EVALUATION OF THE DEMAND FOR ORGAN TRANSP LANTATIONS IN QUEBEC

Objectives: To evaluate the demand for organs for transplantation and to recommend a reorganization of transplantation services in Quebec. D esign: Retrospective study. Setting: Province of Quebec, 1988 to 1992. Patients: All patients on waiting lists for organ transplantation and patients who received transplants registered in national data banks. Main outcome measures: The actual annual demand for organ transplantat ion and the rate of transplantations performed. Results: The rates of heart transplantation were lower than the actual annual demand, which resulted in many patients dying while awaiting transplantation. The ac tual annual demand for heart transplantation decreased during the last 5 years from 10.9 per million people in 1987 to 6.7 in 1992. The rate s of heart transplantation in Quebec were higher than the Canadian ave rage. The actual demand for lung transplantation was only 2.9 per mill ion people on average in 1992. Demand for liver transplantation increa sed annually, reaching 8.6 per million in 1992. The rate of transplant ation increased likewise but remained insufficient. The demand for kid ney transplantation reached 27.2 per million people in 1992, and the t ransplantation rate was 17.8. Conclusions: Taking into account the act ual demand for and supply of organ transplantation, to insure high-qua lity service and to control costs associated with organ transplantatio n, we recommend that the present system in Quebec be reorganized so th at transplantations are performed in 12 centres: 7 for kidney transpla ntation, 2 for hearts, 2 for livers and 1 for lungs.