a Senior Scientific Associate and was appointed to Assistant Scientist at the Toronto General Hospital Research Institute (University Health Network) in November 2019 and to Assistant Professor in the Department of Laboratory Medicine and Pathobiology in July 2020.
Dr. Haykal graduated from the University of Ottawa Faculty of Medicine in2007 as class valedictorian and silver medalist, and subsequently completed her residency training in Plastic and Reconstructive Surgery at the University of Toronto in 2016. During her residency, she completed a four-year Doctorate of Philosophy (PhD) in tissue engineering, regenerative medicine and immunology with a focus on tracheal reconstruction. She obtained numerous grants and awards including a CIHR Vanier Scholarship. Dr. Haykal then pursued fellowship training in microsurgical reconstruction at the Albany Medical Centre in New York. Dr. Haykal joined the University Health Network and the Toronto General Hospital in 2018. Her clinical focus is on complex oncological reconstruction and microsurgical reconstruction of the breast, head and neck and extremity. She started a lymphedema program in 2019 where she offers microsurgical techniques for the treatment of lymphedema.
Dr. Ahmed is a Professor in the Cumming School of Medicine at the University of Calgary. The recipient of the 2022 Hypertension Canada Senior Investigator Award, she is a nephrologist and clinician-scientist with a focus on sex and gender differences in human cardiovascular/kidney physiology and clinical outcomes. Dr. Ahmed is the Vice Chair (Research) for the Department of Medicine, Lead of the Libin Institute Women’s Cardiovascular Health Research Initiative at the University of Calgary and Lead of the Alberta Strategy for Patient Oriented Research Capacity Development Platform. Dr. Ahmed is an Advisory Board member for the Canadian Institutes of Health Research Institute of Gender and Health, a member of the Canadian Medical Association Journal Governing Council and the President-Elect for the Organization for the Study of Sex Differences.
r. Christopher Nguan is an Associate Professor at the University of British Columbia in the Department of Urological Sciences, Surgical Head of Kidney Transplantation at Vancouver General Hospital and the Director of the Surgical Technologies Experimental Laboratory & Advanced Robotics (STELLAR) facility at Vancouver General Hospital.
r Caroline Lamarche is a clinician scientist and transplant nephrologist at Maisonneuve-Rosemont Hospital. She is an assistant clinical professor at the Université de Montréal. After her nephrology training at the Université de Montréal (2015), she completed a Master degree on the use of adoptive immunotherapy to treat/prevent BK nephropathy in kidney transplant recipients. She then pursued a post-doctoral fellowship with Dr. Megan Levings at the University of British Columbia on the use of chimeric antigen receptor (CAR) regulatory T cells (Tregs) to induce transplant tolerance. Her lab is working on the development of adoptive immunotherapy in nephrology and understanding Treg dysfunction.
Dr. Tandon is an Associate Professor of Medicine, Co-Director of the Cirrhosis Care Clinic, Transplant Hepatologist and lead of the Cirrhosis Care Alberta quality improvement program. She obtained her training at the University of Alberta, the Hospital Clinic in Barcelona and Yale University. Her clinical practice and research are focused on cirrhosis with research interests including cirrhosis related complications, malnutrition, frailty, exercise therapy, palliative care, integrative health approaches such as meditation and knowledge translation. It is her career goal to provide wholistic, interdisciplinary, evidence based, patient-centered care through education, empowerment, engagement and team-work.
Emily is a PhD student at the University of Alberta, where she completed her Master of Science (MSc) degree in medicine. With a passion for patient-oriented research and a commitment to improving health outcomes, Emily’s doctoral project focuses on EMPOWER, a 12-week online mind-body wellness program designed for adults living with chronic health conditions.
Dr Basil S. Nasir, M.B.B.Ch
Dr. Victor Ferreira is an Assistant Scientist in the Ajmera Transplant Centre at the University Health Network (UHN) and the Toronto General Hospital Research Institute (TGHRI). He is also an Assistant Professor at the University of Toronto in the Department of Laboratory Medicine and Pathobiology (LMP). He completed his PhD in Medical Sciences – Infection and Immunity Specialization at McMaster University in 2014 and post-doctoral training at UHN. His research program is focused on three pillars: I) using systems vaccinology to reveal insights into vaccine responses in immunocompromised individuals like transplant recipients; II) characterizing the impact of chronic viral infection on host immune responses; and III) developing novel methods for eliminating latent viruses in human organs. His work has been cited >2,500 times and is published in journals including the New England Journal of Medicine, Nature Immunology, the Lancet Infectious Diseases, Clinical Infectious Diseases, the American Journal of Transplantation and Journal of Infectious Diseases.