Canada organ donation rates plateau

By Dr. Ananya Mandal, MDFeb 14 2012

A report released Monday by the Canadian Institute for Health Information reveals that public awareness campaigns and stories of grateful organ recipients have not done much to improve the number of organ donations in Canada. Donor rates have stagnated in the country since 2006 while thousands of Canadians continue to languish on wait lists for organs, the report adds.

“There is a widening gap between organ donation and the need for organs,” said Claire Marie Fortin, manager of clinical registries at the Canadian Institute for Health Information. In 2010, there were 557 living organ donors and 465 deceased organ donors, who together led to 2,103 organ transplants. In 2006, there were 556 living donors and 461 deceased donors for a total of 2,074 transplant procedures.

The annual report compiles data from the Canadian Organ Replacement Register for the years 2001 to 2010. This latest study focused largely on the pressing need for kidneys, which has doubled in the last 20 years. At the end of 2010, 3,362 patients needed a kidney. “The need is particularly acute around kidneys because people can continue to live on dialysis,” Fortin said. “People are maintained in a healthy state for a lot longer so we have growing numbers of people on dialysis.” Kidney donation has not kept pace with that growing need, she said.

In addition to the individual toll, Fortin said the growing number of people who need dialysis treatment while waiting for a kidney has significant cost implications for the health-care system. Dialysis treatment costs about $60,000 per patient per year, while a kidney transplant costs about $23,000 plus $6,000 per year for necessary medication, including anti-rejection drugs. “Over five years, we would be paying $300,000 for dialysis,” Fortin said. “If that patient were to have a transplant, we would be saving $250,000.” Canadians who received a kidney from a deceased donor spent a median 3.7 years on dialysis, while those patients who received a kidney from a living donor waited less than 1.5 years on dialysis.

At the end of 2010, 501 people were on a wait list for a liver, an improvement over 2006 when 723 patients needed a liver. During 2010, 135 people needed a new heart and 22 died while waiting. Between 2001 and 2010, there was a 42 per cent increase in the number of lung transplants performed in the country. However, by the end of 2010 there were still 310 Canadians waiting for a lung, compared to 163 in 2001. In 2010, 229 Canadians died while waiting for an organ.

The living donor rate fell to 16.3 per million population in 2010, from 17 per million population four years earlier. The deceased donor rate was 13.6 donors per million population in 2010 compared to 14 donors per million population in 2006. One reason for the lack of growing numbers is that organ donation from major trauma victims has decreased. Fortin said the decrease is due, in part, because the number of motor vehicle collisions has also decreased over time. “Before, we were relying on a lot of young, healthy adults whose lives may have been shortened unexpectedly through trauma,” she said. “That is not happening as often.”