Organ transplant rates up in Canada but could be higher: report

Organ transplants overall rose by 23 per cent over the last decade in Canada, but 4,600 patients are still currently waiting for the life-saving or live-improving gift, according to a report from Canadian Blood Services.

Deceased organ trasnplant rates are highest in British Columbia, Ontario, Quebec and Nova Scotia, the agency said in the report, released Friday in Ottawa. It was based on data from 2006 to 2015.

"What this report has enabled us to do is to learn in Canada from the provinces where we see significant performance growth," Dr. Graham Sher, CEO of Canadian Blood Services (CBS), told journalists. 

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"They've created this culture and this awareness of the importance of speaking to families, ensuring a donation opportunity is not lost and then ensuring that the organs are procured and made available to patients needing them," Sher said.

The success is also attributed to:

• Placing donation specialists in the intensive care and emergency room.
• Mandating referrals for transplants.
• Using well-trained staff to speak to families.

Despite the progress, Canada lags behind "top-tier" countries such as the U.S. and Spain, where deceased donation rates exceed 30 donors per million population. Canada's rate currently stands at 18.2 donors per million population, up from 14.1 for that measure in 2006.

Some rates stay the same

Spain fostered a culture of donation over three decades and Canada is now embarking on creating one, said Dr. Peter Nickerson, vice-dean of research at the University of Manitoba and a medical adviser to CBS.

About 21 per cent of donations come after cardiac death, said Kimberly Young, director of donation and transplantation at CBS. Before those programs were implemented, most deceased organ donations occurred after catastrophic brain injury. Now organs can be donated after the heart stops.

Young also acknowledged the hundreds of Canadians who've chosen to become living donors, many without ever knowing the recipient.

The living donation rate hasn't increased in the past decade, Young said. One of the reasons it hasn't decreased, as in some countries, is due to the national paired kidney donation program. It pairs compatible donors, including those in different parts of the country. Doctors consider kidney donations the best treatment for end-stage kidney disease.

Lung transplants are in the top tier of comparable wealthy countries, thanks to pioneering research at lung retrieval centres such as Toronto General Hospital, Nickerson said. Likewise, liver donation rates are high. Heart access is relatively equal, he said.

There have also been significant improvements in access to transplants among those who have the hardest time finding a donor match because of a highly sensitive immune system.