Trends in deceased organ donation in Canada

Shemie, Sam D.

doi:10.1503/cmaj.170988

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…Despite increases in the rates of organ donation in Canada following the implementation of donation after circulatory death (DCD), there remains a significant shortage of organs available for transplantation. 4,5 In 2017, 4,333 Canadians were waiting for a solid organ transplant, with 242 patients on the waitlist dying. 4 Given the immeasurable impact of transplantation on the recipients, it is imperative that the altruistic wish to donate is realized in every potential donor, and that donation potential is maximized in every consented organ donor.…”

Section: Organ Donation and Death Determination In Canada: Backgroundmentioning

confidence: 99%

Organ donation in patients on extracorporeal membrane oxygenation: considerations for determination of death and withdrawal of life support

Taran

Steel

Healey

et al. 2020

Can J Anesth/J Can Anesth

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The use of extracorporeal membrane oxygenation (ECMO) is increasing globally, although mortality in this setting remains high. Patients on ECMO may be potential organ donors in the context of withdrawal of life-sustaining measures (WLSM) or neurologic determination of death (NDD). Nevertheless, there are currently no Canadian standards to guide clinicians on NDD or WLSM for the purposes of organ donation in this patient population. Apnea testing remains fundamental to determining NDD and is an area where ECMO may alter routine procedures. In this review, we outline protocols for the performance of apnea testing and WLSM for patients supported with ECMO, highlighting important technical and physiologic considerations that may affect the determination of death. In addition, we review important considerations for NDD in ECMO, including management of potential confounders, strategies for controlling oxygen and carbon dioxide levels during apnea testing, and the appropriate use of ancillary tests to support NDD. In the

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Section: Organ Donation and Death Determination In Canada: Backgroundmentioning

confidence: 99%

Organ donation in patients on extracorporeal membrane oxygenation: considerations for determination of death and withdrawal of life support

Taran

Steel

Healey

et al. 2020

Can J Anesth/J Can Anesth

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“…Since its implementation in 2006, organ donation after circulatory determination of death (DCD) has substantially increased the number of organs recovered for transplant in Canada. 1 Nevertheless, organs from DCD donors sustain ischemic injury that impacts graft quality and often precludes transplantation. While DCD has expanded the donor pool, it remains insufficient to meet transplantation demand.…”

mentioning

confidence: 99%

Implications of the updated Canadian Death Determination Guidelines for organ donation interventions that restore circulation after determination of death by circulatory criteria

Murphy

Weijer

Slessarev

et al. 2023

Can J Anesth/J Can Anesth

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“…1 A CMAJ article by Shemie highlighted the current trend toward increasing use of donation after circulatory death (DCD) grafts to address organ shortages. 2 In 2017, 53 Canadians underwent liver transplant with DCD grafts, the highest number to date. 1 Donation after circulatory death differs from the more common donation after neurological death (DND).…”

mentioning

confidence: 99%

Addressing organ shortages: progress in donation after circulatory death for liver transplantation

Nostedt

Shapiro

Freed

et al. 2020

cjs

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Reducing wait list mortality among patients awaiting liver transplantation remains a substantial challenge because of organ shortage. In efforts to expand the donor pool there has been a trend toward increased use of donation after circulatory death (DCD) liver grafts. However, these marginal grafts are prone to higher complication rates, particularly biliary complications. In addition, many procured DCD livers are then deemed unsuitable for transplant. Despite these limitations, DCD grafts represent an important resource to address the current organ shortage, and as such there are research efforts directed toward improving the use of and outcomes for transplantation of these grafts. We review the current progress in DCD liver transplantation.La réduction du nombre de personnes en attente d'une greffe de foie qui décèdent avant la transplantation demeure un défi important en raison de la pénurie d'organes. On remarque actuellement une tendance à la hausse dans l'utilisation de greffons de foie provenant de don après décès circulatoire (DDC) dans le but d'élargir le bassin de donneurs. Ces greffons marginaux sont toutefois associés à des taux de complications plus élevés, particulièrement pour ce qui est des complications biliaires. De plus, de nombreux foies obtenus à la suite d'un DDC sont jugés inadmissibles à la greffe. Malgré ces restrictions, les greffons provenant de DDC représentent une importante ressource pour atténuer la pénurie d'organes. Des initiatives de recherche sont donc actuellement en cours dans le but d'améliorer leur taux d'utilisation et les issues des transplantations. Nous analysons ici l'état actuel des progrès pour les transplantations de foie provenant de DDC.

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Trends in deceased organ donation in Canada

Cited by 4 publications

References 10 publications

Organ donation in patients on extracorporeal membrane oxygenation: considerations for determination of death and withdrawal of life support

Organ donation in patients on extracorporeal membrane oxygenation: considerations for determination of death and withdrawal of life support

Implications of the updated Canadian Death Determination Guidelines for organ donation interventions that restore circulation after determination of death by circulatory criteria

Addressing organ shortages: progress in donation after circulatory death for liver transplantation

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