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A better understanding of the process: a courageous step

Awareness, promotion and education about organ and tissue donation begin with relevant, accurate and informed information. Here’s a resource we’ve created in collaboration with donor caregivers and medical researchers in the field. We sincerely hope it will help you learn more and better understand this important topic!

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Canada’s first research chair in organ donation, in partnership with Université de Sherbrooke

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To advance our knowledge of organ donation, we are proud to have partnered with the Université de Sherbrooke to create the Justin Lefebvre Research Chair.

Our goal is to better understand the parameters, that improve the experience of organ donation for donors, recipients and bereaved families. By fostering collaboration between academic development, hospital knowledge and community needs, we can create innovative methods to improve transplant success.

Research Chair focuses on several areas*

1

Using imaging to map and target cancer cells in the body and treat them in a targeted way, to predict and monitor response to treatment.

2

Increasing the number and quality of organs harvested, through clinical trials that measure the efficacy and safety of drugs.

3

Reduce depression, post-traumatic shock and grief, by developing end-of-life care interventions for organ donor families.

4

Educating the next generation of organ donation researchers.

*Source :https://fondationjustinlefebvre.com/wp-content/uploads/2024/09/FMSS-ChaireRechercheDonsOrganes-BR-1.pdf

Learn more about research

Saving lives, one gift at a time

The shortage of organs for transplantation is a critical health issue for the people of Quebec and Canada. Transplantation saves lives, improves quality of life and is the treatment of choice for a growing number of diseases. As a result, the demand for transplants continues to grow, but the supply remains inadequate*.

By spreading the word as we do, we ensure that as many people as possible can make informed decisions when it comes to signing their health insurance card.

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*Source : https://fondationjustinlefebvre.com/wp-content/uploads/2024/09/FMSS-ChaireRechercheDonsOrganes-BR-1.pdf

Frequently Asked Questions

Below you’ll find answers to the most common questions you may have about organ and tissue donation.

Ask a question

There are several ways to make your wishes known:

  1. Sign the sticker on the back of your health insurance card (which you will receive when you renew your card).
  2. Register with the RAMQ (Régie de l’assurance maladie du Québec) by filling out a form when you renew your card, or by applying one online. If you are already registered, you will not receive the form with your renewal.
  1. Register with the Registre des notaires du Québec. There are no additional costs for seeing a notary, and you can register your consent or refusal.
  2. Discuss with your loved ones. If your wishes are not known to the various registries, healthcare professionals will ask your loved ones.

 Children can sign as soon as they can write their name, but a parent must sign until the age of 14.

Doctors have a code of conduct that governs their profession. It states, in part:

“I WILL MAKE the health and well-being of my patient a priority;

I WILL RESPECT the autonomy and dignity of my patient;

I WILL ENSURE absolute respect for human life…”.

With this text, you’ll understand that the signature on the card will only be seen by healthcare professionals at the end of life and will in no way affect the care you receive.

Consent can be given for the donation of vital organs (heart, lungs, liver, pancreas, kidneys, intestines), tissues (eyes, bones, skin, heart valves) and research. Family members will be the spokespersons for the deceased’s wishes.Potential organ donors can donate :

KidneysTypically, the two kidneys from a “deceased” donor are transplanted to two different recipients. A living donor can only donate one kidney after a rigorous evaluation process to ensure that your health will not be compromised by the donation. The kidney was the first organ to be successfully transplanted in 1954.
LiverThe liver is usually transplanted into a single recipient. Occasionally, it may be divided into 2 to benefit 2 recipients.
PancreasThe pancreas can be transplanted alone. It can also be transplanted with a kidney in patients with diabetes and kidney failure. It is also possible to remove only the pancreatic islets (the cells of the pancreas that produce insulin) for transplantation.
LungsThe lungs are usually donated in pairs to one recipient, or less commonly, separately to two recipients.
HeartThe heart can be transplanted alone or in combination with the lungs.

The person who can donate tissue is someone whose heart has stopped. In other words, someone who has died. They can donate one or more tissues of their choice. Tissues are transplanted by surgeons who have to treat other living people.

