Valérie Levée and Ève Beaudin – The rumor detector
SCIENCE. Contrary to popular belief, giving our consent to organ donation does not make us a donor. Although Transplant Québec estimates that 5 out of 10 Quebecers have registered their consent in one of the two current registries in Quebec, once all the eligibility steps have been completed, 80% of potential donors are rejected, the Rumor detector.
The donor selection process
At the hospital, if a patient suffers irreversible neurological damage and is mechanically ventilated, the medical team identifies him as a potential donor. In addition, since 2017, those who have benefited from medical care to die may also be potential donors. That’s how in 2021, medical staff identified 724 potential donors, according to the latest Transplant Quebec report.
It is then this organization that assesses the suitability of donors. They must meet the following three conditions:
- be registered in one of the two consent registers, the RAMQ or the Chambre des notaires du Québec;
- having a neurological condition that suggests imminent death;
- they present a state that allows the organs to be adequately supplied with blood and oxygen.
The family must also give their consent. The refusal of the family takes precedence over the consent of the deceased.
In Quebec, organ donation is regulated by joArticle 43 of the Civil Code which specifies that the will of the donor must be respected except “ compelling reason “But the law does not specify which constitutes an imperative reason.
In 2021, of the 724 potential donors, 524 were rejected: 59% for medical conditions incompatible with organ donation, 36% for family refusal and 5% for other reasons. Therefore, only 197 donors were accepted.
And that’s not all, because once the process of organ donation begins, donations can still be canceled if the family reconsiders their decision or if the hemodynamic conditions, linked to blood circulation, are not maintained. .
In 2021, 53 donors were canceled, leaving only 144, or 20% of potential donors.
Every donor saves many lives
These 144 people donated 150 lungs, 90 livers, 223 kidneys, 29 hearts, 12 pancreas and 1 intestine – a total of 505 transplants.
On average, every Quebec donor who reached the end of the selection process donated 3.5 organs in 2021.
Due to double transplants and inter-provincial organ transfers, in Quebec in 2021, there were not 505, but 409 transplant recipients.
A sometimes fatal wait
In 2021, 888 people in Quebec were waiting for an organ transplant: 409 were transplanted and 34 died before receiving an organ. The wait to receive is long.
The kidney, the organ of all superlatives
If the kidney is the most transplanted organ (223), it is also the one for which there is more waiting (544 days) and requests (620). Dead donors are not enough. Because the kidney has the distinction of being the only complete organ that can be donated in a lifetime, an additional 75 kidneys came from living donors in 2021.
Quebec and the rest of Canada
Canadian Blood Services prepares annual reports on the Canadian organ donation and transplantation system, which allow us to compare the situation in Quebec with the rest of the provinces.
With 16.7 donations per death per million inhabitants, Quebec lags slightly behind the rest of the provinces. On the other hand, it clearly appears on the back of the package for live donations.
Knowing that kidneys make up the majority of living donations and that the kidney is also the most sought after and longest-obtained organ, living donation awareness is a way to develop to improve kidney transplantation in Quebec.
Although the signature of the organ donation consent does not convert the person into a donor, each signature counts, taking into account the flagrant lack of organs.
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