CMAJ/JAMC News and analysis
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BC launches computerized organ-donor registry

CMAJ 1998;158:579

© 1998 Heather Kent

British Columbia has developed Canada's first computerized organ-donor registry. The new system, designed to address current problems surrounding consent and long waiting lists, is expected to increase organ and tissue donations significantly.

Previously, BC residents indicated their willingness to donate when renewing a driver's licence. However, because less than half of them informed their families, the BC Transplant Society estimates that 35% of organs that were potentially available were being lost. Conversely, when families were aware of the desire to donate, 96% of them agreed to proceed. Shortage problems are compounded because fewer than 1% of those who sign up eventually donate an organ because they must be declared brain-dead first.

With the new system, potential donors need only register once through a participating drugstore chain, their BC Care Card or a motor-vehicle licensing branch. As well, people can "specifically delineate an organ for transplantation," explains Bill Barrable, chief executive officer for the BC Transplant Society.

All BC intensive care units have confidential telephone and fax numbers linked to the registry, which allow them to check if a person has registered. A copy of the registration is faxed to the doctor; this can then be presented to the family as evidence of legal consent. The registration constitutes "an advance directive for a living will," says Barrable, so written consent from the family is not required. The procedure also allows donors to keep the information confidential if they do not wish to notify family members.

To educate health care professionals about the program, the British Columbia Medical Association has sent material to doctors and the Transplant Society has visited all intensive care units in the province.

The society hopes that 500 000 more people will register by 2000 and ease the province's problems in meeting the current annual need for about 350 organs and 900 corneas. About 25% of the people on waiting lists die before a donor organ is available. Today the average waiting time for a kidney transplant is 809 days. Kidney transplants are consider particularly cost-effective; they cost $20 000, plus $6000 yearly for antirejection drugs, while annual dialysis treatment can cost $50 000. Barrable says that since transplants became "mainstream and are no longer considered experimental, they have become a victim of their own success."

Funded by the Ministry of Health and the private sector, start-up costs for the registry will be $1 million, with annual costs of $71 000.

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| CMAJ March 10, 1998 (vol 158, no 5) / JAMC le 10 mars 1998 (vol 158, no 5) |