Depending on the cause of death, there are different tissues that can be donated:

Types of tissuesWhy this tissue?Noteworthy
Ocular tissuesDegenerative eye diseases, accidents that injure the cornea, and repeated infections.It is the only tissue that can be harvested from people with cancer.
SkinSkin grafts for burn victimsMostly the skin from the back is taken (large surface). The thickness is 0.05 to 1.4 mm, equivalent to a scratch. Nothing is visible when the deceased is exposed in an open casket.
Vascular tissuesSurgery where vessels are required
Tendons and ligamentsOrthopedic surgery after a trauma (accident)Harvested from the lower limbs only.
BonesOrthopedic surgery such as hip and knee replacementRemoval of the femur and sometimes the tibia. Prostheses are applied after removal. Can also be used to make glue which is used in the above surgery.
Cardiac valvesNeeded to replace heart valves in some peopleTissues are in high demand for children born with heart defects.

No, you can’t do all three. If a person chooses to donate his or her body to science, he or she cannot donate organs or tissues (with the exception of the corneas). In fact, to be accepted for donation to science, the body must be intact and must not have undergone any recent surgery.

It is possible for a person to prioritize his or her wishes. They could choose organ donation as their first choice and body donation to science to science as their second choice if the first choice is not possible because it is not possible to do both.

Organ donation is only possible under very specific circumstances.

The person must be hospitalized in an intensive care unit and must be receiving life-sustaining treatment.

Organ donation is only possible in two circumstances: neurological death or circulatory death. These circumstances are likely to occur in the case of :

  • Stroke, including massive cerebral hemorrhage;
  • Head trauma;
  • Cerebral anoxia due to lack of oxygen to the brain (cardiac arrest, drowning, hanging, poisoning)
  • Medical aid in dying (only this category does not require intensive care hospitalization and life-sustaining treatment).

Organ donors can fall into three categories:

  • Living donor
  • Brain-dead donor (neurological death)
  • Donor in cardiac arrest

Unfortunately, very few people can become organ donors. In fact, you are 12 times more likely to need a transplant than to become a donor. In Quebec, about 1% of patients who die are eligible for organ donation. In most cases, these are people with a severe and irreversible brain injury. This injury may be severe enough to cause brain death (i.e., brain death or neurological death).

Neurological death, or brain death, is the complete and permanent cessation of all brain activity as a result of the cessation of blood supply to the brain.

No. There are two ways to die. One is when the brain stops working first – brain death – but the heart has not stopped or has restarted after cardiac resuscitation. 

The second, and better known of the two, is cardiac arrest, in which the heart fails to restart after resuscitation.

Brain death, or neurological death, is medically and legally equivalent to cardiac death.

Death by neurological criteria is a medical diagnosis. A physical examination is performed by two physicians. The examination has been determined by Canadian experts who have written down the procedure to be followed according to the best medical practices.

The tests performed are designed to confirm the absence of innate brain reflexes such as coughing, breathing or blinking. Without these reflexes, life is not possible.

In special situations, such as when a full physical examination is not possible, additional tests may need to be performed. These tests are done using medical imaging (radiology).

Sometimes a person who is neurologically dead can move a part of his or her body (for example, an arm or a leg). These movements are due to a reflex controlled by the spinal cord (like the hammer on the knee). It is not controlled by the brain.

Yes, certain drugs such as narcotics (fentanyl, morphine) or anxiolytics (midazolam, lorazepam) taken in excess can give the doctor the impression that the patient is brain dead. In such a situation, the doctor can either perform a blood test for the drug or perform medical imaging as mentioned in a previous question.

Once the diagnosis of neurological death is confirmed, there is nothing that can be done to save your loved one’s life. The date and time on the death certificate is the time when the diagnosis was confirmed.

Yes, there is death by controlled cardiac arrest. There are two ways of making this type of donation. The first is for a person who will have serious complications, or for whom medical treatment cannot prevent death. In this case, the medical team may discuss the issue of organ donation with the patient’s next of kin after the decision to stop treatment has been made (donor in cardiac arrest). Once the decision to stop treatment has been made, the physician will assess the possibility of the person’s rapid death, after withdrawal of devices or medications that support vital functions. Death must be expected within a short period to avoid damage to the organs that could be transplanted.

