Waiting list for organ donation shrinking, but Quebec can do better

The list of people waiting for an organ donation in Quebec has shrunk. New figures released Wednesday by Transplant Québec show a 17 per cent increase in the number of people receiving transplants and a record number of donations for 2023.

Last year, on December 31, 853 people were on the waiting list managed by Transplant Québec, the organization that coordinates organ donations across the province. At the same date in 2022, 913 people were waiting for an organ transplant.

The statistics also show that 41 people lost their lives while still waiting for an organ donation, six fewer than in 2022.

“On this waiting list, there are people who are removed because of their medical condition, so they are too ill to be on the list,” Transplant Québec’s director general, Martine Bouchard, said in an interview.

She added, however, that the number of people who have had a transplant has also risen considerably. “And that too can have an effect on the number of people on the waiting list,” she added.

The number of referrals increased by almost 35 per cent to 1,156 referrals for organ donation in 2023. Of this number, 270 referrals were eligible, including 21 donors from Medical Aid in Dying (MAID).

According to Bouchard, the growth in the number of referrals can be explained in part by the introduction of coordinating physicians in almost all the CISSS and CIUSSS in Quebec. They work with dedicated staff in the hospitals and at Transplant Québec, in particular to provide training and identify potential donors.

“Inevitably, if there are more referrals, there are more donors and more transplants, so there is less waiting time for certain organs,” Bouchard pointed out.

The 2023 report shows that the waiting time for lung transplants has never been so low, with an average of 57 days, and the number of people waiting for a heart is at its lowest level for 10 years, with 32 people on the waiting list.

Lack of resources

The number of organs transplanted increased by 20 per cent, thanks in particular to the 206 deceased donors, who enabled 696 organs to be transplanted.

“Having 206 donors is an all-time record (…) The only downside is that this is being done under pressure in terms of the resources available,” commented Bouchard.

“We won’t be able to keep increasing by squeezing more juice out of our resources, which are stretched to the limit.”

She envisions that next year it will not be possible to match this record. “I’m not sure that next year we’ll be able to keep up with the same resources. We’re really doing it at arm’s length, hence the need and the plea to Quebec society and also to the government to ensure (that we have) legislation and all the essential elements needed to give us more leverage so that we can improve further to save more lives.”

According to the CEO of Transplant Québec, although the indicators for 2023 are encouraging, the number of potential donors is still below what Quebec can achieve.

“In concrete terms, this means that people who need an organ and are on our waiting list are currently dying when we know we can do better,” she said in a press release.

Quebec has a rate of 23 deceased donors per million population for 2023, up from 19.7 the previous year. Ontario has a similar rate of 23.1 donors per million population. Data for the other Canadian provinces for 2023 are not yet available.

Although Quebec has improved, it is still far behind Spain and the United States in terms of organ donations, which have rates of 48.3 and 48.6 donors per million inhabitants respectively.

“To achieve rates similar to those in Spain or certain jurisdictions in the United States, we need more resources throughout the donation and transplantation chain,” said Bouchard.

The Montreal region remains the best performer on a per capita basis, with a rate of 26.3 potential donors per 100,000 inhabitants. Mauricie-Centre-du-Québec comes second with a rate of 19.3, followed by Capitale-Nationale with a rate of 16.8.

The Bas-Saint-Laurent region, which had one of the lowest rates in Quebec in recent years, has made a spectacular recovery, increasing its number of referrals by 230 per cent to reach a rate of 11.5 per 100,000 inhabitants.

-This story was translated from French by CityNews