Annual statistics on organ replacement in Canada, 2013 to 2022

• In 2022, more than 48,375 Canadians were living with ESKD. Of these, 29,809 Canadians were on dialysis, while an additional 18,566 were living with a functioning kidney transplant.Footnote i
• 3,777 Canadians were waiting for a solid organ transplant as of December 31, 2022. Of these, 73% were waiting for a kidney, 13% for a liver, 6% for a lung, 3% for a heart, 3% for a pancreas and 2% for a combination of organs
• 2,886 solid organ transplants were performed in Canada in 2022. While still below pre-pandemic volumes in 2019 (N = 3,016), total transplants increased by 11% compared with 2020 (N = 2,594) and 5% compared with 2021 (N = 2,752).
• In 2022, there were 827 deceased donors, the highest number over the last decade. This represents a 12% increase compared with 2021 (N = 736) and a 50% increase compared with 2013 (N = 553).
• While Canadian living donations improved by 18% in 2022 (N = 576) compared with the first year of the COVID-19 pandemic in 2020 (N = 490), the number decreased slightly  by 3% compared with 2021 (N = 594).
   

The number of ESKD patients in Canada continues to rise. There was a 17% increase in incident patients receiving renal replacement therapy (dialysis or pre-emptive kidney transplant) over the last 10 years (N = 6,036 in 2022 versus N = 5,171 in 2013).Footnote i

Incident ESKD patients by initial type of treatment, Canada (excluding Quebec), 2013 to 2022

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Number of incident ESKD patients	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022
Hemodialysis	3,982	4,019	4,200	4,229	4,203	4,504	4,645	4,635	4,550	4,702
Peritoneal dialysis	1,041	1,069	1,150	1,276	1,324	1,363	1,351	1,449	1,407	1,190
Pre-emptive kidney transplant	148	151	162	145	176	163	177	145	170	144
Total renal replacement	5,171	5,239	5,512	5,650	5,703	6,030	6,173	6,229	6,127	6,036

Notes
HD: Hemodialysis; PD: Peritoneal dialysis.
Quebec is excluded due to under-reporting of dialysis data between 2011 and 2019, and of transplant data between 2012 and 2022

Source
Canadian Organ Replacement Register, 2023, Canadian Institute for Health Information.

Other trends observed in CanadaFootnote i for ESKD between 2013 and 2022 are as follows:

• Only 2% of Canadians with incident kidney failure received a pre-emptive kidney transplant in 2022 (N = 144); proportions have remained consistent across the last decade.
• Fewer incident ESKD patients chose home dialysis as their initial type of treatment in 2022 (N = 1,222, or 20% of incident ESKD patients). This was a 15% decrease compared with 2021 (N = 1,438, or 23.5% of incident ESKD patients) .
• The median wait time for adult dialysis patients to receive a deceased donor kidney improved by 17% between 2013 and 2022 (from 4.1 years down to 3.5 years). While the living donor wait time increased by 9% over the last decade (from 339 days in 2013 to 371 days  in 2022), it remained substantially shorter than deceased donor wait times.
• The most recent 1-, 3- and 5-year graft survival rates for deceased donor kidney transplants were 94%, 86% and 79%, respectively, while rates for living donor kidney transplants were 97%, 93% and 89%, respectively.

While Canada has made improvements in the donation and transplantation of life-saving organs over the past decade, there remains a large gap between the need for organs and the number of donors and of transplants performed. As a result, organ failure patients often experience lengthy wait times, with some patients dying before a suitable organ becomes available . 

Number of organ donors and solid organ transplants, Canada, 2013 to 2022

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Number of organ donors and solid organ transplants	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022
Deceased donors	553	591	649	760	803	762	820	731	736	827
Living donors	585	553	563	544	535	555	614	490	594	576
Transplants	2,363	2,359	2,517	2,834	2,930	2,785	3,016	2,594	2,752	2,886

Note
Donor and transplant data from 2013 to 2022 is supplemented with aggregate data from Transplant Québec. Additional information can be found in Data Quality Documentation for Users: Canadian Organ Replacement Register, 2013 to 2022 Data.

