Frequently Asked Questions

General Donation Transplant Healthcare Professionals Financial Privacy COVID-19

Ontario Health (Trillium Gift of Life Network) is responsible for delivering and coordinating organ and tissue donation and transplantation services across the province, as well as for planning, promoting and supporting all health care and allied professionals, advocates and the Ontario public in fulfilling their shared and integrated responsibilities in saving the lives of Ontarians waiting for a life-saving transplant.

Please call the Ontario Health (Trillium Gift of Life Network) Provincial Resource Centre, toll free, at 1-877-363-8456. They are available 24 hours a day, seven days a week to answer your questions.

Organs and tissue that can be donated include the heart, kidneys, liver, lungs, pancreas, small intestines, eyes, bone, and skin.

Everyone is a potential donor regardless of age or medical condition. Even individuals with serious illnesses can sometimes be donors. Your decision to register should not be based on whether you think you would be eligible or not. All potential donors are evaluated on an individual, medical, case-by-case basis.

Yes, regulations set by Health Canada for blood donation differ from organ and tissue donation. Everyone has the potential to be a donor regardless of age or medical status. Your decision to register should not be based on whether you think you would be eligible or not. Everyone is assessed at the time of death for medical suitability.

By registering consent for organ and tissue donation, you give hope to the thousands of Ontarians waiting for a transplant. Individuals on the transplant wait list are suffering from organ failure and without the generous gift of life from an organ donor, they will die. Tissue donors can also enhance the lives of recovering burn survivors, help restore sight, and allow people to walk again. Transplants not only save lives, they return recipients to productive lives.

Anyone 16 years of age or older, with a valid Ontario health card, can register their consent for organ and tissue donation at www.BeADonor.ca or in person at any ServiceOntario centre.

Organs or tissue not suitable for transplantation can be used for organ and tissue research (if indicated by donor upon registration).  This research is specific to the field of organ and tissue donation, and is not the same as whole body donation.

If you are already registered, you do not need to register again. If you would like to confirm your registration, it takes two minutes at www.BeADonor.ca. You will need to enter your health card number and date of birth.

Paper donor cards are no longer in use, so you must register your consent to become a donor at www.beadonor.ca or in person at ServiceOntario. Share your donation decision with your loved ones so they know your wishes.

There are two ways to check if you are already registered as an organ and tissue donor:

1. On the www.BeADonor.ca home page choose “Check Now.” This will take you to the ServiceOntario online registration page. Click on “Register, check or update your consent online.” The system will ask for identification. Enter in that information, and click on “Check or Update Registration.” If your registration has been processed, the system will respond, “Yes, you are a registered organ and tissue donor.” (If not, the system will then ask you if you wish to register.)

2. You can also check the back of your photo health card. If the word “Donor” is present, you are registered and do not need
to register again.

When you register as an organ and tissue donor, you can provide consent for the use of your organs and tissues for transplant only, or transplant and organ and tissue research. You are also given the opportunity to consent to any needed organs and tissues. The code on the back of the photo health card represents these decisions.

Z9 and 9Z are the most common codes. Z9 indicates that a person has consented to any needed organs and tissues to be used for transplant only, while 9Z indicates that a person has consented for any needed organs and tissues be used for transplant and organ and tissue research. The complete list of codes can be found here.

If the system is not able to register you online, it may ask you to contact ServiceOntario directly. There are a number of reasons that might prevent you from registering online. Visit any ServiceOntario location to register in person.

You can update or withdraw your consent at any time at www.BeADonor.ca, simply choose “Check or Update Registration” on the home page. You can also visit any ServiceOntario centre to update or withdraw in person. You can also withdraw your consent by mailing a letter to the below address with your name, date of birth, health card number and mailing address.

Organ Donor Consent
ServiceOntario
113-435 James St S
Thunder Bay, ON  P7E 9Z9

Ontario Health (Trillium Gift of Life Network) manages organ and tissue donation in Ontario. If you live outside of the province, please contact the organ procurement agency in your jurisdiction. A full list can be found here.

In order to register consent in Ontario, you must have a valid Ontario health card. This is because the registered consent will be stored in a Ministry of Health database. Without an Ontario health card, you will not be able to formally register. However, it is important to talk to your family about your wishes. When someone passes away and donation is possible, a Specialist, Organ and Tissue Donation will approach families to talk about donation. By talking to your family about your wishes, you can help relieve the burden of making that choice without confirmation of your wishes.

In order to register as an organ and tissue donor in Ontario, an individual must have a valid Ontario health card. Donor registrations are stored in a secure Ministry of Health database. Individuals who do not have Ontario health cards (OHIP cards), including members of the Canadian Forces, are not able to formally register in the Ministry’s donor registry.

However, in Ontario, when someone passes away and donation is possible, an Ontario Health (Trillium Gift of Life Network) Specialist, Organ and Tissue Donation will approach their family to talk about donation, both in cases where the individual has registered to donate and cases where the individual has not registered.

By talking to your family about your decision to give the gift of life by donating your organs and tissue upon death, your family will be able to confirm and honour your wishes by consenting to donation, even in the absence of registration.

For more information about living donation, please see the Canadian Blood Services website: Living Donation.

Ontario Health (Trillium Gift of Life Network) has been working with the Canada Revenue Agency (CRA) on an initiative to help grow organ and tissue donor registrations in Ontario. In 2021, the Canadian House of Commons and the Senate passed Bill C-210 (43-2): An Act to amend the Canada Revenue Agency Act (organ and tissue donors) to support organ and tissue donation and transplantation across Canada. The legislation granted the CRA authority to collect and share with provincial jurisdictions the email addresses of Canadians interested in learning more about organ and tissue donation and transplantation, and donor registration.

Beginning with the 2022 tax filing year (January-April 2023), the CRA has been securing consent from Ontario taxpayers for their email addresses to be shared with Ontario Health (TGLN) so Ontario Health (TGLN) may distribute an email communication directly to interested taxpayers with information about organ and tissue donation and transplantation and how to register as a donor.

Though everyone has the potential to be an organ donor, the reality is that the opportunity for organ donation is rare. Only 2-3% of hospital deaths occur in a way that allows for donation, as deceased organ donation can only take place when an individual dies in a hospital and on a ventilator. Vital organs require blood flow in order to keep them suitable for transplant.

There is a far greater opportunity for tissue donation, which is possible if an individual passes away in a hospital (but not on a ventilator) or at home. Tissue includes eyes, bone, skin and heart valves.

The first and foremost concern for health care professionals caring for critically ill patients is to do everything possible to save lives. The possibility of donation is only considered when all lifesaving efforts have failed.

