Organ donation is the process of surgically removing an organ or tissue from one person and placing it into another.

Organs used for transplantation can come from either a deceased donor or a living donor.  

When you register to become a potential organ donor, you register with your province to become a DECEASED donor, meaning you pass your organs on after you die.  In Canada, the chances of a potential organ donor becoming an actual organ donor are very low.  In fact, a Canadian is five to six times more likely to need an organ transplant than they are to become an actual organ donor.  

In order to be a deceased organ donor in most parts of Canada, a person need to be:

1. in a hospital, most often in an intensive care unit (ICU)
2. surviving with the help of a ventilator (machine to assist breathing), and
3. determined by clinicians to be either neurologically (brain) dead or facing cardio-circulatory death. Donation is only considered after all life-saving methods to save a patient’s life have been tried. 

To illustrate how important it is for all Canadians to register as potential donors, consider this:  in 2015, of the approximately 267,000 deaths occurring in Canada, only about 150,000, or 56%, happened in a hospital.  Of the 150,000 deaths that happened in a hospital, only about 5,000, or 3%, fulfilled the criteria to be a potential organ donor (ventilator & brain dead).  Of these 5,000 potential organ donors, only about 650, or 13%, went on to be actual organ donors.  Those 650 donors resulted in about 1,995 transplants.  To end the waiting list, we need to make sure that all potential organ donors become actual organ donors.  That’s why it is so important to register as an organ donor.

There are two types of donation after death:

1. Donation after Neurological Death (DND), also known as brain death. Often caused by a severe injury or trauma, neurological death is diagnosed through a series of clinically accepted tests including an apnea test that determines if a person can breathe while temporarily disconnected from the ventilator.  Neurological death is permanent and cannot be reversed. 
2. Donation after Cardio-Circulatory Death (DCD) occurs when a patient with severe brain injury dies once a decision to remove all life sustaining treatments have been made.   These patients will have suffered significant and irreversible brain damage and cannot sustain life without the help of a ventilator.  Patients with Cardio-Circulatory death meet specific clinical criteria and the severity of their brain injury would cause them to die quickly once life support was removed.  Patients in a coma are not considered for Donation after Cardio-Ciculatory death since patients in a coma or vegetative state have varying levels of brain function and depending on the severity of the brain injury, these patients and can live off of life support and can sometimes recover or wake up from a coma.

Depending on the patient’s medical history and type of death, a deceased donor can donate up to eight (8) organs for transplant:

• 2 kidneys
• 2 lungs
• Liver
• Pancreas
• Intestine
• Heart

The US Department of Health & Human Services has created a great overview of the organ donation process.  Please click here to view:  https://www.organdonor.gov/about/process.html

Although our numbers are lower due to our smaller population, the process of organ donation in Canada is extremely similar, although Canada still lacks a National Organ Donor Registry.  In Canada, there are nine organ donation or procurement organizations that manage the process of registration, donation and transplantation for Canadians: 

• Legacy of Life – Nova Scotia Organ and Tissue Donation Program  http://www.legacyoflife.ns.ca/index.html
• OPEN – Organ Procurement and Exchange of Newfoundland and Labrador http://www.easternhealth.ca/Give.aspx?d=1&id=323&p=53
• New Brunswick Organ and Tissue Donation Program, New Brunswick  http://www2.gnb.ca/content/gnb/en/departments/health/Hospital-Services/content/organ_donation.html
• Prince Edward Island Organ and Tissue Donation http://www2.gnb.ca/content/gnb/en/departments/health/Hospital-Services/content/organ_donation.html
• Québec-Transplant, Quebec  http://transplantquebec.ca/
• Trillium Gift of Life Network, Ontario    http://www.giftoflife.on.ca/en/
• Transplant Manitoba — Gift of Life Program, Manitoba   http://www.transplantmanitoba.ca/
• The Saskatchewan Transplant Program, Saskatchewan   https://www.saskatchewan.ca/residents/health/accessing-health-care-services/organ-and-tissue-transplants-and-donations
• Alberta Organ and Tissue Donation Registry    https://myhealth.alberta.ca/Pages/OTDRHome.aspx
• BC Transplant, British Columbia   http://www.transplant.bc.ca/

Organ donation from a LIVING donor most often occurs when a deceased donor cannot be found in time.  Living donors can potentially donate:

• One of two kidneys:  a kidney is the most frequently donated organ from a living donor as the donor’s remaining kidney provides the function necessary to survive.
• One of two lobes of the liver:  Cells in the remaining part of the liver regenerate until the liver is almost its original size in both the donor and recipient.
• A lung or part of a lung, part of the pancreas or part of the intestines:  While these organs do not regenerate, both the donated portion and the retained portion are fully functioning.

In most cases, a living donor will donate their organ, or a part of their organ, to help save the life of a loved one or close friend. 

In Canada, if an eligible donor and a patient requiring a kidney transplant are NOT an appropriate clinical match, the Kidney Paired Donation Program (KPD) makes it possible for the donor and patient to be paired with other non-matched pairs(donor-recipient) in Canada in what is essentially a chain-reaction of kidney transplants.  Since its inception in 2009, more than 500 living donors across Canada have participated.  For more information on the Kidney Paired Donation Program, please visit : https://blood.ca/en/media/backgrounder-kidney-paired-donation-program