Source
Canadian Organ Replacement Register, 2023, Canadian Institute for Health Information.

Organ transplants in Canada, 2022: Donations and need

 

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Kidney: In 2022, there were 1,795 transplants. As of December 31, 2022, 2,813 people were waiting for a transplant. There were 117 deaths in 2022 while waiting for a transplant.

Liver: In 2022, there were 594 transplants. As of December 31, 2022, 517 people were waiting for a transplant. There were 108 deaths in 2022 while waiting for a transplant.

Heart: In 2022, there were 153 transplants. As of December 31, 2022, 133 people were waiting for a transplant. There were 8 deaths in 2022 while waiting for a transplant.

Lung: In 2022, there were 352 transplants. As of December 31, 2022, 210 people were waiting for a transplant. There were 37 deaths in 2022 while waiting for a transplant.

Pancreas: In 2022, there were 94 transplants. As of December 31, 2022, 171 people were waiting for a transplant. There were 4 deaths in 2022 while waiting for a transplant. 

Notes
* Transplants include pediatric and adult patients who receive single or combination transplants. Combination transplants represent 2% of all transplants and are counted under each organ.
† Waiting for a transplant and deaths while waiting include patients who are active or on hold on the wait-list for single and combination transplants. 
‡ Pancreas includes islet cells transplantation.

Source
Canadian Organ Replacement Register, 2022, Canadian Institute for Health Information.

Canadian organ donation and transplantation programs have continued to show signs of recovery since the onset of the COVI9-19 pandemic in 2020, which has placed an unprecedented burden on health care systems in Canada and around the world. Improvements have been noted in the following aspects of organ donation and transplantation:

Organ donation

Organ donation levels in Canada nearly rebounded to pre-pandemic levels in 2022, with a total of 1,403 organ donors. This approached 2019 donor numbers (N = 1,434) and was a 5% improvement over 2021 (N = 1,330).

• In 2022, deceased donation numbers started to show substantial improvements since the onset of the COVID-19 pandemic in 2020. With 827 deceased donations in 2022, Canada exceeded 2019 deceased donation volumes (N = 820), and volumes improved by 13% compared with 2020 (N = 731) and by 12% compared with 2021 (N = 736).
• Living organ donation in Canada dropped slightly in 2022 (N = 576) compared with 2021 (N = 594) and was still 6% lower than pre-pandemic volumes (2019: N = 614).

As we emerge from the COVID-19 pandemic, we have witnessed great resilience in the organ donation and transplantation community, with record improvements in waiting times for deceased donor transplantation driven by the life-saving generosity of deceased organ donors across Canada. While we are grateful for the progress made on this front, we have also seen a stagnation in living organ donation that warrants a renewed commitment to advance initiatives to support living donor transplantation across Canada.— Dr. Jagbir Gill, Medical Director, Kidney Transplant Program, St. Paul’s Hospital; President, Canadian Society of Transplantation

Organ transplantation

While transplant numbers in Canada continued to rise in 2022 (N = 2,886) —   improving 5% over 2021 (N = 2,752) — they remained slightly lower than pre-pandemic 2019 volumes (N = 3,016). 

• This increase is primarily the result of kidney transplants, which increased by 6% between 2021 (N = 1,341) and 2022 (N = 1,417) and almost fully recovered to pre-pandemic volumes (2019: N = 1,437).Footnote i  Conversely, heart, pancreas and lung transplants in 2022 were still struggling to approach 2019 volumes (decreases of 32%, 25% and 19%, respectively, in 2022 compared with 2019).Footnote i 

End-stage organ failure is complex, with treatment options and donation practices/processes continuously evolving to optimize outcomes. By collecting and reporting on data in an ongoing and systematic way, CORR can assist with decision-making to monitor system performance and drive improvements. 

• Canadian Organ Replacement Register (CORR) 
• Organ replacement in Canada: CORR annual statistics
• Summary statistics on organ transplants, wait-lists and donors 

Have questions?

Contact us at the following email address:

corr@cihi.ca