Organ donations from seniors could reduce wait times

Deceased seniors or people who have suffered cardiac death represent a pool of potential organ donors that could reduce wait times for those who need organs, a new Canadian report says.

Each year, about 500 Canadians who die in hospital donate their organs to help those waiting, but those donors may represent only a third of those who are clinically eligible to donate, the Canadian Institute for Health Information says.
The report focuses on how to convert potential donors into real donors.

Among the provinces, Quebec had the highest deceased organ donor conversion rate in Canada at 21 per cent, compared with the lowest rates in Manitoba and Saskatchewan at 10 per cent each.

Provinces are more likely to find and procure organs from people younger than 50 than those in their 60s, an age group that showed significant variation between provinces and internationally, the institute said.

"In Canada, donors over the age of 60 represent a quarter of all donors, but Spain has twice that proportion and that's a country that's viewed as a world leader in deceased organ donation," said Kathleen Morris, director of health system analysis at the institute.

Quebec accepted the highest percentage of donors 60 and older at 34 per cent compared with fewer than 10 per cent of deceased donors in Alberta and Manitoba.

Traditionally, organs weren’t procured until brain death. In 2012, B.C., Alberta, Ontario, Quebec and Nova Scotia also accepted organs after cardiac death — when those with severe brain damage who are expected to die imminently  are removed from life support with the consent of family.

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The introduction of programs for donations after cardiac death has been restricted or delayed in some hospitals because of a lack of resources, clinical expertise or less frequently, ethical considerations.

Staffing could also be an issue given that researchers in Ontario found teaching hospitals were 60 per cent more likely to convert potential donors into actual donors than community hospitals. It could be that identifying potential donors is more top of mind for staff at teaching hospitals, Morris said.

Donations also fell off at night when fewer people are on hand to answer questions.

"There are a number of ways including improving consent rates, looking at organs from seniors and looking at non-beating heart deaths that would really help improve the conversion rate of possible donors to actual donors in Canada, and that in turn would make a huge difference for people waiting on transplant lists," she said.

For 2008 to 2012, the deceased organ donor conversion rate averaged 16 per cent nationally. The provincial rates were:

• B.C. – 14 per cent.
• Alberta – 11 per cent.
• Saskatchewan – 10 per cent.
• Manitoba – 10 per cent.
• Ontario – 16 per cent.
• Quebec – 21 per cent.
• New Brunswick – 13 per cent.
• Nova Scotia – 18 per cent.
• Newfoundland and Labrador – 12 per cent.
• P.E.I. – not available

Each deceased donor in Canada provides three organs on average. In theory, tapping the unused potential could provide 3,577 kidneys, livers and other organs.

In 2012, 230 Canadians with end-stage organ failure died while on a transplant wait list.