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"Spain continues to break records and is once again the global leader in organ donation and transplantation", says Dolors Montserrat

Thursday 11 January 2018
Ministerio de Sanidad, Servicios Sociales e Igualdad

The Spanish Minister for Health, Social Services and Equality, Dolors Montserrat, announced on Thursday that "Spain has maintained its position as world leader in organ donation and transplantation thanks to the generosity of donors, and to their families, our healthcare professionals, the Spanish National Transplant Organisation, our great National Health System and the firm and unwavering commitment by this government to giving life to those who need it most".

Spain has maintained its global leadership in this regard for 26 straight years after it broke its own record by reaching 46.9 donors per million population in 2017, a total of 2,183 donors.

This led to 5,259 organ transplants, surpassing the figure of 5,000 for the first time in 2017. This result raises the transplant rate to 113 per million population and consolidates Spain internationally as 'the transplant nation'.

Dolors Montserrat stressed that these are "the best figures in the history of the Spanish transplant system" and demonstrate that "Spain is the most generous country in the world, where more people donate organs that save lives". She therefore especially thanked Spanish society for its generosity at one of the most difficult times in their lives.

In this regard, she added that the organ donor rate per million population has increased by 30% in the last three years. These figures show that six people a day donated their organs in 2017 and 14 transplants were performed daily.

The Spanish minister also highlighted the new strategy that the Spanish National Transplant Organisation is working on. The new team is using this so-called '50x22' Strategy to try and reach 50 donors per million population and 5,500 transplants by 2022 "in order to continue setting new records".

"Professionalism and human generosity can be found behind each transplant. The best healthcare professionals and the most generous people come together on the same country project, a Spanish project, of which we should be proud", she added.

Furthermore, the Spanish minister thanked all the professionals involved in the process and who make "our healthcare system one of the best in the world, demonstrating with each transplant that our great National Health System guarantees quality, universality, fairness, cohesion and equality for all Spaniards in the face of illness. It is not important where in Spain the donor is or where the person needing the transplant resides. We are all equal in Spain, we receive an organ wherever we are from, because giving life knows no regional boundaries. In this regard, Dolors Montserrat recalled that one out of five organs is transplanted in a region other than where the donor comes from. "This clearly shows that Spain is a great country, that together we keep achieving more and that what really matters is that when we donate organs, we donate life", she said.

She also stressed that the Spanish transplant system is an international benchmark that has served as a model for countries around the world.

Finally, the Spanish minister reiterated her thanks and called on all Spaniards to "maintain this generosity, which has made us world leaders in organ donation and transplants and therefore world leaders in providing hope. We are the country offering the greatest hope".

The Spanish minister made these comments at a press briefing held at her ministerial department, at which she released the activity figures from the Spanish National Transplant Organisation for 2017. The minister was accompanied by the Secretary-General for Health, Javier Castrodeza, and the Director General of the Spanish National Transplant Organisation, Beatriz Domínguez-Gil.

New all-time records

Subsequently, the Director General of the Spanish National Transplant Organisation, Beatriz Domínguez-Gil, explained the organ donation and transplantation activity data recorded in Spain during 2017.  According to these figures, Spain set new all-time records in both the total number of donors (up 8.1% to 2,183) and the number of solid organ transplants (up 9.1% to 5,261). New all-time records for the Spanish National Transplant Organisation were also recorded for kidney, liver and lung transplants, and increases were recorded in all types of transplant except pancreas.

In total, 3,269 kidney transplants (up 9%), 1,247 liver transplants (up 8%), 304 heart transplants (up 8%), 363 lung transplants (up 18%), 70 pancreas transplants (down 4%) and eight intestine transplants (up 100%) were performed.  The waiting list has shortened for all organs (except pancreas) from a total of 5,480 at the end of 2016 to 4,896 patients at 31 December 2017. Of those, 74 are children.

Asystolic (non-heart-beating) donation and ER units

According to the ONT, the positive results from last year are due to the measures adopted by the Spanish transplant system to streamline organ donation that were contained in the 2015 Strategy. These include the promotion of asystolic donation and increased collaboration between ICUs (intensive care units) and other hospital services, especially ER units and all critical care units in general.

