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ORGAN DONATION AND TRANSPLANTATION IN
CANADASystem Progress Report 2016 Update
Consultation version – Confidential and not for distribution (2017-11-29)
© Canadian Blood Services, 2017. All rights reserved.
Extracts from this report may be reviewed, reproduced or translated for educational purposes, research or private study,
but not for sale or for use in conjunction with commercial purposes. Any use of this information should be accompanied
by an acknowledgement of Canadian Blood Services as the source. Any other use of this publication is strictly prohibited
without prior permission from Canadian Blood Services.
Production of this report has been made possible through financial contributions from Health Canada and the provincial
and territorial governments. The views expressed herein do not necessarily represent those of the federal, provincial or
territorial governments.
For more information, please contact:
Donation and Transplantation
Canadian Blood Services
1800 Alta Vista Drive
Ottawa ON K1G 4J5
Canada
613-739-2340
Email: [email protected]
Consultation version – Confidential and not for distribution (2017-11-29)
2,906ORGANS TRANSPLANTED
FROM
758DECEASED DONORS AND
544LIVING DONORS
Organ Donation and Transplantation in Canada2016 System Progress Report Update
Record outcomes from organ donation and
transplantation
In 2016
2,835 organ transplant procedures were performed in Canada.
4,492 people on Canada’s organ transplant wait-lists.
260 patients on wait-lists died before receiving transplants.
Donors and transplants per million
population in Canada, 2006-2016
623
697
115
387
1536
839295
Patients on Transplant Waitlist by Province*
Canada: 4,492
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1731
579
302
202
61
31
Kidney
Liver
Lung
Heart
Kidney-Pancreas
Pancreas
KP
Transplanted Organs
17
.0
16
.8
16
.4
15
.3
16
.4
15
.2
15
.5
16
.6
15
.6
15
.7
15
.0
14
.1
14
.7
14
.5
14
.5
13
.7
15
.0
15
.6
15
.7
16
.6
18
.1
20
.9
63.7 65.1 62.4 62.2 62.2 62.1 64.3 67.2 66.371.4
78.1
0
10
20
30
40
50
60
70
80
90
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Living donors PMPDeceased donors PMPTransplants PMP
Transplant results presented here refer only to kidney, liver, heart, lung, and whole pancreas transplants, and do not include combination
transplants with the exception of kidney-pancreas transplants (KP).
Deceased donation performance results
Canada has shown a sustained improvement indeceased donation to a degree which represents animportant achievement for our country. This is theresult of the collective efforts of the provincialODO’s, transplant programs, and ODT researchersincluding CIHR/CNTRP and intensive care units inCanada.
Organ donation after death accounts for the majorityof transplants; a single donor has the potential toprovide as many as 8 organ transplants, with atypical donor making 3 to 4 transplants possible.
+42%
Canada’s national deceased donation rate hasincreased by 42 per cent since 2007, from 14.7 to20.9 DPMP in 2016, with results for 2016 exceedingthe rate in 2015 (18.1) by 15 per cent. Despite thisrecent increase, the national deceased donation rateremains below the target of 22 DPMP proposed inCall to Action, a strategic plan to improve organ andtissue donation and transplantation performance forCanadians.†
dp
mp
The deceased donation rate in Canada is on par with Australia and the United Kingdom, despite Canada adopting a more conservative definition in tracking donation performance than is typically used by the international community. Canada remains at less than half of the rate shown by Spain which adopts a presumed consent model for deceased organ donation.
10.6
9.2
5.3 4.8
dpmp
DCD donors per million population
When comparing the utilization of donation after circulatory death internationally, Canada still does not rank among the highest rates internationally. This represents a critical area of potential for the future.
Canada
Australia
United Kingdom
Spain
* For the DPMP metric, most countries report actual donors, a figure that onlyrequires an organ to be removed or an incision made in the operating room for thepurposes of transplantation. Canada, however, reports utilized donors, a metricthat requires at least one organ to have been transplanted into a patient. Annualreports on organ donation and transplantation activity issued by the NationalHealth Service in the United Kingdom (2012–2015) estimate differences ofbetween four to eight per cent when comparing actual donors and utilized donors.
