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Organ utilization among deceased donors in Canada, 1993–2002

[L’utilisation d’organes de donneurs décédés au Canada de 1993 à 2002]

Kim Badovinac, MA MBA^*, Paul D. Greig, MD FRCS(C), Heather Ross, MD MHSc FRCPC, Christopher J. Doig, MD MSc FRCPC and Sam D. Shemie, MD^¶

^* From the Canadian Institute for Health Information, the
GI Transplant Program, and
Cardiac Transplant Program, Toronto General Hospital – University Health Network, Toronto, Ontario; the
Department of Critical Care Medicine, The University of Calgary, Calgary, Alberta; and the
^¶ Division of Pediatric Critical Care, Montreal Children’s Hospital, McGill University Health Centre, Montreal, Quebec, Canada.

Address correspondence to: Dr. Sam D. Shemie, Montreal Children’s Hospital - McGill University Health Centre, 2300 Tupper Street, Montreal, Quebec H3H 1P3, Canada. E-mail: sam.shemie{at}muhc.mcgill.ca

Background: Optimizing organ utilization from consented donors is a critical need, given a static organ donation rate. We report changes in the characteristics of donors and organ utilization patterns in Canada over a ten-year period.

Methods: For the decade spanning the years 1993–2002, data were extracted from the Canadian Organ Replacement Register (CORR), the national transplant registry. A donor was defined as a deceased person from whom at least one vital organ was retrieved and transplanted.

Results: The donor pool is aging (median age of donors increased eight years over the decade), with proportionately fewer donors dying from head trauma (motor vehicle collisions) and proportionately more from cerebrovascular accidents. At least four organs were utilized from approximately half the donors. These donors were significantly younger every year over the sampling period when compared with donors where three organs were utilized. In 2002, utilization rates were: 87.0% (kidneys), 85.0% (livers), 42.2% (hearts), 30.6% (pancreata), 28.3% (lungs), and 1% (intestines). There was increased utilization of donor pancreata, lungs and liver over the decade, but a flat utilization pattern for hearts, and a small decline in kidney utilization. Utilization rates vary from province to province.

Conclusions: Trends in the Canadian organ donor pool are characterized by an increasing age and a shift towards cerebrovascular diseases as primary causes of death. In order to improve organ utilization and understand regional variability, the scope of data provided to the national registry requires enhanced detail to address the factors that lead to non-utilization. Addressing the low utilization rates for hearts and lungs is especially critical, given the need for thoracic transplantation in Canada.

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