Asystolic (non-heart-beating) donation is consolidating its position as the clearest way to increase the number of transplants, with a total of 573 donors representing an increase of 16%. Asystolic (non-heart-beating) donors now represent 26% of the total. 91 hospitals throughout the country (in 16 autonomous regions) are already accredited to perform this type of organ donation.

Donation from brain-dead donors has also increased (up 5.6%), which had remained stable in recent years.

The involvement of ER doctors and intensive care specialists, as well as their close collaboration with transplant coordinators, is another of the keys to explaining this spectacular increase in the number of donors.

In contrast, the number of live-donor kidney transplants continued to fall, with a total of 332 (compared with 341 in 2016). This is likely due to a greater chance of receiving a transplant from a deceased donor. This type of transplant accounts for 10.2% of the total.

Donors from road traffic accidents account for 4.2% of the total, the lowest percentage to date.

Furthermore, the gradual aging of donors is becoming more evident: over half (54.6%) are over 60; 30% are over 70; and 9% are over 80. The oldest age for an effective donor stands at 91. This donation enabled a liver transplant to be performed.

Refusal from relatives stands at 12.9% (the lowest ever), which falls to 6.5% in the case of non heart-beating donors.

The Spanish National Transplant Organisation quotes inter-regional organ exchange at 21.9%, which means that one out of five organs is transplanted in a region other than where the donor comes from.

Data by autonomous region

All autonomous regions posted a rate in excess of 35 donors per million population, nine surpassed the national average (46.9) and, of those, four posted rates in excess of 70 donors per million population (the regions along the Cantabrian coast).

Cantabria tops the table with a rate of 74.1 donors per million population. This is followed by La Rioja (71), the Basque Country (70.3), Navarre (70.3) and Murcia (66).

In terms of absolute increases, the Region of Valencia stands out with a contribution of close on 30% to the overall increase in donors throughout Spain, followed by Murcia, Catalonia and Andalusia.

In percentage terms and in order, the autonomous regions posting the highest growth in the number of donors are La Rioja (up 37.5%), the Region of Valencia (up 31.9%), Murcia (up 27.6%) and the Balearic Islands (up 25%).

Ranking of hospitals by activity

By hospital, the units posting the greatest activity in 2017 were as follows:

  • Highest number of donors: H. Univ. Virgen de la Arrixaca (Murcia)                                                 
  • Highest number of brain-dead donors: H. Univ. Virgen de la Arrixaca (Murcia) / H. Univ. Central de Asturias (Asturias)                                                                                                     
  • Highest number of non-heart-beating donors: H. Univ. Virgen de la Arrixaca (Murcia)                                                     
  • Highest number of kidney transplants: H. Virgen del Rocío (Andalusia)
  • Highest number of living kidney donors: H. Clinic de Barcelona (Catalonia)
  • Highest number of liver transplants: H. La Fe (Region of Valencia)
  • Highest number of heart transplants: H. La Fe (Region of Valencia)
  • Highest number of lung transplants: H. Vall d'Hebrón (Catalonia)
  • Highest number of pancreas transplants: H. Clinic de Barcelona (Catalonia)
  • Highest total number of transplants: H. La Fe (Region of Valencia)

Within hospital organ donation activity, it is worth noting:

  • The Hospital de Donostia de San Sebastián, which, although no organ transplants are performed there, posted an all-time record in the number of donors (72)

Within hospital organ transplant activity, it is worth noting:

  • The Hospital La Fe de Valencia performed the most transplants in Spain (7% of the total)
  • The Hospital Virgen del Rocío de Sevilla posted an all-time record in kidney transplantation (200 transplants)
  • The Hospital Vall d'Hebrón de Barcelona posted the all-time record for lung transplant activity (89 transplants)
  • The busiest children's transplant team was at the Hospital La Paz de Madrid (51 transplants, of which 20 were live-donor transplants)

Second stage of the National Bone Marrow Plan

Spain also posted a new record in the number of new bone marrow donors in 2017, which rose to 78,291 (up 196%), practically twice the figure expected for this year. The pace of new donors has reached an average of 220 new donors joining the system every day.

If this pace can be continued, Spain will reach its targets for the second stage of the Bone Marrow Plan (400,000 donors by mid-2018) two and a half years ahead of schedule.

At 1 January 2018, a total of 357,492 (up 26.7%) bone marrow donors were registered in Spain. This compares with a figure of 281,748 registered at the same time in the previous year.

Non official translation