Donor Identification and Referral as a Critical Patient Safety Event Leading to Preventable Harm for Transplant Candidates

This is an ODTC-funded project. See ODTC project summary.

Donor Identification and Referral as a Critical Patient Safety Event Leading to Preventable Harm for Transplant Candidates

What is this project about?

Project background

Over 80% of transplants arise from organ donation after death, which is predicated on frontline healthcare professionals identifying and referring potential donors to local organ donation organizations in a timely manner.

Failure to identify and refer a potential donor in a timely manner is a critical patient safety event causing preventable harm to transplant candidates (an underserved and vulnerable population) in terms of longer wait times, disability and death.


This project aims to develop an implementation strategy to reduce missed donor identification and referral opportunities and improve accountability mechanisms in deceased donation.

Project Outputs and Publications

  • Donor audits in deceased organ donation: a scoping review | Vérifications des donneurs et donneuses dans le don d’organes après le décès : une étude de portée  Amina Silva, PhD . Jehan Lalani, MHA . Lee James, MN . Shauna O’Donnell, MSc . Alexandre Amar-Zifkin, MLIS . Sam D. Shemie, MD . Samara Zavalkoff, MD Can J Anesth/J Can Anesth 

    • This manuscript collates and summarize national and international literature on donor audits (DA) and their impact on deceased organ donation and transplantation system performance and quality assurance.  

      Donor audits identify missed donation opportunities and quality improvement initiatives. Scoping review reveals: significant deceased organ donation potential; failure to identify/refer potential donors and family decline are major barriers to donation; and while NDD ratio of potential vs actual donors is significantly higher than DCD, misses disproportionality occur during DCD.

  • Preventable harm in the Canadian organ donation and transplantation system: a descriptive study of missed organ donor identification and referral Zavalkoff S, O'Donnell S, Lalani J, Karam IF, James L, Shemie SD. Can J Anaesth. 2023 Mar 29. doi: 10.1007/s12630-023-02399-1. PMID: 36991298

  • National Quality Improvement in Deceased Donation Data Forum - Virtual Meeting June 3, 11, and 14, 2021 
    The purpose of the Quality Improvement in Deceased Donation Data Forum was to advance national deceased donation data collection and reporting by developing Pan-Canadian agreement on clinical referral triggers, donor definitions, dataset, and system reporting metrics to support a highly reliable ODT system that reduces preventable harm to potential donors, their families, and transplant candidates. We would like to thank our forum participants, expert speakers, and Planning Committee, as well as the organizational support provided by Canadian Blood Services and the funding support provided by the Organ Donation and Transplantation Collaborative for working together to improve the national deceased ODT system on behalf of Canadians. 


The Organ Donation and Transplantation Collaborative is an initiative led by Health Canada with provinces and territories (except Québec), Canadian Blood Services, patients, families, clinicians and researchers. Funded by Health Canada, the project Donor Identification and Referral as a Critical Patient Safety Event Leading to Preventable Harm for Transplant Candidates, contributes to the Collaborative’s vision to achieve organ donation and transplantation system improvements that result in better patient outcomes and an increase in the number and quality of successful transplantations. For more information, please consult the Organ Donation and Transplantation Collaborative (the Collaborative) website:

Medical management to optimize donor organ potential

Potential organ donor identification and system accountability (2019)

Donor Management Evidence Bulletins