New Donor Pathways Boost Quebec Transplants Amid Calls for Major Reform

MONTREAL, QC – April 16, 2026 – Quebec saw 617 life-saving organ transplants from 196 deceased donors in 2025, a testament to what Transplant Québec calls "remarkable progress" in its latest annual report. The figures highlight a system experiencing significant growth, largely fueled by evolving medical practices that have broadened the definition of a potential donor.

However, behind the celebratory numbers lies a pressing reality: as of the end of last year, 898 people remained on the waiting list for a transplant. This stark figure has amplified calls from experts for systemic reform to build on recent successes and meet the province's growing needs.

The Evolving Face of Donation

A key driver of the increase in transplants is a fundamental shift in the donor profile over the past quarter-century. While donation after neurological death (or brain death) remains a primary source, new pathways have emerged as significant contributors.

In 2025, donations following death determination by circulatory criteria (DCD) accounted for 35% of all donors. DCD occurs when organ retrieval follows the irreversible cessation of heart and lung function, typically after a family and medical team have made the independent decision to withdraw life-sustaining treatment from a patient with no hope of recovery. The process requires meticulous coordination to ensure organs remain viable.

Furthermore, Quebec has seen an increase in donations from individuals who have chosen medical aid in dying (MAID). Last year, 27 individuals who were approved for MAID generously donated their organs, providing a new lease on life to others. This pathway is governed by strict ethical protocols established by medical bodies to protect all parties. A critical principle is the complete separation of the decision to pursue MAID from any discussion about organ donation. The request for MAID must be fully approved before donation can even be considered, and the patient must provide explicit, first-person consent for donation.

These advancements in medical practice have been instrumental in expanding the donor pool, allowing more people to give the gift of life and contributing to the 1,611 transplants performed in Quebec over the past three years alone.

A System at a Crossroads: The Call for Reform

Despite the positive trends, the nearly 900 people still waiting for organs cast a long shadow. To close this gap, Transplant Québec insists that continued progress is not guaranteed without significant structural changes, pointing to a series of recommendations made during a 2024 parliamentary commission.

That commission explored ways to facilitate organ donation but ultimately recommended shelving the controversial idea of a "presumed consent" system for now. Instead, it urged the government to focus on foundational improvements. Key among these are the creation of a comprehensive legislative framework for organ donation, the establishment of a single, centralized online registry for citizens to formally record their consent or refusal, and the official designation of one organization to oversee the entire process from donor identification to transplantation.

"These results point to significant growth dating back several years, and we're extremely proud of them," said Martine Bouchard, Executive Director of Transplant Québec, in a statement. "But while we can take pride in this rapid growth, continued progress depends on the recommendations set out of the 2024 parliamentary commission being implemented. It is essential to focus our efforts on these priority issues if we wish to keep saving more lives."

Implementing these changes, advocates argue, would streamline processes, improve training for healthcare professionals, and ensure that potential donors in all hospitals are systematically identified and referred to Transplant Québec, an obligation that is not yet universally applied.

Quebec's Progress in a Global Context

The 38% increase in donors and 225% increase in referrals since the 2000s are significant internal milestones. When measured against other jurisdictions, however, the figures suggest both success and untapped potential.

In 2025, Quebec's deceased donor rate was approximately 21.6 per million inhabitants. This rate is comparable to, but slightly behind, Ontario's rate of 22.4. However, it lags considerably behind international leaders. Spain, long considered the global benchmark, boasts a rate of 51.4 deceased donors per million, while the United States has reached 48.5. This comparison underscores the argument that with systemic improvements, Quebec could further boost its donation rates.

Regional data from the report shows that high performance is achievable within the province. The metropolitan Montreal area leads in potential donor referrals with a rate of 22 per 100,000 inhabitants, followed closely by the Saguenay-Lac-Saint-Jean region at 20.6. These successes in specific regions offer a potential roadmap for strategies that could be scaled province-wide to help more patients.

The Human Toll of the Waiting List

Beyond the statistics and policy debates, the numbers represent individuals and families whose lives hang in the balance. For the 898 people on the waiting list, the annual report is both a source of hope and a painful reminder of their ongoing struggle.

Living with organ failure often means a grueling routine of medical treatments, such as dialysis for kidney patients, constant fatigue, and an inability to work or lead a normal life. The wait for a call that may or may not come is an immense emotional and psychological burden. Patient advocacy groups frequently share stories of this profound uncertainty, where every day is a mix of hope for a second chance and fear that time is running out.

Each of the 617 transplants performed last year represents a life transformed, freeing a person from debilitating illness and offering them a future. Yet for every success story, there are others still waiting, their health declining as they hope for the generosity of a stranger and a system that can deliver that gift in time. The urgent need to implement the proposed reforms is not just about improving statistics, but about turning that hope into a reality for hundreds of Quebecers.