Canadians are Dying Because Our Organ Donation Rate is Dismally Low

We’re far behind countries like Spain and the United States. Here’s what we can do better.
Organ Donor Facts
- Anyone can become a donor at any age.
- All major religions approve of organ and tissue donation in Canada.
- You need to register to become a donor and make your wishes known to family.
- There is no cost to becoming a donor or donating an organ/tissues.
Here's where to sign a registry in your province.

Every year, thousands of Canadians are added to organ wait lists. Although one donor can save up to eight lives and benefit more than 75 people, hundreds of Canadians die each year waiting for an organ that never comes.

Spain has the highest organ donation rate in the world — 36 donors per million people in 2014. Today, Canada’s rate is half that — 18 donors per million people — and in the lower third of developed countries.  Even the United States is doing better that us, at 26 donors per million. Why are our numbers so low?

We talked to Dr. Lori West, director of the Canadian Donation and Transplantation Research Program, an agency committed to increasing our donation rates, to find out what we can do better.

Expand the pool of potential donors

In the past, donors had to meet the criteria for brain death to be considered. But people die for all sorts of reasons; the second highest cause of death in Canada today is heart disease. Even when a circulatory system is done, other major organs like the liver, lungs, pancreas and kidney may still be healthy.

In 2005, 32 year-old Sarah Beth Therian died of a heart arrhythmia. Determined to fulfill her final wish of becoming an organ donor, her family asked the hospital to consider her organs be included under a new protocol called DCD (dead after circulatory death). She became the first Canadian in four decades to donate organs after cardiac death and ten years later, one third of all donors are DCD.

There’s more that can be done. People who die from infectious diseases, such Hepatitis C, or who opt for MAiD (medical assistance in death) could be considered as donors in the future.  “We shouldn’t deny them the opportunity to donate if they wish,” says West. “Statistics from other countries suggest that it's worth having these uncomfortable discussions.”

The bigger the pool of potential donors, the more life-saving organs that are available.

Find better ways of transporting organs.

Money for organ donor research leads to the development of new technologies into better ways of transporting organs. Instead of transporting organs on ice, new machines can help keep them warm and viable for longer by infusing them with blood. This means that organs can go much longer before transplant into a new recipient.

FILM EXTRA: Dr. James Shapiro shows us a machine that has kept a liver alive for 18 hours.

New machines can keep a pair of lungs breathing outside the body for as long as 24 hours. In one recent case, a young woman died suddenly of a pulmonary embolism. Doctors were able to remove her lungs, dissolve the clots that caused her death with drugs and then transplant those repaired lungs into another body.

Train doctors to be donation specialists.

Currently hospitals work with a healthcare professional that co-ordinates the activities related to organ donation, but Dr. West says that we should go one step further. 

SCENE FROM THE FILM: Transplant co-ordinator nurse Karen Elgert springs in to action at University of Alberta hospital once a heart is found for baby Bergen.

Spain’s secret to success has been a small army of specially-trained professionals that work directly with the intensive care team in each hospital to look for opportunities to gain donors and follow the right protocols to protect organs and tissues. The system is much more proactive in terms of identifying donors, obtaining consent and procuring the organs.

Have a national organ donation registry.

Currently health is a provincial mandate, so Canada has a patchwork of organ donation services across the country. Some provinces, like Ontario, are performing at a high rate, but nowhere in Canada are we performing at the rate that organ donations professionals consider benchmark.

In February 2016, Conservative MP Ziad Aboultaif, whose own son has been the recipient of three donated livers, tabled a private member’s bill calling for a national registry. The bill calls for the development of a national strategy to improve organ donation between provinces. It’s an idea that Aboultaif hopes will save hundreds of lives a year: “Until you go through it, no one can understand how precious normal life is.”

Become an organ donor and make your wishes known to family.

Some medical experts are calling for a “presumed consent model” already in use in 20 European countries, where organ donation rates are consistently higher. That means that everybody will be considered a donor unless they explicitly take action to indicate otherwise. A panel of experts considering it in Canada found that for now, neither the public nor doctors were receptive to the idea.

In the meantime, only 20 per cent of Canadians have joined their province’s organ and tissue registry. Provinces like Ontario are taking steps to make it easier by asking about organ donations on health card and driver’s license renewals which has increased registrations.

Dr. West says that donors need to make their wishes known: “Take a photo of your donor card and put it on Facebook.” Potential donors can fill in an End of Life Directive to help their family decide what to do.

Even when everything is in place, as many of 20 per cent of families refuse to transplant a registered donor’s organs.  While there has been some discussion around making donation irrevocable by family members, so far there’s been no impetus towards making it happen.

VIDEO EXTRA: Dr. Luiz Sampaio explains why it's also important to donate organs for medical research.

Available on CBC Gem

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