Despite progress, Canada’s organ supply still isn’t meeting demand: CIHI

In 2018, there were 2,782 organ transplant procedures performed in Canada, according to the latest information published by the Canadian Institute for Health Information (CIHI). This is an increase of 33% since 2009. Despite this progress, Canada still has a shortage of organs for transplant. At the end of 2018, there were 4,351 people on wait lists for organ transplants (2,890 active and 1,461 on hold). Additionally, 223 people died that year while on a wait list for an organ transplant.

The increased need for organ transplantation is in part being driven by the rising number of Canadians diagnosed with end-stage kidney disease, which went up 32% over the 10 years studied.

“Improved organ donation practices across Canada have resulted in a 33% increase in transplant procedures over the last decade. However, more than 4,000 Canadians are still on a waiting list for a transplant, and many die each year while waiting,” said Greg Webster, CIHI’s director of Acute and Ambulatory Care Information Services. “We know that organ transplants save lives. For most organs, patient survival is greater than 80% after 5 years.”

CIHI also provides information on types of donors. Last year, there were 555 living donors (people who donated a kidney or a lobe of liver) and 762 deceased donors in Canada. The number of deceased donors increased by 56% between 2009 and 2018, whereas the number of living donors remained stable.

System changes increase donation after cardiac death

Due to organ shortages, many countries have expanded deceased organ donation practice beyond brain death cases to include donation after cardiac death (DCD) — meaning the heart has permanently stopped beating. In Canada, DCD has been practised since 2006. This has led to an increase of almost 430% in the number of DCD organs used for transplantation, from 42 in 2009 to 222 in 2018.

Although Canada is seeing more DCD donors, there is considerable variation in the type of organs being transplanted: liver, heart and pancreas had fewer to no organs used from DCD donors compared with kidney and lung.

“There are many factors that come into play when determining which organs are suitable to transplant into a patient. With the increase in donation after cardiac death, we have seen a substantial increase in the number of organ donors in Canada, and this has shortened wait times, particularly for those waiting for kidney or lung transplants,” said Dr. Jagbir Gill, transplant nephrologist and associate professor of medicine at the University of British Columbia. “DCD transplants of other organs like hearts is a bit more variable due to the complex nature of determining organ suitability for transplantation. As more experience in this area grows, we hope to see gains in DCD transplants in all organ groups as well as improved access to transplantation.”

Progress is also being made on the number of donors after brain death (NDD, or neurological determination of death). From 2009 to 2018, NDD donors increased by 21%. An increase in deceased donor rates is promising because 1 deceased donor can provide up to 8 organs for transplantation.

Organ donation by the numbers

This information is published in CIHI’s annual Canadian Organ Replacement Register report, which includes statistics on all donations for kidney, heart, lung, liver, pancreas and intestine transplantations. The 2018 highlights include the following:

  • Kidneys (1,706) and livers (533) were the top organs transplanted, followed by lungs (361), hearts (189) and pancreases (57).
  • As of December 31, 2018, more patients were on wait lists for kidneys (3,150) and livers (527), compared with lungs (270), hearts (157) and pancreases (156).
  • Of the 762 deceased organ donors, 60% were male. Of the 555 living organ donors, 63% were female.
  • For deceased donors, the average number of organs used for transplantation was 3 for all donors and 4 for donors age 39 and younger.

Canadian health systems rely on organ donations to help save the lives of those in need. The release of CIHI’s organ donation data is an important reminder for all Canadians who wish to become donors to register to be an organ donor and to speak to your family about your wishes. Read up on how to become an organ donor External link, opens in new window.

The Canadian Institute for Health Information (CIHI) is an independent, not-for-profit organization dedicated to providing essential health information to all Canadians. CIHI works closely with federal, provincial and territorial partners and stakeholders throughout Canada to gather, package and disseminate information to inform policy, management, care and research, leading to better and more equitable health outcomes for all Canadians.

Canadian Organ Replacement Register

https://www.cihi.ca/en/organ-replacement-in-canada-corr-annual-statistics-2019

—CIHI

—AB

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