When a Specialist, Organ and Tissue Donation is preparing to speak with a family about donation, they will access the Ministry of Health database to see if their loved one was a registered donor. That information would be shared with the family and they would be asked to reaffirm that choice. Once consent is given, medical tests are completed to determine what organs and tissues are suitable for transplant. The organs are then matched with someone on the transplant wait list and surgery takes place in an operating room at the hospital. The entire donation process, from the time the family agrees to move forward with donation to recovery, typically takes about 36 to 48 hours to complete.

It is Ontario Health (Trillium Gift of Life Network) practice to reaffirm an individual’s consent to donate with the family. In descending order of priority, the appropriate legal authority may be as follows:

1. The patient’s spouse or same-sex partner.
2. A child of the patient.
3. A parent of the patient.
4. A brother or sister of the patient.
5. Any other relative of the patient.
6. Any person who is lawfully in possession of the body (e.g., an executor of the will, or administrator of the estate).

In cases where there is no next of kin for the deceased, donation can proceed when registered consent has been recorded with the Ministry of Health database.

When you register your consent to donate, this information is recorded and stored in a Ministry of Health database. Your decision will only be accessed should there be potential for donation, and your status as a registered donor will be shared with your family. It is Ontario Health (Trillium Gift of Life Network) practice to reaffirm an individual's consent to donate with the family. In most cases, families honour their loved ones' decision to donate if they have evidence that it's what they wanted.  

Register as an organ donor and talk to your family about your wishes; one day this act could save a life.

Eligibility to donate is assessed at the time of death from information obtained during a medical social questionnaire completed with families. In addition, every organ is tested for suitability to ensure that as many people as possible can be helped through transplant.

Ontario Health (Trillium Gift of Life Network) will work with transplant centres to match the tissue and blood type of the donor to an individual(s) on the wait list. Medical urgency, blood type/group, the size of the organ, and the relative distance (of a prospective match) all form the basic criteria for organ allocation. If a match is found, the individual(s) who, for medical reasons, is the sickest will receive the donated organ. If the medical urgency is the same, the individual who has been on the wait list the longest will receive the organ. If there is no suitable match within Ontario, a check is made through databases of prospective recipients across Canada and possibly in the United States, in order to save lives.

Ontario Health (Trillium Gift of Life Network) practice is to allocate organs first to patients who may need them most. In very rare circumstances, TGLN may facilitate directed deceased donation on a case-by-case basis. Each potential directed deceased donation case needs to meet the following criteria:

  • The designated recipient is a family member, or an individual with a long-standing emotional relationship;
  • The donation will still proceed if directed donation cannot be realized;
  • There are no other patients in urgent clinical need of the organ (death is determined to be imminent within 72 hours);
  • The intended recipient is on the wait list or meets the listing criteria; and the donor organ is medically compatible for the intended recipient.

There are no costs to the donor’s family for organ and tissue donation. However, expenses related to funeral arrangements remain the responsibility of the donor’s family.

The body is released to the family, and funeral arrangements can continue as planned.

Organ and tissue donation does not impact funeral plans. Cremation and an open casket funeral are both possible.

• Organ recovery from the abdomen or chest usually involves one surgical incision that clothing would cover.
• When corneas are donated, typically the whole globe of the eye is removed. Funeral homes provide eye caps to maintain the shape
   and form of the eyes. This is usual practice whether eyes are donated or not.
• The appearance of the skin after recovery is similar to that of sunburn. A paper-thin layer of skin is removed from the back of the
   body permitting an open casket funeral.

Ontario Health (Trillium Gift of Life Network) mandate and jurisdiction remain strictly within the province of Ontario. If you wish to be an organ and tissue donor, and your death occurs outside the province of Ontario, you may still be considered for donation. That will depend upon the presence and availability of donation programs in that country. It is very important to share your wishes with your family so they understand what you would want to have happen in any situation.

A foreign citizen who dies in Ontario could also be an organ/tissue donor, if the family gives the final consent.

Many hospitals across Ontario are equipped with advanced ventilator capacity necessary to maintain the viability of organs for transplant. If an individual is identified as a potential donor in a hospital that does not have the capability of facilitating donation, Ontario Health (Trillium Gift of Life Network) will pay the cost of transporting the potential donor to the nearest hospital that does have the capability. This is only done with the support and consent of a family.

Some ethnicities are at greater risk for liver, kidney, and/or heart disease. In some cases, an organ transplant may be necessary.

Matches are NOT based on race, but compatible blood types and tissue markers are more likely to be found in people of the same ethnicity. Unfortunately, racialized people are under-represented among organ and tissue donors. Despite accounting for over 34 per cent of the population in Ontario, only about 20 per cent of donors come from racialized communities.

The more people who register as donors, and the greater the diversity, the better the chances of matching donated organs and tissue to recipients in need.

All major religions support organ and tissue donation because it can save the life of another. If your religion restricts the use of a body after death, consult your religious leader: these restrictions may not include organ and tissue donation, if the donation could save another life.

There are two main ways people choose to donate after they die: organ and tissue donation and whole body donation. Ontario Health (Trillium Gift of Life Network) manages organ and tissue donation. More information on whole body donation can be found here.

If donation of your whole body is your preference, only ocular tissue can be donated for transplantation. Whole body donation is not possible following the recovery of other organs and tissues. You can make arrangement with the anatomy school of your choice to donate your whole body following the recovery of ocular tissue.

You would likely pass on the plans to your family and next-of-kin so they can proceed with transferring your body to a school of anatomy, and that they are aware that only ocular donation should occur if you wish to proceed with whole body donation. Ocular donation typically occurs 12-24 hours after death and the body is then released to the custody of family members or next-of-kin to proceed with funeral practices.

Saving lives through organ and/or tissue donation is possible for those who choose to receive medical assistance in dying. Your suitability to be a donor will be determined based on your medical status, diagnosis and history.

Once you have expressed your interest in donation, Ontario Health (Trillium Gift of Life Network) will work with you and your doctor or nurse practitioner to support your wishes and determine how they can be met. TGLN will also be able to advise you on any possible additional testing that may be required in order to be a donor, as well as other considerations that may impact your plan for assisted dying.

It is important that you make your decision to donate known to your family and your doctor or nurse practitioner as part of your process so that TGLN can be contacted on your behalf.

For further information and resources in relation to MAiD, please read our MAiD brochure or visit the link to MAiDHouse.

Organ transplantation is a surgical procedure that places a healthy organ from a donor into the body of a person in need.

When a patient receives a diagnosis for their disease, their physician may initiate a discussion about organ transplantation as a potential treatment option.

Should both the patient and physician agree to proceed with exploring organ transplantation as a potential treatment option, the patient is referred to one of Ontario’s eight transplant hospital programs for an evaluation to determine suitability for transplantation. A comprehensive evaluation with the transplant clinical team is the first step of the transplant assessment process. This may include medical and psychological evaluation with a transplant coordinator, transplant physician, nurse and social worker. During the evaluation process, patients will undergo thorough testing to determine if a transplant is the safest and best treatment option.