43.4
31.0
0
5
10
15
20
25
30
35
40
45
50
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Canada SpainUnited States United KingdomAustralia
20.9
20.8
21.4
†This document can be found at blood.ca
584 NDD Donors
174 DCD Donors
758 Deceased Donations
14.7
18.1
20.9
14.0
14.3
16.1
0.7
3.84.8
0.0
5.0
10.0
15.0
20.0dp
mp
TotalNDDDCD
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National performance: Continued success hinges ondonation after circulatory deathIf Canada is to continue improving its deceaseddonation rate, it must increase the number of donorsmaking donations after circulatory death (DCD).Donations made in 2016 by DCD donors represent 23per cent of the total number of donations made bydeceased donors — and the area of the organdonation and transplantation system with thegreatest potential for growth.
1 in 4 DONATIONS ARE MADE
THROUGH DCD
0
50
100
150
200
250
300
350
400
BC AB SK MB ON QC NB NS NL
20152016
Canada: 20.9
20.3
16.1
12.2
12.125.2
20.4
13.2
17.2
18.2
Performance among provinces variesThe degree to which provincial variability inperformance affects variability in nationalperformance trends is an important consideration. In2012, the ODT community set a first-tier target of 22DPMP, and national donation rates are presentlycontinuing to approach that target at 20.9 DPMP in2016.
DCD accounts for the largest increase in deceaseddonation over time and the greatest future donationpotential. DCD has been implemented in 5 of 11provincial ODOs. Two other provincial ODOs arebeginning implementation.
DCD
Deceased donation in Canada 2006-2016
Deceased donation by province 2015 - 2016
Deceased donation by province 2015 – 2016 (dpmp)2016 deceased donation rates by province
APPROXIMATELY
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20.1
12.4
8.8
13.1
19.4
20.8
10.6
15.2
18.4
20.3
16.1
12.2
12.1
25.2
20.4
17.2
13.2
18.2
0.0
5.0
10.0
15.0
20.0
25.0
30.0
BC AB SK MB ON QC NB NL NS
2015 2016
456 463 439 444 420 448 455 489 470 513 584
422 42 43 46
67 8664 121
136
174
0
100
200
300
400
500
600
700
800
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
NDD
DCD
11.1
7.9
16.1
18.5
0.0
5.0
10.0
15.0
20.0
25.0
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Canada AustraliaSpain United KingdomUnited States
Living donation performance results
Canada’s living donation rate (i.e., organ donation rate by living donors) in 2016 was 15.0 DPMP, which is down from 4% from 15.7 DPMP in 2015.
Our rate compares well internationally, and outcomes for kidney transplant recipients and their living donors compare to the best in the world.
11%DECREASE IN LIVING
DONATION SINCE
2007
Living donation in Canada 2006-2016 (dpmp)
15.0
International living donation rates, 2006–2016 (dpmp)
Source for international rates is IRODaT
0
500
2006 2015 2016
Kidney KPD Liver
Living donor transplants 2009, 2015, 2016
In 2016 there were 544 living donor transplantsa 3% decrease over 2015; however, the KPDprogram saw its second most successful yearsince its 2009 inception and has facilitated 474transplants as of 2016.
Living donor rates by province 2015 – 2016 (dpmp)
This rate — which is primarily made up of kidney donors, but does include liver and lung donors — has decreased by 11 per cent since 2007.
0
50
100
150
200
250
300
BC* AB** SK MB ON QC ATL
20152016
Number of living donors by province 2015 - 2016
16.815.7 15.0
14.613.4 13.0
2.1 2.3 2.0
0
5
10
15
20
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Total
Kidney
Liver
Consultation version – Confidential and not for distribution (2017-11-29)
23.7
18.5
2.6
11.6
20.3
6.7
8.0
19.8
19.8
7.0
19.0
18.3
6.7
7.5
0.0
5.0
10.0
15.0
20.0
25.0
30.0
BC AB SK MB ON QC ATL
2015
2016
Between 2006 and 2015, Canada’s transplant rate (which includesorgans from both deceased and living donors) increased from 63.7 to71.4 transplants per million population, and in 2016 this rate climbedeven higher to 78.1 transplants per million population. This representsan 9 per cent increase relative to 2015 and a 23 per cent increaserelative to 2006. The actual number of transplants in 2016 (2,835)represents a 32 per cent increase from 2007.
