Annual statistics on organ replacement in Canada, 2012 to 2021

• In 2021, more than 48,000 Canadians were living with ESKD. Across Canada, 29,835 people were receiving dialysis (includes Quebec). An additional 18,239 were living with a functioning kidney transplant (excludes Quebec).
• Canada’s deceased donor rate has not changed since 2020, remaining at 19.2 donors per million population. This represents a 12% decrease compared with pre-pandemic levels in 2019 (21.8 donors per million population) but a 23% increase compared with 2012 (15.6 donors per million population).
• Canada’s living donor rate in 2021 was comparable to pre-pandemic levels at 15.5 donors per million population, representing a 20% increase compared with 2020 (12.9 donors per million population).
• 2,750 solid organ transplants were performed in Canada in 2021. This is an increase of 6% compared with the first year of the COVID-19 pandemic in 2020 (N = 2,594 ) and a 23% increase compared with 10 years ago (N = 2,235).

The number of ESKD patients in Canada continues to rise. There was a 24% increase in incident patients receiving renal replacement therapy (dialysis or pre-emptive kidney transplant) over the last 10 years (N = 4,921 in 2012 versus N = 6,091 in 2021) (excludes Quebec as long-term trending is not available for this province).

Incident ESKD patients by initial type of treatment, Canada (excluding Quebec), 2012 to 2021

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Number of incident ESKD patients	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021
Hemodialysis	3,850	3,977	4,018	4,196	4,227	4,188	4,488	4,626	4,604	4,517
Peritoneal dialysis	923	1,041	1,069	1,150	1,276	1,324	1,363	1,351	1,447	1,403
Pre-emptive kidney transplant	148	148	151	162	145	176	163	177	145	171
Total renal replacement	4,921	5,166	5,238	5,508	5,648	5,688	6,014	6,154	6,196	6,091

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 2021.

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

Other trends observed in Canada (excludes Quebec) for ESKD between 2012 and 2021 are as follows:

• While only 2% of Canadians with incident kidney failure received a pre-emptive kidney transplant in 2021 (N = 171), this represents a 16% increase compared with 2012 (N = 148).
• More incident ESKD patients are choosing home dialysis as their initial type of treatment, with an increase of 22% in the last decade (2012 = 19% of incident ESKD patients, 2021 = 23%).
• The wait time for adult (age 18+) dialysis patients to receive a deceased donor kidney improved by 10% between 2012 and 2021 (from a median duration of approximately 3.7 years in 2012 to 3.3 years in 2021). The living donor wait time was shorter overall but increased by 30% over the last decade (from approximately 0.8 years in 2012 to 1.1 years in 2021).
• Post-transplant kidney graft survival rates have not improved over the last 10 years. Deceased donor 1-, 3- and 5-year graft survival rates were 94%, 88% and 77%, respectively, in 2021. Living donor kidney transplant grafts in 2021 had 1-, 3- and 5-year survival rates of 98%, 95% and 88%, respectively.

For dialysis data that includes Quebec, please see the renal replacement therapy data tables (XLSX).

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 transplants. 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, 2012 to 2021

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Number of organ donors and solid organ transplants	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021
Deceased donors	541	553	591	649	760	803	762	820	731	736
Living donors	538	585	553	563	544	535	555	614	490	592
Transplants	2,235	2,363	2,359	2,517	2,834	2,930	2,785	3,016	2,594	2,750

Note
Donor and transplant data from 2012 to 2021 is supplemented with aggregate data from Transplant Québec. Additional information can be found in Data Quality Documentation for Users: Canadian Organ Replacement Register, 2012 to 2021 Data.

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

Organ transplants in Canada, 2021: Donations and need

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Kidney: In 2021, there were 1,673 transplants. As of December 31, 2021, 3,060 people were waiting for a transplant. There were 105 deaths in 2021 while waiting for a transplant.

Liver: In 2021, there were 589 transplants. As of December 31, 2021, 536 people were waiting for a transplant. There were 95 deaths in 2021 while waiting for a transplant.

Heart: In 2021, there were 142 transplants. As of December 31, 2021, 135 people were waiting for a transplant. There were 12 deaths in 2021 while waiting for a transplant.

Lung: In 2021, there were 352 transplants. As of December 31, 2021, 222 people were waiting for a transplant. There were 37 deaths in 2021 while waiting for a transplant.

Pancreas: In 2021, there were 79 transplants. As of December 31, 2021, 180 people were waiting for a transplant. There were 3 deaths in 2021 while waiting for a transplant.

Notes
* Transplants include single and combination transplants for both pediatric and adult patients.
† 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.

Canada’s organ donation and transplantation programs have been additionally challenged during the COVID-19 pandemic, which has placed an unprecedented burden on health care systems in Canada and around the world. While the first year of the pandemic saw a shifting of priorities and resources to address the surge of critically ill COVID-19 patients, Canada is beginning to show signs of recovery, with improvements noted in the following aspects of organ donation and transplantation:

Organ donation

Organ donation levels in Canada nearly rebounded to pre-pandemic levels, with a total of 1,328 donors in 2021. This approached 2019 donor numbers (N = 1,434) and was a 9% improvement over 2020 (N = 1,221).

• This improvement was mainly attributed to living donor numbers, which showed marked improvement in 2021 compared with 2020 (N = 592 versus N = 490, respectively; N= 614 in 2019).
• Deceased donor numbers did not meaningfully change between 2020 and 2021 (N = 731 versus N = 736, respectively; N = 820 in 2019).

We’ve learned a lot over the course of the COVID-19 pandemic: how we can safely transplant patients despite the threat of a potentially deadly respiratory virus, how to use organs effectively under these circumstances (including from donors who may be infected) and how the system must be adapted to address the challenges created by a global public health crisis. More recently, we’ve seen signs of recovery in organ donation and transplantation activity, almost comparable to pre-pandemic levels.— Dr. Joseph Kim, Director, Kidney Transplant Program, University Health Network

Organ transplantation

• 2021 transplant numbers in Canada were still 9% lower than they were in 2019 before the start of the COVID-19 pandemic (N = 2,750 versus N = 3,016, respectively). However, this is a 6% improvement over 2020 (N = 2,594).
• The percentage of incident ESKD patients treated with pre-emptive kidney transplants in 2021 (excludes Quebec) is essentially equal to that seen before the pandemic, at 3%. This is an improvement over 2020, when only 2% of incident ESKD patients received a pre-emptive transplant (excludes Quebec).

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
• Data Quality Documentation for Users: Canadian Organ Replacement Register, 2012 to 2021 Data (PDF)
• Archived reports