If the transplant team determines that the patient is suitable for transplantation based on their evaluation and the patient chooses to proceed, they are then placed on the waitlist by the transplant hospital program. Patients on the waitlist are categorized and matched with donors based on factors like blood type, health status and waiting time.

It's important to note that while Ontario Health (Trillium Gift of Life Network) plays a significant role in overseeing the donation and transplantation process, the actual decision to place a patient on the waitlist rests with the transplant hospital program based on their assessment of the patient's suitability for transplantation.

Ontario Health (Trillium Gift of Life Network) manages the donor and recipient matching as well as the transplant process, including the recovery and transportation of donated organ(s) and/or tissue to the transplant hospital or appropriate tissue bank.

It is impossible to predict exactly how long you will have to wait for an organ once you have been added to the wait list, but most patients wait months to years to receive a transplant. Factors affecting wait times include donor-recipient matching and the health of the patient awaiting transplant.

Tissue wait lists are managed by individual physicians. Ontario Health (Trillium Gift of Life Network) coordinates the recovery of the tissue and ensures that it is delivered to the appropriate tissue bank which will process and distribute the tissue across the province for transplantation.

Many factors are considered when matching an organ to a potential recipient. While the specific criteria differ for various organs, matching criteria generally include:
•    Blood type and size of the organ(s) needed
•    Time spent waiting for a transplant
•    The relative distance between donor and recipient

For certain organs other factors are vital, including:
•    The medical urgency of the recipient
•    The risk of organ rejection
•    Whether the recipient is a child or an adult

Please refer to our patient infographics for more information about organ matching.

Once the transplant physicians make the decision to list a patient, that person is then registered on the wait list database that is managed by Ontario Health (Trillium Gift of Life Network). Patients on the wait list are categorized by factors such as blood type, health status and length of time waiting.

Hospitals notify Ontario Health (Trillium Gift of Life Network) that there is a potential donor and trained specialists work with family members to offer the opportunity to proceed with organ donation. After the family has given their consent, a complex matching process is initiated to determine the best possible recipient for each available organ and limit the chances of rejection. This process is based upon a set of algorithms and rules developed by transplant experts across the province.

Ontario Health (Trillium Gift of Life Network) facilitates the donation case, recovery of the organ, and the transportation of the organ to the transplant site - right up to delivery to the operating room where the patient receives the transplant.

All costs for the surgery, whether for donation after death or for living donation, are covered under the Ontario Health Insurance Plan (OHIP) for all Ontarian residents who quality for OHIP. In the case of living donation, the recipient’s OHIP coverage will also cover the cost of a donor from another country – but only when that donor is in Ontario. OHIP does not cover the travel costs or the required preliminary tests for that donor (in the country of origin).

•    Kingston Health Sciences Centre
•    London Health Sciences Centre
•    St. Joseph’s Healthcare Hamilton
•    The Ottawa Hospital
•    The Hospital for Sick Children
•    Unity Health Toronto
•    University Health Network
•    University of Ottawa Heart Institute

There are three different ways to become an organ and/or tissue donor:

  • Deceased organ donation is a rare occurrence. For someone to become a deceased organ donor, they must die under specific circumstances. Organ donation is possible in only 1-2% of hospital deaths.

    In Canada, there are two ways in which a person may become an organ donor: Organ donation following Death Determination by Neurologic Criteria (DNC) or organ donation following Death Determination by Circulatory Criteria (DCC)

    For more information, see What does the process for organ donation look like?

  • Deceased tissue donation can occur following any death if the tissues are suitable. Unlike organs, tissues do not require blood flow to preserve the opportunity to donate therefore, donation is possible after death has occurred. Tissues are recovered within 12 to 24 hours after death and are processed and stored for an extended period of time at tissue banks.

  • Living donation takes place when someone donates an organ or part of an organ to another person and goes on to lead a healthy life. For example, individuals with two healthy kidneys may be able to donate one of their kidneys to a loved one or close friend.  Similarly, a healthy individual may donate a portion of his/her liver (lobe). It is interesting to note that the liver, in both the donor and recipient, will regenerate to full size within months. 

Organ donation following Death Determination by Neurologic Criteria (DNC) is possible when there is a permanent cessation of brain function, meaning the brain has stopped working. The brain will not restart on its own and cannot be restored through medical intervention. Two physicians complete a series of clinical assessments to confirm the complete loss of consciousness (both wakefulness and awareness) and the absence of brainstem reflexes, including the ability to breathe independently. This can result from a severe brain injury, for example. Following confirmation of DNC, the family is informed, and once they accept the diagnosis of death, Ontario Health (TGLN) connects with the family to discuss the opportunity to donate and obtains consent. Hemodynamics are maintained by invasive physiological support, such as mechanical ventilation and IV medications, while donor suitability is assessed and if suitable, the organ recovery process is planned.  

Organ donation following Death Determination by Circulatory Criteria (DCC) is only possible when all lifesaving efforts have been exhausted, it is certain the patient will not survive, and the family decides to withdraw life-sustaining measures or if a patient requests MAID. Ontario Health (TGLN) then connects with the patient and/or family to discuss donation opportunities and obtains consent to donate. While donor suitability is assessed, when applicable, hemodynamics are maintained including mechanical ventilation and IV medication. If the patient is deemed suitable to donate, the date and time for WLSM or MAID provision is established, and the organ recovery process is planned.

Non-perfused organ donation (NPOD)
Currently, a clinical protocol for non-perfused organ donation in unexpected deaths has been implemented at select hospitals which has allowed for more patients to donate lungs. At these facilities, notification to Ontario Health (TGLN) occurs following an unexpected circulatory arrest and unsuccessful CPR. The NPOD protocol is put in place to preserve the opportunity for donation, and lungs are recovered within 3 hours of cardiac cessation.

The NPOD protocol has also been applied in different donation following DCC scenarios, such as following withdrawal of life-sustaining measures when a patient does not die within the traditional time frame for lung donation, or in circumstances where a person’s end-of-life plan includes MAID at home and organ donation.

DCC Hearts
Historically, heart recovery from DCC donors has not been possible due to concerns about physiological damage to the heart following withdrawal of life-sustaining measures (WLSM).

Advancements in technology have led to changes in recovery and preservation techniques, making DCC heart transplantation possible.

Ontario Health (Trillium Gift of Life Network [TGLN]) has been working with the heart transplant teams in Ontario and the United States to facilitate the implementation of a protocol for DCC heart recovery.

Conditions such as strokes, traumatic brain injuries, brain tumours, infections, cardiac arrest, drowning, and medication overdoses may lead to DNC or lead to non-recoverable illnesses or injuries where WLSM will be planned, followed by DCC. Organ donation can only occur once the strict death determination by neurologic or circulatory criteria are met.

Furthermore, individuals with grievous irremediable illnesses who choose Medical Assistance in Dying (MAID) as part of their end-of-life journey may also become organ donors. The organ donation process is similar to donation following DCC.

