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Organ donation rates not keeping up with demand

A organ and tissue donation co-ordinator with Trillium Gift of Life Network carries blood samples from a dying patient to match organ transplants with recipients at Sunnybrook Critical Care Unit.

Moe Doiron/Moe Doiron/The Globe and Mail

The gap between the number of potential organ donors and patients on waiting lists is growing in Canada and hundreds of people are dying each year as a result, a new report has found.

In 2010, 557 living and 465 deceased donors contributed 2,103 solid organ transplants, numbers that are virtually unchanged from 2006, according to the report published Monday by the Canadian Institute for Health Information.

Stagnant donation rates are a major concern because the demands for new organs is growing, particularly as a result of huge increases in the rates of end-stage renal disease.

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"The number needing transplants continues to rise," said Greg Webster, director of primary health care information and clinical registries at CIHI. "The number of transplants being provided remains stable, so that means the gap is increasing."

The rate of living donors in Canada was 16.3 per million, down from 17 million in 2006, while the deceased donor rate was 13.6 per million in 2010, a decrease from 14 million in 2006.

Nearly 230 people died waiting for organs in 2010, while more than 4,400 were still on the waiting list by the end of that year, according to the report. The vast majority of those waiting were in need of a kidney.

The report found that nearly 40,000 Canadians were living with end-stage renal disease in 2010, more than triple the rate recorded in 1991. The increase is a serious problem and, if anything, will rise in the future. Diabetes is the predominant cause of end-stage renal disease and the number of Canadians diagnosed with Type 2 diabetes has risen sharply in recent years.

Being on a donation waiting list can take a heavy toll, with many patients bed-ridden and experiencing progressively worsening health. For individuals with renal failure, it meansdialysis, which can severely impact quality of life and increase the likelihood of death.

But the financial toll from Canada's organ donation supply gap is also massive.

CIHI calculated that the hemodialysis costs for one patient is $60,000 every year, while a kidney transplant comes with a one-time cost of $23,000, plus $6,000 a year for necessary medications after the fact. Over five years, the transplant is a quarter of a million dollars cheaper than dialysis, CIHI said, and it can substantially improve a patient's quality of life.

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There are many possible solutions that could help mitigate the shortfall in organ donations, Mr. Webster said, including efforts to prevent the development of Type 2 diabetes, which is linked to excess weight and obesity.

But if more people signed up as organ donors, it would also help relieve the pressure. Mr. Webster noted that the number of living donors who contribute a kidney to a patient in need has been rising in recent years.

People who receive a kidney donation from a living donor tend to wait less, with the average length of time spent on dialysis at just under 1.5 years. Those receiving a kidney transplant from a deceased donor wait on dialysis for nearly four years, CIHI said.

At the end of 2010, 501 patients in Canada were waiting for a liver, 135 for a heart, 310 for a lung and 98 for a pancreas, while 3,362 were waiting for a kidney.

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