Canadian Blood Services operates three national patient programs which serve to maximize transplant access for patients most in need by facilitating interprovincial organ sharing. These programs include the National Organ Waitlist (NOW), as well as the interprovincial organ sharing programs for Kidney Paired Donation (KPD) and Highly Sensitized Patients (HSP). These programs operate on the Canadian Transplant Registry (CTR) web-platform, which is maintained by Canadian Blood Services.
The NOW enables 24/7, web-based access to immediately view, list, and update the status of patients waiting for non-renal organs in Canada, as well as to update the medical urgency of patients as their status changes. Organ Donation Organizations (ODOs) use the NOW to match and allocate available organs to ‘high-status’ transplant candidates and to identify nationally listed non-renal patients who may be a match for organs that cannot be transplanted in the donor’s home province. ODOs register donors in their provincial donor management systems and use the NOW as a first step in the organ allocation process to identify patients in most critical need of an organ anywhere in Canada. The CTR sends alerts to ODOs to provide up-to-date information about organ availability and patient priority and enables transplant programs to update changes to patient urgency status any time of the day or night.
This report presents results for a cross-section of active candidates on the NOW as of the end of December 2018, as well as results for patients active during the year and historical information about the active candidate pool over time.
At the end of 2018, there were 851 active candidates on the NOW. These patients have been waiting for an average of 15 months from their respective list dates, with 65% having been listed in 2018. Approximately half of these active patients were waiting for a liver transplant, 14% in need of a heart transplant, 27% in need of a lung transplant, and 10% in need of a pancreas transplant. Beyond the 851 active candidates on the NOW, an additional 305 patients had an organ request which is on hold.
The NOW has improved the efficiency and safety of the system used for sharing organs for patients in most urgent need by automating the centralized national organ waitlist that enables patients’ status to be continually updated, to the minute. The CTR and the services available to provincial programs are evolving to meet the interprovincial sharing needs of the organ and tissue donation and transplantation community in Canada.