More than 1,000 Canadians have made a donation in 2008 compared to 812 in 1999, according to a study by the Canadian Institute for Health Information (CIHI), an increase of 28% over the last decade. This increase is much smaller than the increase in demand.
The CIHI study shows, for example a growing gap between supply and demand in regard to kidney transplants. In 2008, six kidney transplants per 100 patient-years of dialysis were performed compared to 8 in 1999. This is partly due to the increased incidence of renal failure associated with diabetes, whose numbers grew from about 1,000 new cases in 1996 to nearly 1,900 in 2008.
Living donors account for more than two thirds of the increase in available organs, but the rate of deceased donors has not increased as rapidly. Living donors are usually members or friends of the family having close links with the recipients. The blood relatives accounted for 64% in 2008, the spouses, 16% and those with no relationship, 17%.
“In 2008 there were 492 deceased donors, this figure is surprisingly low given the numbers, well below international standards, eligible deaths that occur annually in this country,” said Dr. Sam Shemie of CBS.
People who die as a result of catastrophic brain injuries, for example trauma or stroke, are generally the largest proportion of deceased donors. The mortality rate attributable to these lesions, however, decreased.
Although most organs are taken after the patient is considered brain-dead, that is to say that the NDD was found, four provinces (British Columbia, Ontario, Quebec and Nova Scotia) now collect organs for donation after cardiac death. The cardiac death is defined as the absence of irreversible circulatory and respiratory functions. In 2008, the rate of donors after cardiac death was less than 10%.
“The need of transplantable organs has never been greater,” said Dr. John Gill, an associate professor of medicine at the University of British Columbia. “The donation of organs and tissues should be offered to all patients who die in Canadian hospitals and should be an essential component of care at the end of life,” he said.