Contact Ontario Health (TGLN) to determine donation potential and to learn the patient’s registered donation preference on the back of their Ontario Health Card and in the Registered Person's database. To donate organs, the patient must be on a ventilator and hemodynamic support must be maintained; organs need to be perfused with oxygenated blood until they are recovered for transplant.

Statistics show a joint approach involving a member of the healthcare team and an Ontario Health (TGLN) Specialist trained in
speaking to families about donation is the most successful method in offering the opportunity for donation.

The Provincial Resource Centre (PRC), staffed 24/7 by a team of Clinical Services Coordinators is responsible for intake of organ and tissue donation referrals, and facilitates donation, including recovery of organs and tissue for donation. The PRC supports health care professionals; obtains consent for donation; facilitates donor testing and screening; coordinates essential logistics; and by telephone, offers organs and tissues to transplant programs and tissue banks respectively. The PRC is also responsible for looking up potential donors' registered consent decision on the Registered Person's database.

Timing of Notification to Ontario Health (TGLN)
The timing of the notification to Ontario Health (TGLN) depends on whether or not a patient is suitable to donate both organs and tissue or exclusively tissue.

In Critical Care and Emergency, call Ontario Health (TGLN) for all ventilated patients, including those life-sustained with non-invasive ventilation (e.g. BiPAP®/CPAP) and for patients who have requested Medical Assistance in Dying (MAID), who meet any of the following criteria:

G: A grave prognosis or a Glasgow Coma Scale score of three.
I: An injured brain or a non-recoverable injury or illness.
F: Family or patient ever brings up the topic of donation or the topic of withdrawal of life-sustaining measures.
T: Therapy is limited, there's going to be a de-escalation of therapy or if there are plans to have a meeting with the family to discuss withdrawal of life-sustaining measures.

+: For patients who have requested MAID

  • after the first confirmation of eligibility assessment with a reasonably foreseeable natural death,
  • after the second confirmation of eligibility assessment when natural death is not reasonably foreseeable


Non-Ventilated Patients in Critical Care Units
In critical care areas, call Ontario Health (TGLN) for all non-ventilated patients who meet any of the following criteria:

  • Within one (1) hour of death
  • When the topic of donation is raised by the family/patient
  • For patients who have requested MAID:
    • after the first confirmation of eligibility assessment with a reasonably foreseeable natural death,
    • after the second confirmation of eligibility assessment when natural death is not reasonably foreseeable


Clinical Triggers for Units with Non-Ventilated Patients
In non-critical care areas, call Ontario Health (TGLN) for all patients 79 years of age and younger who meet any of the following criteria:

  • Within one (1) hour of death
  • When the topic of donation is raised by the family/patient
  • For patients who have requested MAID:
    • after the first confirmation of eligibility assessment with a reasonably foreseeable natural death,
    • after the second confirmation of eligibility assessment when natural death is not reasonably foreseeable

Notify Ontario Health (TGLN):

  • Within one hour of the patient’s death
  • As per hospital policy and/or established Clinical Triggers
  • When the patient/family is requesting information about organ and tissue donation

During the initial call:

  • Ontario Health (TGLN) will collect demographic information and ask baseline questions to determine if there is the opportunity to donate tissue
  • A TGLN number will be provided to document in the medical chart

Once preliminary eligibility to donate tissue has been established:

  • An Ontario Health (TGLN) Specialist in the area of both donation and speaking with families will arrange with the healthcare provider to speak to the family by phone while they are at the hospital
  • If the family is not at the hospital, the healthcare provider will be asked to provide contact information to Ontario Health (TGLN) for follow-up with the family
  • Blood samples as well as eye care instructions may be requested by Ontario Health (TGLN)
  • Ontario Health (TGLN) will collect further information about the patient’s current admission and past medical history prior to contacting the families in situations where the family is not at the hospital
  • As directed by Ontario Health (TGLN), the body is then transferred to the morgue while the recovery is organized (eyes may be recovered on the unit where death occurred)
  • An operating room is required for the recovery of skin, bone and cardiac tissue
  • Recovery staff and OR will be arranged by Ontario Health (TGLN)
  • Upon request, Ontario Health (TGLN) will contact family when recovery is complete

After donation:

  • Ontario Health (TGLN) (or the Eye Bank of Canada, if appropriate) will send a letter to the family to thank them for the donation and to inform them of the donation outcome

Ontario Health (TGLN) has organized the order of the clinical history questions and has worksheets available to help hospital staff streamline the process. This enables Ontario Health (TGLN) to determine if the person is eligible for donation for transplant, or research and teaching.

Yes. Consistent with the Gift of Life Act, telephone consent requires two witnesses to confirm the patient substitute’s identity and document consent for donation. The Provincial Resource Centre at Ontario Health (TGLN) always has a second Ontario Health (TGLN) staff member available to enable telephone consent.

Hospitals who have implemented Routine Notification are required to report every impending patient death to Ontario Health (TGLN) so that specially trained staff can identify potential donors and approach families to re-affirm consent. In late 2010, the Auditor General of Ontario recommended the expansion of Routine Notification to all hospitals with advanced ventilator capacity (necessary to maintain the viability of organs for transplant). Work continues to roll this program out across the province.

Ontario Health (TGLN) Specialists in the Provincial Call Centre are the first point of contact for hospital referrals, allowing Ontario Health (TGLN) to immediately begin work to determine a patient’s eligibility for organ and tissue donation.

Research indicates that experience and a person’s comfort level in speaking to families about donation impacts both the family’s experience and its choice to donate tissue. Under the Gift of Life Act regarding the discussion of donation, Ontario Health (TGLN) has the authority to specify the manner in which contact with the family is made. Ontario Health (TGLN) Specialists receive quarterly training in approaching families both by telephone and in person. As a result, the Ontario Health (TGLN) Specialists have higher positive consent outcomes than hospital staff when they approach families.

The ultimate responsibility for speaking with families belongs to Ontario Health (TGLN). In situations where a healthcare provider indicates the family does not wish to donate, an Ontario Health (TGLN) Specialist may contact the family to ensure the family had the information needed to make an informed decision (e.g., a registered consent decision to donate by their loved one).

Ontario Health (Trillium Gift of Life Network) offers a specialized resource guide to assist hospitals throughout the accreditation process. This resource provides guidance on meeting organ and tissue donation accreditation standards, ensuring hospitals can demonstrate compliance and leading practices in donation. Hospitals can contact their Trillium Gift of Life Network Specialist directly to access these materials and receive additional support tailored to specific needs.

Yes. The Program for Reimbursing Expenses of Living Organ Donors (PRELOD) was launched in April 2008 to provide reimbursement of qualified expenses that may include: travel, parking, transit, meals, accommodation, and a loss of income subsidy. For program details please contact the PRELOD Administrator at prelod@ontariohealth.ca, or at 1-888-9-PRELOD / 416-619-2342. To learn more, visit the PRELOD/TPER page.

