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. 2024 Jan 28;196(3):E79-E84.
doi: 10.1503/cmaj.230883.

Organ donation after medical assistance in dying: a descriptive study from 2018 to 2022 in Quebec

Matthew J Weiss  1 , Mathilde Dupras-Langlais  2 , Marie-Josée Lavigne  2 , Sylvain Lavigne  2 , Annie-Carole Martel  2 , Prosanto Chaudhury  2
Affiliations

Organ donation after medical assistance in dying: a descriptive study from 2018 to 2022 in Quebec

Matthew J Weiss et al. CMAJ. .

Abstract

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.

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Conflict of interest statement

Competing interests:: Prosanto Chaudhury is a board member with the Canadian Society of Transplantation and a medical director, transplantation, with Transplant Québec. No other competing interests were declared.

Figures

Figure 1:
Figure 1:
Referrals considered for organ donation after medical assistance in dying (MAiD).
Figure 2:
Figure 2:
Transplanted organs from donors who underwent medical assistance in dying in Quebec, 2018–2022.
See this image and copyright information in PMC

References

    1. Weiss MJ. Organ donation in the context of medical assistance in dying in Quebec: overview of a new practice [article in French]. French-speaking palliative care notebooks 2019;19:1–12.
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    1. Comité éthique en science et en téchnologie. Ethical issues related to organ donation in the context of Medical Assistance in Dying [article in French]. Québec: Government of Quebec; 2016. Available: https://www.ethique.gouv.qc.ca/media/3clerfw0/don-organes_vf_2016-04.pdf (accessed 2023 June 2).