Patients waiting for transplants in 2016
Number of solid organ transplants in Canada by donor type, 2006–2016
Transplants per million population in Canada by organ type, 2006–2016
In spite of the increases in transplant numbers, Canada still has a shortageof organs. Approximately 4,500 patients are waiting for transplants at anygiven time. Since Canada will continue to have a shortage of organs intothe future, there is a need to provide equitable access to the limitednumber of donated organs for all potential recipients.
Transplantation performance results
260 patients died on all
waitlist in 2016
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Transplant results presented here refer only to kidney, liver, heart, lung, and whole pancreas transplants, and do not include combination
transplants with the exception of kidney-pancreas transplants (KP).
63.771.4
78.1
0
10
20
30
40
50
60
70
80
90
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Kidney Liver Heart Lung Total
1519
1588
1530
1577
1559
1609
1698
1778
1805
2012
2291
555
554
546
516
557
521
537
585
553
563
544
2074 2142 2076 2093 2116 2131 22352363 2358
25752835
0
500
1,000
1,500
2,000
2,500
3,000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Deceased donor transplants
Living donor transplants
Total donor transplants
3,421
433
189
256
48*
2
4,492CANADIANS
WAITING
*Does not
includes islet
patients (49)
117
26MULTI/OTHER
KP
Kidney transplants by province per million population, 2006–2016
0
5
10
15
20
B.C. Alta. Sask./Man. Ont. Que. Atlantic
2007
2014
2015
Liver transplants by province per million population, 2007–2015
0
2
4
6
8
10
12
B.C. Alta. Sask./Man. Ont. Que. Atlantic
2007
2014
2015
Lung transplants by province per million population, 2007–2015
0
1
2
3
4
5
6
7
B.C. Alta. Sask./Man. Ont. Que. Atlantic
200720142016
Heart transplants by province per million population, 2006–2015
Transplants by province per million population, 2007–2015
Canada: 78.1
89.0
98
21.7
43.2
93.267.1
47.947.947.947.8
9897.4
88.3
0
10
20
30
40
50
60
70
Cda. B.C.* Alta.** Sask. Man. Ont. Que. Atlantic
200620152016
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Acknowledgements
This report acknowledges the generosity of organ donors and
their families, and those patients with end-stage organ failure
who depend on all organizations involved to improve
opportunities for donation and transplantation.
This report was made possible through the dedicated efforts of
the members of the Organ Donation and Transplantation Expert
Advisory Committee. It includes input from the Canadian
Institutes of Health Research, the Canadian National Transplant
Research Program, the Canadian Institute for Health
Information, the Deceased Donation Advisory Committee, the
Donation and Transplant Administrators Advisory Committee,
the Kidney Transplant Advisory Committee and the Living
Donation Advisory Committee.
Data Sources
The Canadian data collected for this report was compiled from a number of sources and standardized\ and
validated to the greatest degree possible by experts from Canadian Blood Services. Source material was derived
from figures compiled from the Canadian Transplant Registry, and materials published by the Canadian Institute
for Health Information and the Canadian Organ Replacement Register. Canadian Blood Services’ personnel also
collected and validated 2015-2016 data from the various provincial organ donation organizations.
Demographic data was taken from Statistics Canada reports, Annual Estimates of Population for Canada,
Provinces and Territories.
The international donation and transplantation data collected for this report was compiled from a number of
sources and standardized and validated to the greatest degree possible by experts from Canadian Blood
Services. Source material was derived from figures compiled from the International Registry on Organ Donation
and Transplantation, the Organ Procurement and Transplantation Network in the United States, and the
Organizacion Nacional de Trasplantes in Spain.
Population data for per million population estimates based on Statistics Canada, Demography Division. CANSIM
Table 109-5355: Estimates of population (2011 Census and administrative data), by age group and sex for July
1st, Canada, provinces, territories, health regions (2015 boundaries) and peer groups. Accessed November 14,
2017.
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