Eligible visits include visits to an Ontario hospital with a living donation transplant program where a person undergoes specific testing for the purposes of organ donation. Expenses related to attending a visit to a transplant hospital are considered ‘eligible’ after the transplant hospital has determined that you are suitable to undergo further testing as a living organ donor based on your health history and blood type. The transplant hospital will document the date of each of eligible visit, the purpose of your visit, and verify that the appointment has not been cancelled. This information will be documented on the Appointment Verification Form.

Any person who donates or intends to donate an organ or part of an organ to an Ontario resident covered by the Ontario Health Insurance Program (OHIP) can apply to PRELOD. This includes potential donors who were accepted by a transplant program for further assessment and proceeded to be assessed and evaluated for the purposes of living donation, but were unable to proceed to surgery.

Ontario residents who donate an organ to a recipient from another province are not eligible for PRELOD. Please contact the living donation program where you donated your organ to learn about living donor reimbursement programs available across Canada.

  • Travel (mileage, bus, train, public transit, taxi, shuttle, rideshare services and parking).
  • Accommodations
  • Meals
  • Lost income during recovery
    • Childcare in lieu of loss of income for a non-working parent
    • Companion travel/accommodation/meals during the surgery period (detailed in brochure)
    • Medical/Non-Medical and “Other” expenses related to donation

  • OPTIFAST® reimbursement is available for living liver donors.

    All claims must meet the requirements as set out by the PRELOD policy. In special circumstances, PRELOD may consider reimbursement to non-working living donors for childcare expenses.

Limited reimbursement for prescription medications related to donation is available for patients who do not have coverage under a personal or corporate plan. Receipts must be provided.

Actual donors are eligible for the PRELOD loss of income subsidy only after surgery and it does not cover time off work for testing and evaluation prior to surgery. The loss of income subsidy is intended to assist those who experience a loss of income after surgery and have no other sources to support their needs. Other sources of income include but are not limited to: paid time off work (including sick and vacation time), disability benefits and Employment Insurances. Eligible applicants can apply for the loss of income subsidy after surgery for any 8-weeks in a 14-week period, but not prior to surgery.

The loss of income subsidy is available to employed or self-employed actual living organ donors who experience a loss of income after surgery, and have no other income sources available to them. The loss of income subsidy is not available to non-working actual living donors.

The purpose of PRELOD is to assist in reducing the financial burden associated with living donation. PRELOD has been designed to meet reasonable expenses incurred during the donation process.

Reimbursement is calculated in accordance to the policy and guidelines established by the Ministry of Health. Claims are reimbursed in accordance with the PRELOD policy. Reimbursement of eligible out-of-pocket expenses and the loss of income after surgery subsidy are subject to the PRELOD policy guidelines. All categories have an upper limit that can be claimed. For further details on eligibility criteria please review the PRELOD policy.

Ontario Health (Trillium Gift of Life Network) administers a Ministry of Health program (Transplant Patient Expense Reimbursement or TPER) to reimburse patients waiting for heart, heart-lung, lung, small bowel, require a Ventricular Assistance Device (VAD) implant as a bridge to transplant and are required to relocate near their transplant hospital for the purposes of transplantation. Patients may apply for reimbursement of qualified relocation accommodation expenses incurred as of May 1, 2009. For more information: TPER Background and TPER Application Form.

PRELOD covers expenses incurred for appointments to a living donation program for living donor testing, a living donor procedure, or follow-up visits, up to 12 months after the procedure.

If you have been assessed by an Ontario transplant program and have donated an organ to an Ontario resident, you may apply for financial assistance.

To learn more about PRELOD or TPER (including eligibility criteria) or to download an application package, visit the PRELOD/TPER Page. For program details please contact the PRELOD Administrator at prelod@giftoflife.on.ca, or at 1-888-9-PRELOD / 416-619-2342.

Download and complete the Access to Information Request Form. Details for submitting an FOI request to Ontario Health are available here. Be sure to clearly identify the records you are requesting, include your contact information and $5 application fee.

Yes, under FIPPA, there is a $5 non-refundable application fee. Additionally, TGLN may charge additional fees for search and preparation time, and other fees as permitted under FIPPA.

You will be notified if the processing fees will exceed $25. For estimates in excess of $100, you will be asked to provide a deposit of 50%.

Examples of fees permitted and associated costs include, but are not limited to:
Photocopies and computer printouts        20 cents per page
Manually searching records                     $7.50 for each 15 mins spent by any person
For preparing records for disclosure        $7.50 for each 15 mins spent by any person

You have 30 days from the receipt of TGLN’s response to request a review of our decision by the Information and Privacy Commissioner (IPC) of Ontario. The Commissioner can be reached at:

Information and Privacy Commissioner Ontario
2 Bloor Street East, Suite 1400
Toronto, ON M4W 1A8
Tel: (416) 326-3333 Fax: (416) 325-9195

If you decide to appeal the decision to the IPC, please provide the Commissioner’s office with a (i) A copy of the original request you sent to TGLN; ii) The request number assigned to the request; iii) A copy of this decision letter; and iv) The appeal fee in the amount of $25.00.

If the records you seek relates to a deceased individual, TGLN requires confirmation as to whether that individual has a personal representative (eg. Executor/estate trustee) and information as to how to contact that individual.

If you are the personal representative of the deceased individual’s Estate, in order to process your request, TGLN requires evidence of the same. Evidence may include a copy of the individual’s Last Will and Testament or a Certificate of Appointment of Estate Trustee with a Will/Certificate of Appointment of Estate Trustee Without a Will. TGLN is unable to proceed to process any requests for personal information regarding a deceased individual without the above information, in addition to the Access to Information Request Form and $5 processing fee.

For further information contact the Ontario Health FOI Office. Emails can be directed to foi@ontariohealth.ca.

Coronaviruses are spread mainly from person to person through close contact. There are actions that can help prevent the spread of germs that cause respiratory illnesses. Take these everyday steps to reduce exposure to the virus and protect your health:

• staying up to date on your COVID-19 vaccines and flu shots
• wearing a tight-fitting, well-constructed mask in indoor public settings, especially if you are at higher risk of severe infection
• visitors and patients should follow any requirements for masking in hospitals, long-term care homes, and other health care spaces
• staying home when you are sick and wearing a mask until day 10 from symptom onset
• washing your hands often
• covering your mouth when you cough or sneeze
• regularly cleaning high touch surfaces
• optimizing indoor air quality
• if you are high risk, talk to your health care provider about antiviral treatment options in case you get sick

If you start to feel symptoms of COVID-19

If you begin to feel symptoms of COVID-19, you should stay home and self-isolate immediately and take a self-assessment to help determine how to seek further care.
 
