If you are a designated hospital calling TGLN with a patient who meets Donor Referral Indicators,
or have a patient who you believe is a potential donor call:
Ontario Health (Trillium Gift of Life Network) has created and collected resources to support transplant and donation health care professionals.
Hospitals that are designated facilities under the Gift of Life Act must meet the referral provisions detailed under Part II.1 - Notice and Consent. These hospitals have, or will have ‘Routine Notification’ mandated throughout their centre. This means hospitals are responsible for calling and notifying TGLN when a patient has died, or prior to death according to their established referral indicators.
Notifying TGLN ensures donation eligibility can be established. Donation consent decisions can be accessed in the Ontario Health Insurance Plan database before families of eligible patients are approached by TGLN about donation opportunities. Since 2005, this practice has helped maximize organ and tissue donation for transplantation in Ontario.
Learn more about routine notification for donation eligibility.
Ontario Regulation 179/05 has identified six classes of facilities for the purposes of the Gift of Life Act. They are:
Any hospital that provides neuro-surgical or trauma services.
Any hospital that does not meet the requirements set out in Section 1 and that is able to make a neurologically determined death (NDD) in accordance with the medically accepted standards for NDD in Ontario.
Any hospital that does not meet the requirements set in Sections 1 or 2.
Any hospital, health facility or university that participates in the collection, screening, processing, storage or distribution of tissue for transplantation.
Any hospital that transplants organs for the direct clinical benefit of patients.
Laboratories (Laboratory Licensing Act) performing screening tests for infectious diseases and/or histocompatibility testing.
Class A
Hospital - Trauma and/or neuro-surgical servicesAny hospital that provides neuro-surgical or trauma services.
Class B
HospitalAny hospital that does not meet the requirements set out in Section 1 and that is able to make a neurologically determined death (NDD) in accordance with the medically accepted standards for NDD in Ontario.
Class C
HospitalAny hospital that does not meet the requirements set in Sections 1 or 2.
Class D
Tissue/Bone bankAny hospital, health facility or university that participates in the collection, screening, processing, storage or distribution of tissue for transplantation.
Class E
Transplant ServiceAny hospital that transplants organs for the direct clinical benefit of patients.
Class F
Laboratory ServiceLaboratories (Laboratory Licensing Act) performing screening tests for infectious diseases and/or histocompatibility testing.
Organ and tissue donation is possible following the pronouncement of death using neurologically determined death (NDD) criteria or in planned situations of withdrawal of life sustaining therapy followed by pronouncement of death by circulatory determination (DCD).
Neurologically determined death is defined as the “irreversible loss of the capacity for consciousness combined with the irreversible loss of all brainstem functions, including the capacity to breathe” (Canadian Neurocritical Care Group 1999). Previously, the terms “brain death”, “neurological death” and “death by neurological criteria” were used interchangeably.
In Ontario, organ and tissue donation after death by circulatory death (DCD) is now a possibility for patients who do not meet the strict criteria for neurologically determined death or brain death. Patients who meet the criteria for DCD are critically ill and dependent on mechanical ventilation. DCD is a possibility for families who have decided to withdraw life sustaining therapy after a physician has determined that there is no long-term prognosis for recovery.
Ontario Health (Trillium Gift of Life Network) is committed to supporting the learning opportunities for healthcare professionals across Ontario. By using these education materials, you can enhance your knowledge of the merits of donation which ultimately leads to saving and enriching lives.
This eLearning module has been created for independent self study. At the end of the module you are invited to take a quiz which offers a printed certificate for a mark of 90% or more. Note: You must view this e-module in its entirety to receive the certificate.
Click on one of the following choices to enter the module:
Allied Health Professional Roles in Organ and Tissue Donation
Learning Modules
I care for patients and families in a critical care unit/emergency department setting
I care for patients and families in a ward setting
*** Please note that the TGLN eLearning platform has been optimized to run on Google Chrome and Internet Explorer 9 (or later). TGLN has endeavored to ensure maximum compatibility on other browsers, and appreciates your understanding should the functions of the module not be fully compatible with systems outside the recommended browsers. Please note that the TGLN eLearning module may not be fully compatible behind certain firewalls.
The purpose of these education modules are to provide clinicians with the opportunity to consider the implications of caring for potential organ donors while working through virtual patient scenarios.
The following links contain learning scenarios on Neurological Determination of Death and Donor Managment.
For any inquiries on the donation process or patient management, please contact us.
Organ and Tissue Donation Following Medical Assistance in Dying: Program Development Toolkit
The Organ and Tissue Donation Following Medical Assistance in Dying: Program Development Toolkit was developed by TGLN as a tool to support healthcare professionals in hospitals across Ontario. Download pdf to print.
CCCF 2022: Deceased Donation Stream - The Paradigm Shift to Brain-Based Definition and Determination of Death
Speaker: Sam Shemie
Moderator: Bram Rochwerg
CCCF 2022: Deceased Donation Stream - Death by Neurologic Criteria
Moderators: Sonny Dhanani, Laurie Lee
CCCF 2022: Deceased Donation Stream - DNC Continued and Death by Circulatory Criteria
Moderators: Teneille Gofton, George Isac, Sonny Dhanani
Medical Management to Optimize Donor Organ Potential: A Canadian Forum
Severe Brain Injury to Neurological Determination of Death: A Canadian Forum
National recommendations for donation after cardiocirculatory death in Canada
*Now part of Canadian Blood Services (CBS)
This document provides the provincial policies relating to wait listing, wait times, organ offers and allocation to the deceased donor waiting list. These policies apply to all transplant candidates and recipients of organs from deceased donors.
This document is updated regularly to reflect new or amended policies.
Wait List, Organ Offers and Allocation Policies
The following patient referral and listing criteria are guidelines which Health Care Providers would utilize to refer a patient to a transplant centre for assessment and assess the suitability of potential candidates for various types of transplantation.
Position Statements on Non-Canadian Residents &
Out-of-Country Transplant Funding
Clinical Handbook for Kidney Transplantation
Clinical Handbook for Heart Transplantation
FAQs: Clinical Handbook for Heart Transplantation
Clinical Handbook for Lung Transplantation
FAQs: Clinical Handbook for Lung Transplantation
CorHealth Ontario has developed Considering a Left
Ventricular Assist Device (LVAD) - A Guide for Patients
and Caregivers which has been designed to provide
information for patients and caregivers on what to think
about when considering getting a LVAD.
Click here to learn more or download the guide.
Clinical Handbook for Liver Transplantation
FAQs: Clinical Handbook for Liver Transplantation
Ontario Clinical Guidelines Ventricular Assist Devices
Addendum - Ontario Clinical Guidelines - Ventricular Assist Devices for Destination Therapy
Toolkit for Use of Increased Risk Donors for Organ Transplantation