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    Canadian Institute for Health Information. Annual statistics on organ replacement in Canada: Dialysis, transplantation and donation, 2010 to 2019. 2020. https://www.cihi.ca/sites/default/files/document/corr-dialysis-transplantation-donation-2010-2019-snapshot-en.pdf

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    Shemie SD, et al. National recommendations for donation after cardiocirculatory death in Canada: Donation after cardiocirculatory death in Canada. CMAJ 2006; 175:S1. doi: 10.1503/cmaj.060895

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    Rao V, et al. Effect of organ donation after circulatory determination of death on number of organ transplants from donors with neurologic determination of death. CMAJ 2017; 189:E1206E1211. doi: 10.1503/cmaj.161043

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Living and Deceased Kidney Donation in Canada

Aninda Dibya SahaAninda Dibya Saha is with the Institute of Medical Science, University of Toronto, and Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada. Ana Konvalinka is with the Institute of Medical Science, University of Toronto; Toronto General Hospital Research Institute, University Health Network; Division of Nephrology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto; Soham and Shaila Ajmera Family Transplant Centre, Toronto General Hospital, University Health Network; and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.

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Ana KonvalinkaAninda Dibya Saha is with the Institute of Medical Science, University of Toronto, and Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada. Ana Konvalinka is with the Institute of Medical Science, University of Toronto; Toronto General Hospital Research Institute, University Health Network; Division of Nephrology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto; Soham and Shaila Ajmera Family Transplant Centre, Toronto General Hospital, University Health Network; and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.

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Kidney transplantation is the optimal treatment for end stage kidney disease. There are two types of kidney donors—living or deceased—and their proportions vary in different countries. This summary focuses on the living and deceased donation of all organs in Canada, which uses a voluntary opt-in system, where an individual who is eligible to become an organ donor may choose to opt-in to a national or provincial registry.

The total number of kidney transplants performed in Canada in 2019, the last year with data available, was 1483 (1) (including 53 kidney-pancreas transplants but excluding Quebec). The number of total living donors in Canada increased only modestly in the last decade, from 557 living donor transplants in 2010 to 614 in 2019 (2). The living donation rate declined slightly during this time (3). In contrast, the number of deceased donors nearly doubled during the same time, from 466 donors in 2010 to 820 donors in 2019, with a similar trend also being observed for the number of kidney transplants from deceased donors (1, 2) (Figure 1). The increase in deceased donors has been driven by the higher prevalence of donation after circulatory death (DCD) donors, which increased from <10% of all deceased donors in 2010 to 29% of all deceased donors in 2019 (2). DCD was launched in 2006 and was accompanied by strong advocacy efforts and the implementation of a legal framework, leading to its success (2, 4, 5, 6) (Figure 2).

Figure 1.
Figure 1.

Number of kidney transplants performed in Canada

Citation: Kidney News 13, 12

Number of kidney transplants performed in Canada
Figure 2.
Figure 2.

Reasons for the increased number of DCD donors in Canada

Citation: Kidney News 13, 12

Reasons for the increased number of DCD donors in Canada

There is an interesting sex bias when it comes to the composition of living compared to deceased donors in Canada. Excluding Quebec (data unavailable), 62% of living donors in Canada were female, whereas a similar proportion of deceased donors (61%) were male. Furthermore, of the living organ donors, 57% were unrelated to the transplant recipient (2). Interestingly, although living donation has been stagnant since 2010 (3), at 16.3 donors per million population, Canada has one of the higher living donation rates compared to most other countries with available data (7). Overall, Canada's deceased donor transplantation has increased markedly, mostly due to increased DCD donors. Efforts directed at increasing awareness and living kidney donation are warranted globally.

References

  • 1.

    Canadian Institute for Health Information. CORR transplants by organ type: Quick stats. 2021. https://www.cihi.ca/en/corr-transplants-by-organ-type-quick-stats

    • Search Google Scholar
    • Export Citation
  • 2.

    Canadian Institute for Health Information. Annual statistics on organ replacement in Canada: Dialysis, transplantation and donation, 2010 to 2019. 2020. https://www.cihi.ca/sites/default/files/document/corr-dialysis-transplantation-donation-2010-2019-snapshot-en.pdf

    • Search Google Scholar
    • Export Citation
  • 3.

    Canadian Institute for Health Information. Treatment of end-stage organ failure in Canada, Canadian Organ Replacement Register, 2010 to 2019: Donors—data tables. 2020. https://www.cihi.ca/sites/default/files/document/end-stage-kidney-disease-transplants-2010-2019-data-tables-en.xlsx

    • Search Google Scholar
    • Export Citation
  • 4.

    Shemie SD, et al. National recommendations for donation after cardiocirculatory death in Canada: Donation after cardiocirculatory death in Canada. CMAJ 2006; 175:S1. doi: 10.1503/cmaj.060895

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Rao V, et al. Effect of organ donation after circulatory determination of death on number of organ transplants from donors with neurologic determination of death. CMAJ 2017; 189:E1206E1211. doi: 10.1503/cmaj.161043

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Shemie SD. Trends in deceased organ donation in Canada. CMAJ 2017; 189:E1204E1205. doi: 10.1503/cmaj.170988

  • 7.

    International Registry in Organ Donation and Transplantation. IRODaT–2020 preliminary numbers in organ donation and transplantation. Donation & Transplantation Institute, 2021. https://tpm-dti.com/irodat-2020-preliminary-numbers-in-organ-donation-and-transplantation/

    • Search Google Scholar
    • Export Citation
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