Please visit: Ontario.ca/coronavirus for more information.

Additional steps have been implemented during the potential organ donor screening process related to COVID-19. Organ donation from a patient identified as being high risk will not proceed. Organ donation and COVID-19 donor testing will be performed on all other donors in addition to screening.

One donor can save 8 lives and transform up to 75 others. Individuals on the transplant waitlist are suffering from organ failure and without the generous gift of life from an organ donor, many will die. Tissue donors save the lives of recovering burn survivors, and enhance the lives of others to help restore sight, and allow people to walk again. Transplants not only save lives, but they also return recipients to full, productive lives. It means you are deciding to help someone in need of a transplant if and when you have the opportunity to donate in the future.

Before patients are referred to a transplant centre to be considered for the transplant waitlist, they must meet a variety of criteria that considers both health and lifestyle.

In order to ensure that a transplant has the greatest chance of success, transplant recipients must follow many specialized recommendations for medications and vaccinations that reduce the risk of harm from infection after transplant. These are determined by experts in each Ontario transplant centre based on internationally accepted guidance for safe transplant.

Each transplant centre makes recommendations for transplant on a case-by-case basis, considering medical urgency and an evaluation of risks to the patient in the context of their particular organ transplant. This guidance was developed in consultation with a variety of experts, including those specializing in infectious diseases and bioethics.

Ontario Health (Trillium Gift of Life Network) recommends that transplant candidates be vaccinated. The decision about proceeding with transplant varies by organ and ultimately rests with the patient, the transplant physician and the transplant program.

In Ontario, patients have received transplants even if they did not have up-to-date COVID-19 vaccinations.

Death Determination (Neurologic Criteria) Death Determination (Circulatory Criteria)

Death determination by neurologic criteria, also known as brain death, means the brain has permanently lost consciousness including the ability to be awake, think, feel, and understand, or control basic functions like blinking, breathing, and coughing. In Canada, if someone has been determined to be dead by neurologic criteria or brain dead a formal death certificate is completed.

Death determination by neurologic criteria or brain death can happen due to serious brain injuries such as a stroke, bleeding in the brain, and swelling caused by tumors, infections, or severe head trauma. Brain death can also happen if blood flow or oxygen supply to the brain is not enough, such as when the heart suddenly stops beating (cardiac arrest), in cases of drowning, or medication overdoses. These injuries cause swelling in the brain which stops blood and oxygen from reaching the brain tissue. Without proper oxygen and blood supply, the brain tissue begins to die. Once brain tissue dies, it cannot be brought back to life. Once all brain tissue dies, the person can no longer blink, breathe, cough, think, or feel. This is permanent and there is no chance of recovery once all brain tissue dies.

When someone has a severe brain injury, experienced doctors perform tests to see if the brain is functioning. The tests assess the person's awareness of their environment and essential life functions (brainstem reflexes) like blinking, breathing, and coughing. In Canada, the tests to confirm brain death are done according to strict national guidelines. When the brainstem functions necessary for life are gone, they will never come back, and it confirms that the person has died.

Several tests are performed by doctors to assess the area of the brain that controls basic life functions to see if it is working. First, they will check if your loved one responds to any voice commands or stimulation, like touch or pain. Next, they will shine a light in their eyes to check if their pupils react, insert a suction catheter or popsicle stick into the back of the mouth to see if they cough or gag, and put cold water in their ears to assess eye movements.

The last part of this assessment is called the "apnea test". Doctors temporarily disconnect the ventilator (breathing machine) or set it to a low setting to naturally raise carbon dioxide levels in your loved one's body, while maintaining a flow of oxygen. During this test, the healthcare team regularly checks blood samples (every five minutes or so) to measure carbon dioxide level in the blood, which rise when a person stops breathing.  

In a living person, when carbon dioxide reaches a certain level, it tells the brain to signal the person to take a breath. In death determination by neurologic criteria or brain death, carbon dioxide levels keep rising, with no signs of breathing, even with very high levels of carbon dioxide. This means that the essential life function to breathe is gone and will not return.

If all of the above tests show that the basic life functions controlled by the brain are not working, then death is confirmed. If the standard tests are incomplete or inconclusive, doctors may do additional tests, like a brain scan, to see if blood is flowing to the brain. This may help confirm the diagnosis of death determination by neurologic criteria or brain death.

Even though the heart may be beating and the person may appear to be breathing, the brain is not guiding these actions. Instead, machines like the ventilator (breathing machine) and medications are controlling these functions. When these machines are turned off, your loved one will not breathe, the lungs will not receive the oxygen they need, and the heart will stop beating. This is because, in a living person, the brain controls breathing and sends oxygen to the heart to keep it beating. However, in brain death, when doctors determine death based on neurologic criteria, the brain has stopped functioning and can no longer send these vital signals. 

While machines and medications can assist the lungs to breathe and the heart to beat, they cannot restart brain function - this is permanent. Death occurs when brain function ends.  

Unfortunately, that is not the case. Research has shown that a person in a coma or a persistent vegetative state still has some level of brain activity, even though they are not awake and may not respond to things like sound or touch. However, when someone is brain dead or death has been determined by neurologic criteria, it means they have lost the ability to think, feel, understand, or interact with the world around them and this is permanent.

Unfortunately, once death determination by neurologic criteria or brain death is confirmed, there is nothing more that can be done to help the person recover. Because the brain keeps us alive, the end of brain function is death.

Using the strict Canadian guidelines developed by experts regarding death determination by neurologic criteria, there has never been a recorded case in Canada of a person recovering from the diagnosis of death determination by neurologic criteria.

Your loved one might show spinal reflexes like twitching or muscle contractions. Seeing these movements may be confusing and upsetting. These reflexes happen because there are still electrical signals in the spinal column, but they are not coming from the brain. If you notice these movements, it means that the spinal column, not the brain, is controlling these movements. Spinal reflexes are often seen in patients who are "brain dead" or determined dead by neurologic criteria. If they occur, the healthcare team is available to help you understand what is happening.  

Once the formal assessments for death determination by neurologic criteria or brain death are completed, the healthcare team will inform you of the time of death and complete the death certificate. If needed, the coroner may also be notified.

The healthcare team will also discuss the next steps with you. If organ and/or tissue donation is possible, they will connect you with a Specialist in Organ and Tissue Donation from Ontario Health (Trillium Gift of Life Network). The conversation about organ donation needs to occur while your loved one is receiving oxygen and medications while on the ventilator.

It may be comforting to know that while national guidelines require only one doctor's assessment to confirm death determination by neurologic criteria or brain death, in Canada, two doctors must complete two separate assessments before organ donation can proceed.

Depending on the end-of-life decisions made, the timing varies.

