Gill J S, Klarenbach S, Cole E, Shemie S D
Division of Nephrology, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada.
Am J Transplant. 2008 Aug;8(8):1580-7. doi: 10.1111/j.1600-6143.2008.02314.x.
There has been no significant increase in the number of deceased organ donors in Canada over the past decade. Canada's donation and transplant system will be restructured with the formation of a new national organization to oversee activity in provincially governed donation and transplantation services. We review the current status of deceased organ donation, highlight issues contributing to the current stagnation in donation and identify changes that will enable success in a new Canadian system. Determining Canada's organ donation performance is difficult because the data required to calculate meaningful metrics of donation performance are not available. Canadians wait longer for transplantation than Americans, and Canada is falling further behind the United States primarily because of fewer donations after cardiac death. The ongoing divide between intergovernmental jurisdictional domains limits national initiatives to improve Canada's donation system. The success of a new national system will be enabled by uniform provincial legislation to ensure that all patients are offered the option to donate, commitment of resources to support organ donation by provincial governments, transparent reporting of comparable metrics of donation performance, establishment of processes to introduce and implement new initiatives and alterations to reimbursement models for organ donation and recovery.
在过去十年中，加拿大已故器官捐赠者的数量并未显著增加。加拿大的捐赠和移植系统将进行重组，成立一个新的国家组织来监督省级管理的捐赠和移植服务活动。我们回顾了已故器官捐赠的现状，突出了导致当前捐赠停滞的问题，并确定了在新的加拿大系统中取得成功所需的变革。确定加拿大的器官捐赠表现很困难，因为计算有意义的捐赠表现指标所需的数据并不存在。加拿大人等待移植的时间比美国人更长，而且加拿大正进一步落后于美国，主要原因是心脏死亡后的捐赠较少。政府间管辖领域之间持续存在的分歧限制了改善加拿大捐赠系统的国家举措。一个新的国家系统的成功将通过统一的省级立法来实现，以确保为所有患者提供捐赠选项，省级政府承诺提供资源支持器官捐赠，透明报告可比的捐赠表现指标，建立引入和实施新举措的流程，以及改变器官捐赠和回收的报销模式。
