Canadian Organ Replacement Register (CORR) Recent Trends in Donor Activity CAT Clinical Donation...
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Canadian Organ Replacement Register (CORR) Recent Trends in Donor Activity CAT Clinical Donation Symposium Dr. Lilyanna Trpeski Program Lead for CORR CORR Annual Meeting, Banff Friday March 16, 2007
Canadian Organ Replacement Register (CORR) Recent Trends in Donor Activity CAT Clinical Donation Symposium Dr. Lilyanna Trpeski Program Lead for CORR CORR
Canadian Organ Replacement Register (CORR) Recent Trends in
Donor Activity CAT Clinical Donation Symposium Dr. Lilyanna Trpeski
Program Lead for CORR CORR Annual Meeting, Banff Friday March 16,
2007
Slide 2
OUTLINE About CORR New Initiatives at CORR Donor activity and
characteristics Retrieved organs usage
Slide 3
What is CORR? Canadas national database on patients treated for
end-stage organ failure Captures information on: Treated patients
Specifics of the treatments Organ donors : deceased and living
Transplant and dialysis facilities Transplant and waiting list
aggregate statistics from OPOs
Slide 4
cont A fairly limited dataset with respect to organ donation
and transplantation, but coverage is extremely high (95%+)
especially given the voluntary nature of the registry Initiated in
1981, largely through the grassroots efforts of the nephrology
community In 1988 Transplant and OPO community joined CORR
Strategic direction is governed by a Board of Directors comprised
of representatives from CSN, CST, KFOC, CANNT, CAT and Health
Canada Current President, Dr. Joanne Kappel (St Pauls Hospital,
Saskatoon Kidney) Greg Kalyta (TGLN) is the CAT representative Kim
Young CCDT representative
Slide 5
Data Sources ProvWaiting ListDonorTransplant ABHOPE Edmonton;
HOPE Calgary Deceased - HOPE Edm; HOPE Calgary Living Transplant
programs Transplant programs BCBCTS SKSK Transplant Program
Provincial office Regina Office SK Transplant Program MBTransplant
Program Gift Of Life Program Transplant Manitoba Gift Of Life
Program Transplant Program ONTGLN QCQu bec-TransplantDeceased - Qu
bec-Transplant; Living Transplant programs Transplant programs
NS/PEMOTP (Halifax) NBMultiple Organ Retrieval and Exchange Program
NLOPEN
Slide 6
Transplant and Donor Data Flow at CORR
Slide 7
New Initiatives in CORR
Slide 8
Current Activities & Directions Expansion of data set in
2007/8 Increased focus on data quality (includes linkage projects)
Enhanced presence on www.cihi.ca/corr Enhanced analytical support
to the research community includes the initiation of a Research
Subcommittee chaired by Dr. Louise Moist Still working on improved
timeliness of data!
Slide 9
Data Quality Initiatives Example 1: Reported Deaths Validation
Process Investigated discrepancies of number of deaths among
transplant patients obtained from facility profile data and record
level data Surveyed OPOs for routine collection of follow up data
including deaths among transplanted patients
Slide 10
Transplant Programs-AB SK Transplant Program-SK Transplant
Program-MB Transplant Hospitals ON (TGLN??) Transplant programs- QC
MOTP (Halifax)- NS/PE
Slide 11
Example of Tracking Missing Death Infromation
Slide 12
Data Quality Initiatives Example 2: Examinations of HLA Values
Dr Nickerson evaluated HLA data received from OPOs between
2000-2004 HLA data re-collection obtained with a help from OPOs New
data elements for HLA and PRA proposed
Slide 13
Proposed Changes to the Serology Test Capture in CORR SEROLOGY
RECIPIENT TABLE CHANGES ADD FIELDS: HLA Cw1 and Cw2 Class II PRA
current and Class II PRA peak Test Methods ( ELISA, CDC,
FLOW/LUMINEX) Donor specific antibodies Y/N RENAME current
cytotoxic to Class I PRA current peak cytotoxic to Class I PRA peak
DONOR SEROLOGY CHANGES ADD FIELDS: HLA Cw1 and Cw2
Slide 14
www.cihi.ca/corr Privacy Impact Assessment Presentations
E-Reports on Statistics on Organ Transplants, Waiting List and
Donors produced bi-annually CORR inSITES (2 issues in 2007) ideas
welcomed!