When consent to organ donation is provided after speaking with the Ontario Heath (TGLN) Specialist in Organ and Tissue Donation, the ventilator and medications will remain in place while organs are tested (i.e., blood tests, chest x-ray, ultrasound, or CT scan) and matched with potential recipients. Once an organ is matched, the recovery surgery will be arranged. The ventilator and medications will be removed during the organ recovery procedure.  

If organ donation is not possible or if you decide not to proceed with organ donation, the healthcare team will organize a time with you to remove the ventilator and medication support. 

It is important to understand that removing the ventilator and medications does not cause death, because your loved one has already died.  

Additionally, if organ donation is not an option, tissue donation may still be possible, offering another meaningful way to help others in need. An Ontario Health (TGLN) Specialist will guide the next steps to facilitate tissue donation once the ventilator and medications are removed.

Your loved one’s healthcare team will work with you to provide the time and privacy needed to say goodbye and honour any special considerations you desire.

From the time you enter the hospital, you become part of the team caring for your loved one. Doctors, nurses, educators, donation specialists, and individuals experienced in bereavement will be available to explain what is happening, give you information about the next steps, or simply to offer support for you throughout this difficult journey.

Someone will always be available – 24 hours a day, seven days a week – to answer your questions related to donation. Your healthcare team can also contact Ontario Health (TGLN) if you have not yet met with a donation specialist and you have questions.

Organ and tissue donation is the most precious, unique and selfless gift. It is the ultimate act of kindness, making those who choose to donate true heroes of our time.

Apnea - Absence of breathing.

Brain Injury - Damage to the brain caused by various factors such as trauma, stroke, tumors, infections, or lack of oxygen.

Brainstem - The lower part of the brain that connects to the spinal cord and controls basic life functions such as breathing, heart rate, and consciousness.   

Brainstem Reflexes - Reflex actions such as blinking, coughing, gagging, motor and pupillary response to light. The absence of all brainstem reflexes indicates that the brain is no longer able to send messages to the body to make it work - to breathe and to perform other vital functions.

Coma - A deep, prolonged and sometimes irreversible unconsciousness from which the patient cannot be awakened.

Death Certificate - A legal document issued by physicians certifying the death of an individual, including the cause and manner of death. 

Death determination by neurologic criteria (DNC) - Also known as brain death, this refers to the conditions where the brain has permanently lost the ability to be conscious and control basic functions, leading to death.

Neurologic - Refers to the brain and/or other parts of the central nervous system.

Neurologic Criteria - Standardized guidelines used to assess brain function.

Ontario Health (Trillium Gift of Life Network) - is responsible for delivering and coordinating organ and tissue donation and coordinating transplantation services in Ontario. 

Ontario Health (TGLN) Specialists in Organ and Tissue Donation - Specialists in donation employed by Ontario Health (TGLN), who are available to assess eligibility to donate organs and/or tissues, provide support to patients and/or families/substitutes and health care professionals, and facilitate organ and tissue recovery.

Persistent Vegetative State - A persistent loss of brain function that leaves the patient awake but unaware. The condition does not require respiratory or circulatory support (a ventilator).

Spinal Reflexes - Movements that are caused by electrical impulses conducted by, or originating from nerves or spinal cord rather than the brain.

Stroke - A sudden loss of consciousness, sensation, or voluntary motion caused by a lack of oxygen supply to a particular area of the brain.

Ventilator - A machine which mechanically assists a patient’s breathing, or takes over this function when they cannot breathe.

Organ Donation: Organ donation from one individual can help up to eight others with the donation of the heart, lungs, liver, pancreas, kidneys, and intestine.

Heart - A heart transplant may be the only option to treat severe, end-stage heart failure resulting from coronary artery disease, severe untreated hypertension, heart valve problems, infection, as well as inherited or congenital heart diseases.

Kidneys - Kidneys can become diseased or damaged due to diabetes, uncontrolled hypertension, infection or polycystic kidney disease impairing their ability to function (filter and remove waste through urine). This results in the need for ongoing dialysis or a kidney transplant.

Liver
- When a liver becomes extensively damaged due to disease or injury, it is unable to perform essential functions including processing nutrients, making proteins, and helping your body prevent infections. This damage can happen quickly or over time, and when it does, a liver transplant is needed to survive.

Lungs - Lung transplants help restore breathing for people whose lungs are getting worse due to various underlying conditions like asthma, COPD (Chronic Obstructive Pulmonary Disease), cystic fibrosis, pulmonary fibrosis (scarring of the lung), and pulmonary hypertension.

Pancreas - A primary function of the pancreas is to make insulin, the hormone that regulates glucose absorption. An individual with serious complications that result from insulin-dependent diabetes can significantly benefit from a pancreas transplant, as it provides a cure for this disease.

Intestines - Small bowel disorders can result from birth defects, infection or intestinal diseases such as Crohn’s. When a bowel is unable to function properly (absorb nutrients from food), an individual may need to go on TPN (total parenteral nutrition) to receive appropriate nutrition and this can result in long-term complications such as infection or liver disease.

Tissue Donation: One tissue donor can enhance the lives of up to 75 others through the donation of eyes, heart valves, skin and musculoskeletal tissues such as bones and tendons.

Musculoskeletal - Musculoskeletal tissue (bones and ligaments) can prevent amputation, help restore mobility, repair physical deformities, and replace bone removed due to bone tumors.

Ocular - Corneas and sclera (ocular tissue) restore the gift of sight that has been lost or reduced due to infection, disease or trauma. One ocular donor can restore the sight of up to ten others.

Heart Valves - Heart valves and cardiac tissue help return heart function to normal. These tissues are regularly transplanted into children born with congenital defects or stenotic valves, and women of child-bearing years to eliminate the need for daily blood thinners.

Skin – Donated, paper-thin layers of skin can be lifesaving for burn and trauma survivors because it provides a natural wound covering during healing. 

Culture and religion play a significant role in end-of-life experiences, including how people respond to illness, how grief is demonstrated, what rituals are important at death, and which members of the family are present.

People from every major religion have donated, and many religions support donation or respect an individual’s choice. If you have specific questions about your faith, speak to your religious leader. 

Additional cultural perspectives and general information brochures on organ donation in a variety of languages.

The act of donating organs and tissues after death is a selfless and compassionate gesture that can have a profound impact on the lives of others. By giving the gift of life following Death Determination by Circulatory Criteria (DCC), individuals can leave a lasting legacy that can positively impact many lives.

When a person's heart permanently stops beating, the brain does not receive oxygen from circulating blood, the brain tissue dies, and death is determined by circulatory criteria. The health care team knows that the person’s heart has stopped when there is no blood pressure or the ECG (electrical tracing of the heart) shows no heart beats.

When a decision is made to transition care to an end-of-life focus, it means that the medical treatments being given will not change a patient’s underlying condition. The patient’s family/substitute decision maker, together with the health care team, decides to stop treatments that will not improve the underlying condition and instead focus on making the patient as comfortable as possible. The treatments that will be stopped include the ‘breathing machine’, also known as the ventilator and other medications or machines that support the patient’s heart and blood pressure. 

