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Nova Scotia predicts big bump in organ donations under new law

Nova Scotia is expecting organ and tissue donations to rise by 40 to 50 per cent in the first year of the province’s opt-out law, which works out to an additional 10 organ donations and an additional 138 tissue donations in the first year.

The provincial Liberal government passed the Human Organ and Tissue Donation Act in 2019, switching from an opt-in system to one in which all adults will be presumed donors unless they’ve previously registered their refusal.

Individuals can also register partial consent, specifying which organs or tissues they would like to donate after death.

Nova Scotia was the first jurisdiction in North America to commit to an opt-out system, but some European countries, including Spain and Belgium, are already practising presumed consent. The law could take effect this fall, once regulations are drafted, but no firm date has yet been announced.

When Nova Scotia introduced its legislation last April, Dr. Stephen Beed, the medical director of Nova Scotia’s organ donation program, pointed to European adopters as examples of how presumed consent can lead to increased donation rates.

How the province came up with its estimate

Beed said donations rose in some European countries by as much as 35 per cent after implementing an opt-out system.

Health Minister Randy Delorey said Nova Scotia’s estimate of increased donations is based on research and the expertise of the province’s transplant teams.

The government plans to spend $3.2 million this fiscal year on the rollout of the new system, which Finance Minister Karen Casey highlighted in her budget address at Province House on Feb. 25.

Cindy Ryan displays the tattoo that marks her two liver transplants. She applauded Nova Scotia’s presumed consent law when it was introduced at Province House last April. (Andrew Vaughan/The Canadian Press)

The money will be directed to the Nova Scotia Health Authority, accounting for part of the $77.7-million increase to the organization’s budget this year.

Delorey said it’s hard to predict what the budget for the new organ donation system will look like in future years.

Some costs associated with initial setup and public education and awareness campaigns will only be incurred once.

“But then we anticipate over time to see an increase in the number of transplants conducted, which would again cause the costs to go up,” said Delorey.

Potential health-care savings

However, additional transplants could bring spending down in other areas of health care, Delorey said. For instance, spending on dialysis could drop if more kidneys are transplanted.

According to a Health Department spokesperson, the overall costs for a kidney transplant and aftercare are less than multiple years on dialysis.

Nova Scotia legislators voted in favour of the opt-out system last April, but the law has yet to come into force. Delorey said he expects the necessary systems to be in place by fall 2020.

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