Organ donations and transplants in Canada increased between 2020 and 2021: report

A nurse tends to a patient in the intensive care unit at the Bluewater Health Hospital in Sarnia, Ont., on Tuesday, January 25, 2022. THE CANADIAN PRESS/Chris Young

Both the number of organ donations and transplants in Canada rebounded in 2021 after the number in plunged in 2020 in part due to the COVID-19 pandemic, according to a new report from the Canadian Institute for Health Information.

The report, published Thursday, looked at the latest statistics from the Canadian Organ Replacement Register to provide a snapshot of the statistics in organ donation, transplantations and end-stage kidney disease since the first year of the pandemic.

In 2021, there were a total of 1,328 organ donors across Canada, a nine per cent increase compared to 2020.

"Canada’s organ donation and transplantation programs have been additionally challenged during the COVID-19 pandemic, which has placed an unprecedented burden on health care systems in Canada and around the world," the CIHI report stated. "While the first year of the pandemic saw a shifting of priorities and resources to address the surge of critically ill COVID-19 patients, Canada is beginning to show signs of recovery."

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The 2021 data also reveals that over the past decade there has been a 23 per cent increase in both organ donations and transplants performed. There were 2,235 solid organ transplants performed across Canada in 2012, compared to 2,750 in 2021.

This number also represents a six per cent increase in transplants in 2021 compared to 2020. The number of transplants performed in 2020—2,594—was the lowest number of yearly transplants since 2015.

It’s a good sign that we’re approaching pre-pandemic rates again, experts say.

“We’ve learned a lot over the course of the COVID-19 pandemic: how we can safely transplant patients despite the threat of a potentially deadly respiratory virus, how to use organs effectively under these circumstances (including from donors who may be infected) and how the system must be adapted to address the challenges created by a global public health crisis,” Dr. Joseph Kim, Director, Kidney Transplant Program, University Health Network, said in the report. "More recently, we’ve seen signs of recovery in organ donation and transplantation activity almost comparable to pre-pandemic levels.”

We still haven’t rebounded completely, according to the data—there were 3,016 transplants performed in 2019, nine per cent more than in 2021.

And long-term gaps in the system that predate the pandemic are still affecting patients.

“While Canada has made improvements in the donation and transplantation of life-saving organs over the past decade, there remains a large gap between the need for organs and the number of donors and transplants,” the report stated. “As a result, organ failure patients often experience lengthy wait times, with some patients dying before a suitable organ becomes available.”

In 2021, a total of 105 people died while waiting for a kidney transplant. The second most deadly wait time was in liver transplants, where 95 patients died while waiting for a liver.

As of December 31, 2021, there were 4,043 Canadians on wait lists to receive an organ transplant, according to an earlier report from CIHI in June.

Wait times for those with end-stage kidney disease to receive a kidney transplant have gotten both better and worse. Over the last decade, the wait time for a kidney from a deceased donor has improved by 10 per cent, but the wait time for a kidney from a living donor increased by 30 per cent. However, it’s still much faster to receive a kidney from a living donor, with patients waiting around 1.1 years as of 2021 compared to 3.3 years from a deceased donor.

MORE LIVING DONORS PROVIDED ORGANS IN 2021

Organ donation statistics are split into donors who are deceased, meaning those who agreed ahead of time to donate viable organs after they died, and donors who are living, such as those who donate one of their kidneys to a loved one.

The number of deceased donors dropped in 2020 and didn’t budge in 2021, with the rate in both years remaining around 12 per cent below pre-pandemic donation rates. 

But while the deceased donor rate stayed down, more living donors chose to donate an organ in 2021 compared to 2020, according to the data.

The living donor rate in 2021 was around 15.5 donors per million people, which is similar to the pre-pandemic rate and also a 20 per cent increase on the 2020 rate.

There were more than 100 extra transplants from living donors in 2021 compared to 2020.

MORE CANADIANS BEING TREATED FOR END-STAGE KIDNEY DISEASE

The number of Canadians dealing with end-stage kidney disease has been steadily rising over the past decade, according to the CIHI report.

Since 2012, there was a 24 per cent increase in patients receiving either kidney dialysis or pre-emptive kidney transplants. The data spans all of Canada except for Quebec, for which long-term data wasn’t available.

The steady growth of Canadians receiving these treatments plateaued in 2020 and 2021, likely due to a combination of patients being wary of going to the doctor during the pandemic and the pandemic halting or delaying numerous medical procedures and treatments.

More and more patients are opting for at-home dialysis, with this treatment increasing as a first choice by 22 per cent over the last decade. A patient with end-stage kidney disease who hasn’t had a transplant has to receive dialysis around three times a week in sessions that last four hours, making an at-home option more accessible for many patients.

Kidney transplants in adults are associated with some of the highest survival rates for solid organ transplants, but those survival rates have not improved over the last 10 years. Survival rates are higher among those who receive a kidney from a living donor, with an 88 per cent survival rate at five years post-transplant, compared to those who receive a kidney from a deceased donor for a 77 per cent survival rate after five years.