During this transition, the main goal is to prioritize the patient’s comfort, and medications to keep them comfortable are continued throughout the dying process. The healthcare team is responsible for ensuring the patient’s comfort and supporting families throughout the end-of-life process, and when possible, include opportunities for important family, cultural, and/or religious practices at end-of-life. 

The healthcare team is responsible for end-of-life care. Ontario Health (Trillium Gift of Life Network) encourages families/substitute decision-makers to connect with their healthcare team to understand what will happen throughout the end-of-life process and to ask the following questions:

o  What treatments will be stopped, and what will be added during end-of-life care?

o  What symptoms might my loved one have when treatments are stopped? 

o  How will my loved one’s comfort be taken care of when treatments are stopped? (e.g. what medications will be used?)

o  What supports are available at the hospital for families/substitute decision-makers when a decision is made to transition to end-of-
    life care? (e.g. social worker, spiritual care, nurse, physician)

o  How can we make sure my loved one’s important persons are present during the end-of-life process?

o  How do we plan for cultural or religious practices throughout the end-of-life process?

As part of high-quality end-of-life care, it is important for families to be fully informed and empowered to make decisions that align with their loved one’s beliefs and values regarding donation. The donation decision is time sensitive, and when a decision is made to transition to end-of-life care, the healthcare team will introduce families and/or substitute decision makers to an Ontario Health (Trillium Gift of Life Network) Specialist. The Specialist will inform the family if the person has registered their consent for organ and tissue donation, and share the next steps to honor their donation decision. If there is no registered consent decision, the Specialist will support the family in making a decision based on the person’s values and beliefs regarding donation.

Ontario Health (Trillium Gift of Life Network) is responsible for planning and coordinating organ and tissue donation and transplantation services in the province, with a mission to save and enhance the lives of Ontarians. 

The Gift of Life Act is the legislation that oversees organ and tissue donation in the province of Ontario and requires hospitals to notify Ontario Health (Trillium Gift of Life Network) when patients are at end of life or have died. This notification means that potential donors are given the opportunity to give the gift of life to others in need. 

After consenting to organ donation on behalf of your loved one, several steps will be taken to determine their medical suitability to donate and to match their organs with potential recipients:

• First, bloodwork and diagnostic imaging, such as X-rays, CT scans, and ultrasounds, will be conducted to determine your loved one's medical suitability for donation.

• Next, an Ontario Health (Trillium Gift of Life Network) Specialist will ask you to complete a medical and social history questionnaire similar to the questions asked when donating blood. This questionnaire will help to further explore your loved one's medical history and ability to donate.

• Bloodwork will be drawn and tested for recipient matching. 

• If someone is found to be a suitable match for your loved one's organs, the Ontario Health (Trillium Gift of Life Network) Specialist will work with you, along with the hospital operating room team, transplant teams, and healthcare staff, to plan when treatments will be stopped and arrange the surgery to recover the organs.

Recipient matching is a complex process that considers several factors such as, blood and tissue type, organ size, and distance between the donor and potential recipient. There may be instances where a suitable recipient cannot be found for your loved one to donate organs to. The Ontario Health (Trillium Gift of Life Network) Specialist will keep you informed through the process.

A few hours prior to stopping all treatments and transitioning to end-of-life care, transplant teams will arrive at the hospital and set up the operating room in preparation for the organ recovery surgery.

A medication named heparin is given to prepare the organs for donation just before removing treatments such as the ventilator or ‘breathing machine’. When treatments are removed, the healthcare team will also provide medications to support your loved one's comfort during the dying process.

Following the removal of treatments, the healthcare team monitors your loved one's vital signs and when there is an absence of blood pressure, respiratory effort, and pulse, two physicians will continuously observe your loved one and the monitoring equipment for an additional five minutes to confirm death. This waiting period is a requirement to proceed with organ donation following withdrawal of life sustaining treatments. When death is confirmed, your loved one is then promptly transferred to the operating room for the organ recovery surgery.

It is important to note that the timing of your loved one's death can be unpredictable and may impact whether the organs will be healthy enough to be transplanted. The healthcare team will work closely with the Ontario Health (Trillium Gift of Life Network) Specialist to determine if organ donation is still possible and explore all potential donation opportunities.

The dying process can be unpredictable and sometimes it may take longer than expected. In some cases, a person’s organs may have been without oxygen for too long and may not be healthy enough to transplant.

The healthcare team will continue to care for your loved one's comfort.

It is important to remember that the gift of life is in the decision to donate, and even if organ donation is not possible, tissue donation may still be an option. The timeline for tissue donation is different from that of organ donation and can occur within 12 to 24 hours after death.

Ontario Health (Trillium Gift of Life Network) and the healthcare team understand it is disappointing when organ donation is not possible, and will support families and/or substitutes during this difficult time.

The timeline of the organ donation process can be influenced by several factors, including:

Family requests: The family may require additional time to say goodbye to their loved one before the donation process can proceed.

Geography: The distance between the donor, the donor hospital, laboratory facilities, and potential recipients can affect the time it takes to complete organ suitability testing and transportation of the organs. On average, it takes 36 to 48 hours for organ donation to be assessed, recipient matching to be completed, and organ recovery surgery to take place, but in some cases, it may take up to 72 hours due to the geographical distance.

Laboratory and diagnostic testing availability: Hospitals across the province have varying capabilities to perform routine donor testing such as CT scans and donor-specific blood tests. Due to the complexity of testing, the timeline of the donation process may be impacted.

Availability of healthcare, transplant, and Ontario Health (Trillium Gift of Life Network) teams: The availability of the healthcare, transplant, and Ontario Health (Trillium Gift of Life Network) teams needed to perform the organ recovery surgery is a significant factor that impacts the timing of the donation process. Additionally, operating room availability at both the donor and recipient hospitals may also affect the timeline.

Despite these factors, the healthcare team and Ontario Health (Trillium Gift of Life Network) will work to ensure that the donation process is carried out as efficiently and respectfully as possible. It's important to remember that while the donation process may take time, the decision to donate is what truly matters.

Case Follow-up - The recovery process marks the closure of the clinical aspects of the donation case, however, support for donor families continues by Ontario Health (Trillium Gift of Life Network).

Days following - An Ontario Health (Trillium Gift of Life Network) Specialist will connect with families and/or substitutes in the days following the donation to inform them of the lives that have been saved as a result of their loved one's generous gift.  

Aftercare Program - Ontario Health (Trillium Gift of Life Network) Family Services team offers an aftercare program to support all donor families for at least 12 months following the death of their loved one.

The aftercare program provides families with resources about grief, helps facilitate the anonymous exchange of letters with recipients, and when possible, co-ordinates ceremonies to honor donors and their families.

Additional information on support for families and/or substitutes.

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