http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=reports_corrinsites_may2006_e
Media releases (2 per year) List of publications where CORR data
have been used Historical reports/Last CORR Highlight Report in
2006 Directory of participating centres free PDF Instruction
Manuals
Slide 15
Donor Activity and Usage
Slide 16
Organ Donors, 1 Canada, 1996-2006 (Number) 1 Deceased donors
are defined as donors originating in Canada where at least one
solid organ was used for transplant. Data are from Quarterly
Reports provided by Canadian OPOs. Source: Canadian Organ
Replacement Register, Canadian Institute for Health Information-
eStatistics (2007) 12%
Slide 17
Number of Living Related Donors (LDR) and Living Unrelated
Donors (LUR) in Canada,1996- 2006 Source: Canadian Organ
Replacement Register, Canadian Institute for Health
Information-eStatistics (2007)
Slide 18
Distribution of Deceased Donors by Age Groups, Canada,
1999-2006
Slide 19
Slide 20
Slide 21
Distribution of Living Related Donors by Age, Canada,
1999-2006
Slide 22
Deceased Donors (DCD), Living Donors (LD) by Gender, Canada,
1996-2006
Slide 23
Ethnicity by Donors in Canada, 1996-2006 NDD- Neurologically
determined death; LRD-Living related donor; LUR-Living unrelated
donor
Slide 24
Distribution of Deceased Donors by Cause of Death, Canada,
1999-2006
Slide 25
Distribution of Deceased Donors by Cause of Death, Province of
Retrieval, 1996-2006
Slide 26
Proportion of Deceased Donors with MVA as a Cause of Death,
Canada and US, 1999-2006
Slide 27
Change in Numbers of Patients on Waiting Lists, Canada
2005-2006
Slide 28
Transplants 1 and Waiting List at Year-end, 2 Canada, 1995-2004
(Number) 1Includes single and combination transplants. 2Waiting
list includes active and on-hold patients and excludes patients who
died while on the waiting list. Excludes patients waiting for islet
cell transplants. Source: Canadian Organ Replacement Register,
Canadian Institute for Health Information (2006)
Slide 29
Usage of Organs Obtained from Deceased Donors
Slide 30
Average Number of Organs Used for Transplantation, Canada,
1996-2006
Slide 31
Organs Retrieved, Transplanted, Shared Between Province, Canada
and Us, 1995-2006
Slide 32
Slide 33
Slide 34
Reason Other then Medical for Not Used Organs, Canada 2003,
2004, 2005
Slide 35
Growth in Number of Transplanted and Recovered Organs,
2005-2006 Organs TransplantedOrgans Recovered from Deceased Donors
Transplanted20052006Percent ChangeRecovered20052006Percent Change
Organs Total1,9052,124 11.4% All DD organs1,7261,8074.69% Deceased
donor*1,4011,569 12.00% All CDD organs010 Living donor504555 10.0%
Kidney1,0551,19813.5%Kidney71379010.80% Deceased donor61271116.1%
Living donor4434879.9% Pancreas**66729.09%Pancreas
(all)14385-40.56% Liver41745910.07%Liver3724038.33% Deceased
donor35739310.08% Living donor606610.00%
Intestine110.00%Intestine28300.00%
Heart1731772.31%Heart167159-4.79% Lung14016517.86%Lung13319949.62%
Deceased donor13916417.99% Living donor110.00% * Including 8 CDD
kidneys in 2006; ** Including pancreas and kidney pancreas
transplants;
Slide 36
What is New in 2006 !!!! First 4 CDD Donors procured at TGLN in
2006 10 CDD Organs were transplanted: 8 kidneys 2 livers
Slide 37
Number of Referred Patients,Potential Donors and
Procured(Actual) Donors, 2001-2006 Canada Data from e-CORR Annual
Report-2005 Potential/Referrals=42% Procured/Potential=85.6%
Slide 38
Deceased Donor Practice by Province
Slide 39
Donor Aggregate Collection Form 1. Number of POTENTIAL deceased
organ donors identified by your OPO: ____________ NDD _____________
CDD (Declared NDD/CDD, consent obtained, organ offered - may not be
accepted and/or retrieved) 2. Number of ACTUAL deceased organ
donors identified by your OPO: ____________ NDD _______________ CDD
(All conditions for POTENTIAL DONOR, plus at least one organ
retrieved and transplanted) 3. Number of in-province referrals to
your OPO: ____________ NDD _______________ CDD(All Patients
referred to the OPOs as possible potential donors) Total number of
organs retrieved locally: ____________ NDD _______________ CDD
Slide 40
Completeness of Serology Data
Slide 41
Data Completeness in CORR
Slide 42
Completeness of Height and Weight
Slide 43
Completeness of Blood Type
Slide 44
Completeness of Race
Slide 45
Conclusions Number of deceased donors increased in Canada by
more then 10% in 2006 compared to n005 New Donors after Cardiac
Death procured in Ontario Average age of donors remained similar to
year 2005 CVC remained a main cause of death in deceased donors in
Canada. Need to differentiate ECD in the future.
Slide 46
cont Need for better communication and some decisions need to
be made Teleconference between OPO and LABs More timeliness
reporting to CORR
Slide 47
Acknowledgements The Canadian Organ Replacement Register (CORR)
is a register of the Canadian Institute for Health Information.
CORR data would not exist without the support of transplant
programs and organ procurement organizations across Canada. CORR
has support and participation from the CSN, CST, The Kidney
Foundation of Canada, CANNT and CAT.