Improving organ donation in Canada
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* Steven R. Martin

*   © 2007 Canadian Medical Association or its licensors

Wayne Kondro's recent article on organ donation programs1 highlights some of the challenges that the Canadian transplant community faces as it responds to the changes that have occurred in the transplantation landscape over the last 3 or 4 decades. Although a national organ donation agency may be beneficial, it is inaccurate to suggest, as Kondro does, that a nationwide wait-list does not exist and that organ sharing is somehow an afterthought.

For more than 20 years, the liver transplant community has had a nationwide agreement on wait-list priority for both urgent and nonurgent cases. This allocation system includes a consensus on organ sharing for urgent cases right across the country. A list is updated weekly by each regional organ procurement agency and is disseminated to the transplant centres. About half of the 50–60 urgent liver transplantations each year are performed using organs that come from another region. Although it is informal and operates with limited funding, the “liver study group” meets annually, has achieved consensus on many difficult issues and continues to find ways to optimize liver allocation and transplantation outcomes across Canada.

The driving forces behind changes in organ allocation policy in the United States are not exactly the same as those in Canada; solutions should be sought that reflect our reality. Where a national agency may be most beneficial is in providing the infrastructure to gather the statistics that will be most useful in tracking trends in transplantation. This will permit stakeholders to implement the necessary modifications in practice in a timely manner.

## REFERENCE

1.  1. Kondro W. Fragmented organ donation programs hinder progress. CMAJ 2006;175(9):1043.
    
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