The second way is for a person who has been accepted for medical aid in dying and who does not have cancer. With this method, death is assured.

The option of donation is part of end-of-life care.

Absolutely! Living donation is possible in Quebec. It can come from a family member or a Good Samaritan. It is possible to donate a kidney, part of a liver (i.e. a lobe) or part of a lung. In Quebec, living kidney donation is available at major university hospitals.

Absolutely! There are very few contraindications to organ donation. For example, a person with hepatitis or HIV can donate their organs if the recipient also has these diseases. Every precaution is taken to ensure that no disease is transmitted during the organ donation process. disease during the organ donation process. For example, people with diabetes, high blood pressure, or high cholesterol may be able to donate organs.

Did you know that the oldest donor was 92 years old and gave his liver? It is the quality of the organ that is considered, not the age.

After obtaining a loved one’s consent, there are several important steps in the organ evaluation process. Your loved one will answer questions about their lifestyle and medical history. Several blood tests and x-rays examinations will be performed, most of which will be done in the intensive care unit. These tests are done to assess how well your organs are functioning.

Sometimes, as a result of these tests, an organ cannot be transplanted because there is no compatible recipient or the organ is not functioning properly. The entire process takes 2 to 3 days on average.

Transplant Québec manages a single waiting list for all people waiting for a transplant in Québec are placed. There are many allocation criteria to ensure fairness for all and to respect ethical principles. Some of these criteria are blood, tissue and anatomical compatibility, the urgency of receiving the transplant and the donor’s medical condition.

The tissue donation process begins after the heart stops beating. A specialist will ask for your authorization to put you in contact with Héma-Québec. They will inform you about the rest of the process so that you can make a free and informed decision. They will also be able to answer any questions you may have.

Tissues are harvested according to the needs of the surgeons who will use them. This may explain why, despite your loved one’s wish to donate tissue, was not collected.

The process does not begin until your loved ones have been informed of the possibility of donation and have given their consent.

Absolutely. No one will know you’ve been an organ donor unless your loved ones tell them.

No. The removal of organs and tissues does not affect the display of the body at the funeral home. The removal of organs and tissues is done with respect and dignity for the body by a team of surgeons who specialize in this type of procedure. The donation in no way interferes with the funeral services and is completely undetectable when the body is on display.

Organ donation can have a positive impact on the grieving process of the loved ones who have consented to donation. They may feel that life goes on in a different way and that their loved one’s death was not in vain. The testimonies we collect from family members show that, in the majority of cases, this gesture contributes to their comfort.

There may be a delay of one or two days between the time of death and the funeral home’s ability to retrieve the body. In addition, a poor approach to the family at the time of the donation request can disrupt the grieving process. Our resource nurses are committed to providing the best possible context for the request, and to avoiding this situation.

The resource nurse: The main role of the resource nurses is to promote organ and tissue donation in their respective hospitals, and to provide support to families. Some have a regional role and serve several hospitals. The primary role of the resource nurse is to accompany and support the family, to clearly explain the diagnosis of death and to provide them with all the information they need to make a free and informed decision about organ and/or tissue donation. Offer this end-of-life option, because it’s also a life choice!

The coordinator of Transplant Québec: He/she is responsible for the implementation of the organ donation process, from the referral and identification of potential donors to the allocation of organs.He/she also trains and informs professionals in the health and social services network about organ donation.

Yes. If neurological death is likely, then the medical examiner must be called quickly to avoid any contentious situation. By law, the coroner has the authority to authorize or deny organ and/or tissue donation. The coroner must issue an authorization number before the donation can take place.

No religion prohibits organ donation. In fact, most religions consider organ donation to be a humanitarian act. However, some restrictions may apply. Consult your religious leader to find out your religion’s exact position on this issue. As healthcare professionals, our job is simply to help loved ones make an informed decision, most importanly, to respect their decision.

Useful links

In Quebec, there are several websites that promote organ and tissue donation to the public.

visuel justin ressources
Transplant Québec Héma-Québec Signez don Canadian Blood Services ACDO Chain of life Kidney Fondation Dr Pierre Marsolais Mission