Organ donation shortfalls in Ontario hospitals without transplant programs

Organ donation pamphlets are handed out across Canada. Leon Neal/Getty Images

TORONTO – Ontario hospitals without organ transplant programs are not faring as well in garnering organ donations as their counterparts, a new report suggests.

Transplant hospitals in the province with clinical programs in place for organ transplants had four times more donors than large general hospitals. The report, published Monday in the Canadian Medical Association Journal, suggests that this difference accounts for 121 fewer organ donors a year.

This disparity could be caused by the age and health of deceased patients and the condition of their organs, the report notes.

“Some of the shortfall may be explained by appropriate medical judgment, given that older organs are sometimes unsuitable for transplantation to young recipients. However, unfair age discrimination may be an additional explanation,” the authors write.

Dr. Donald Redelmeier, of the Institute for Clinical Evaluative Sciences and the University of Toronto, led the study.

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Read the full study here.

The scientists looked at all patients who died from catastrophic brain injury in Ontario from 1994 to 2011.

About 79,750 people died in 56 hospitals and 1,898 were organ donors.

Transplant hospitals made up for 22,515 of the deaths and 1,118 organ donors – a rate of about 5 donors per 100 deaths.

Large general hospitals made up 57,231 deaths and only 780 donors – about 1.4 donors per 100 deaths.

The hospitals that had services for transplant recipients openly publicized their services. Aside from that difference, the  hospitals in the study all operated under the same rules.

Over the 17 years of the study, actual donors increased steadily in Ontario.

The researchers say that many factors help determine whether a patient’s organs are donated or not: “the time pressure is substantial, because incidents often arise on weekends or at night when clinicians are short staffed, sleep deprived and uncertain about diagnosing brain death,” the report says.

Doctors may also be hesitant because of “distraught emotions” in relatives of potential donors at a critical time in decision-making.

The authors point to more training, education and policy to foster growth in organ donations at large hospitals.

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“These hospitals account for most of the potential donors and missed opportunities for deceased organ donation,” the study notes.

In January, Ontario’s coordinator of organ and tissue transplants said that more than 1,000 patients received a transplant in 2012, marking the third record-breaking year in a row.

The Trillium Gift of Life Network says that 1,053 organ transplants were performed last year – an 11 per cent increase compared to the year before.

When launched last April, 185,430 people registered to consent to organ and tissue donation.

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