Access to organ transplants on the rise in Canada

Progress report shows a decade of national collaboration is working to save more lives

(OTTAWA) – Canadian Blood Services alongside partners in the Canadian Organ Donation and Transplant Network have released a report detailing a decade’s worth of data on national organ donation and transplantation performance. The Organ Donation and Transplantation in Canada: System Progress Report 2006–2015 includes the most current Canadian statistics on deceased and living donation and transplantation performance. Produced in collaboration with national, provincial and territorial partners, the report examines donation rates, transplant rates, access to transplants across the country and how transplantation benefits patients and health-care systems.

“While we are starting to see the benefits of collaboration in programs and services for patients, there is still variability in access to organs among jurisdictions,” said Dr. Graham D. Sher, chief executive officer of Canadian Blood Services. “With the consistent implementation of factors that contribute to high performance, there is opportunity to establish a world-class organ donation and transplantation system in Canada - one where patients have equal access to transplants regardless of where they live.”

The report shows that Canada is getting closer to its system performance goals and that there is a lot of evidence to support building on the momentum in Canada to further advance organ donation and transplantation.

Between 2006 and 2015, the number of transplants increased by 23 per cent, but Canada still has a shortage of organs with approximately 4,600 patients currently waiting.

“An organ transplant provides far better health outcomes for many patients when compared to other therapies like kidney dialysis,” said Dr. Peter Nickerson, Vice-Dean (Research) and Distinguished Professor, Flynn Family Chair in Renal Transplantation, Faculty of Health Sciences, University of Manitoba and medical advisor, Canadian Blood Services. “For example, a kidney transplant can double the life expectancy of a patient with end stage kidney disease, and increase their quality of life.”

Transplants not only provide patients with far better health outcomes, they generate economic benefits for health systems.

Both deceased and living donors can donate organs. According to the report, deceased organ donation is at an all-time high in Canada, with B.C., Ontario, Quebec, and Nova Scotia leading the way.

“Because provinces with the largest populations are also some of the highest-performing deceased organ donation systems, a majority of Canadians have a much greater chance of receiving an organ transplant,” said Dr. Sam Shemie, Division of Critical Care, Montreal Children’s Hospital, McGill University Health Centre, Professor of Pediatrics, McGill University and medical advisor, Canadian Blood Services. “One reason for Canada’s growing rate is an increasing number of donations after circulatory death and the establishment of related programs in many provinces.”

Report highlights

  • Since 2006, the national deceased donation rate has risen from 14.1 to 18.2 donors per million population (dpmp) or 29 per cent.
    • This is the highest national deceased donor rate reported in Canada to date.
    • Four provinces have led the way (B.C., Ont., Que. and N.S.). The number of deceased donors has increased by 42 per cent, from 460 in 2006 to 651 in 2015.
  • Canada’s transplantation rate — which includes organs from both deceased and living donors — increased from 63.7 to 71.4 transplants per million population
    • The actual number of transplants increased by 23 per cent from 2,074 to 2,559.
    • More than 4,600 patients are still waiting for transplants
  • Transplantation is the best therapy for patients with end-stage kidney disease, and the only treatment for patients suffering from end-stage liver, heart and lung disease.
    • Compared to dialysis, a kidney transplant can more than double a patient’s life expectancy.
  • Transplantation through the national Kidney Paired Donation program is also the most cost-effective treatment for patients with end-stage kidney disease.
    • Starting in the second year after transplant, health-care systems in Canada avoid between $33,000 and $84,000 per transplant patient per year of dialysis.
  • There are certain key factors that contribute to improved deceased donation rates:
    • Mandatory referral which helps ensure donation opportunities are not missed;
    • the presence of in-hospital donation specialists;
      optimized programs focused on deceased donations; and
    • consistent implementation of best practices.
  • Canada’s provinces are at different stages of implementation of these key factors, which is contributing to variation in deceased donation rates.

About the collaboration

This report was produced in collaboration with national, provincial and territorial partners, including critical care, organ donation programs, transplant programs, national organizations like the Canadian Institute for Health Information, The Canadian Institutes of Health Research and other research partners including The Canadian National Transplant Research Program, Canadian Society for Transplantation, and health charities. This powerful group of partners is linked and focused on collaboration and leadership to improve donation and transplantation in Canada. Known collectively as the Canadian Donation and Transplant Network, members are ongoing partners in improvement and through the Organ Donation and Transplantation Expert Advisory Committee, have produced this first national progress report.

The research community plays a central role in developing, informing and advancing leading practices in this field. Research is foundational to system improvement and innovation. Canada has a history of world-class transplantation research thanks to the efforts of investigators and institutions that contribute at the national and international levels.

The Canadian donation and transplantation network would also like to acknowledge and honour the donors and donor families who have given their most precious gift. The collaborators on this report also acknowledge the thousands of patients in need of a transplant and those who have died waiting.

Canadian Blood Services collaborates with health systems to report on performance as part of its ongoing role in organ donation and transplantation. It maintains national patient programs and services for organ listing and organ sharing, and the Canadian Transplant Registry. Working with governments, academics, health professionals and health administrators, Canadian Blood Services continues to develop a more coordinated and integrated system for organ listing and allocation across the country. It also plays a leadership role in national programs for professional education, leading practices and knowledge translation for clinical practice, and in public education and awareness initiatives.

Read the short version of the report here: Results Highlights: Organ Donation and Transplantation in Canada – System Progress Report 2006–2015 (PDF)

Read the full report here: Organ Donation and Transplantation in Canada – System Progress Report 2006–2015 (PDF)