• Matthew J Weiss, Mathilde Dupras-Langlais, Marie-Josée Lavigne, Sylvain Lavigne, Annie-Carole Martel, and Prosanto Chaudhury.
• Transplant Québec (Weiss, Dupras-Langlais, M.-J. Lavigne, S. Lavigne, Martel, Chaudhury), Montréal, Que.; Division of Critical Care, Department of Pediatrics (Weiss), Centre Mère-Enfant Soleil du CHU de Québec, Que.; McGill University Health Centre (Chaudhury), Montréal, Que. matthew.weiss.med@ssss.gouv.qc.ca.
• CMAJ. 2024 Jan 28; 196 (3): E79E84E79-E84.

BackgroundSince 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.MethodsWe reviewed all cases referred for donation after MAiD from January 2018 to December 2022. We presented all data descriptively with no comparison statistics.ResultsTransplant 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.InterpretationThese 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.© 2024 CMA Impact Inc. or its licensors.

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