RT Journal Article
SR Electronic
T1 Organ donation after medical assistance in dying: a descriptive study from 2018 to 2022 in Quebec
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E79
OP E84
DO 10.1503/cmaj.230883
VO 196
IS 3
A1 Weiss, Matthew J.
A1 Dupras-Langlais, Mathilde
A1 Lavigne, Marie-Josée
A1 Lavigne, Sylvain
A1 Martel, Annie-Carole
A1 Chaudhury, Prosanto
YR 2024
UL http://www.cmaj.ca/content/196/3/E79.abstract
AB Background: Since the implementation of medical assistance in dying (MAiD), deceased organ donation after MAiD has been possible in Quebec. We sought to describe organ donations after MAiD in the first 5 years after this practice was implemented in Quebec.Methods: We reviewed all cases referred for donation after MAiD from January 2018 to December 2022. We presented all data descriptively with no comparison statistics.Results: Transplant Québec received 245 referrals for donation after MAiD, of which 82 were retained (33.5%). Of the 163 nonretained referrals, 152 (93.2%) had a recorded reason, including 91 (55.8%) for medical unsuitability on initial screen (e.g., organ dysfunction, medical history), 34 (20.8%) for patient refusal and 21 (12.9%) instances where patients withdrew from the MAiD process entirely. Six patients died before MAiD. Eighteen of the 82 retained cases were cancelled later in the process, almost all (n = 17, 94.4%) because of medical contraindication discovered during detailed donor evaluation. Sixty-four patients became actual donors after MAiD, increasing from 8 in 2018 to 24 in 2022. The total conversion rate from referral to an actual donor was 26.1% (64/245). A total of 182 organs (116 kidneys, 20 livers and 46 lungs) were transplanted after MAiD. During the study period, MAiD donors represented 8.0% (64/803) of total deceased donors, increasing from 4.9% (8/164) in 2018 to 14.0% (24/171) in 2022.Interpretation: These data describe a substantial increase in deceased donation after MAiD in the first 5 years of implementation in Quebec. Future studies should focus on how to optimize systems to ensure these requests are treated in the most ethical and medically effective way.