Electronic Thesis and Dissertation Repository


Doctor of Philosophy


Epidemiology and Biostatistics


Dr. Amit Garg


Canadians on the transplant waiting list are dying every day because there are not enough available solid organs for transplantation. An important aspect of addressing this problem is to increase deceased organ donation consent rates. Consent rates are, in part, affected by the number of adults registering their commitment to deceased organ donation in the event of their death through a donor registry. In provinces such as Ontario, approximately 30% of the population is registered for deceased organ donation and approximately 60% of families consent to organ donation. These low figures have been attributed, without evidence, to the relatively high proportion of immigrants or ethnic minorities living in Ontario.

This research uses Ontario’s large administrative databases to examine organ and tissue donor registration in the general population and familial consent among those referred for organ and tissue donation. Modified-Poisson regression was used to identify characteristics associated with donor registration and familial consent.

The first manuscript examines deceased organ donor registration and familial consent among Chinese, South Asian and the remaining general public. Chinese and South Asian individuals registered and their families consented less for deceased organ donation than the general public.

The second manuscript examines deceased organ donor registration among immigrants compared to long-term residents and identifies and quantifies characteristics associated with organ donor registration. Compared to long-term residents, immigrants as a group were much less likely to register for organ and tissue donation. Characteristics among the immigrant population associated with a higher likelihood of registration included economic immigrant status, living in a rural area (population < 10 000), living in an area with a lower ethnic concentration, less material deprivation, a higher education, ability to speak English and French, and more years residing in Canada.

The third manuscript examines familial consent among immigrants and identifies and quantifies characteristics associated with familial consent. Compared to long-term residents, families of immigrants as a group were less likely to consent for deceased organ donation. However, there was no statistical difference in consent rates among immigrants and long-term residents who had registered for organ and tissue donation.

The information gained from this study will guide organ procurement organization’s strategies and approaches to organ and tissue donation. These results can be used to implement and design donor awareness campaigns targeted at groups with lower donor registration and consent rates that are culturally sensitive and effective.