Spain reaches a new all-time high with 48.9 donors per million population and is close to 5,500 transplants

This figure raises the transplant rate to 116 p.m. p. This great result has been possible thanks to the solidarity of our society, whose generosity is evident year after year and to the enormous effort of the coordination and transplant network of Spain.

'50×22' plan

For the director of the National Transplant Organization (ONT), Beatriz Domínguez-Gil, these data demonstrate the effectiveness of the measures included in the Strategic Plan '50×22', launched by the ONT and the Regional Transplant Coordinations at the end of 2017, with the aim of reaching 50 pmp donors and 5,500 transplants in the year 2022.

According to these data, the Spanish transplant system has been about to achieve, with two years in advance, the objectives set forth in this Plan, designed to quantitatively and qualitatively improve the transplant activity in our country.

These are achievements that have also contributed to the alliances woven by the ONT with the scientific societies of the different professionals, doctors and nurses, who participate in the donation and transplant process.

The '50×22' Plan includes, among other measures, those aimed at facilitating collaboration between intensive care units and other hospital services, especially emergency services, with hospital transplant coordinators; encourage donation in asystole and its transformation into a multi-organ donation; enhance live renal donation and pediatric donation, and promote organ donation in the private sector, under the supervision of the public sector, so that all citizens who wish may be organ donors, regardless of the health system that choose.

New historical highs

Although it was based on a high level of excellence, difficult to overcome, and an adverse environment for donation, given the advanced age of potential donors in our country, the effort for innovation has already begun to bear fruit: with new historical maximums in donation and transplantation both in the number of donors, with a total of 2,301, and in the number of solid organ transplants that stands at 5,449. Historical maximums of activity in renal and pulmonary transplantation are also recorded.

In total, 3,423 kidney transplants, 1,227 liver transplants, 300 cardiac, 419 pulmonary, 76 pancreas and 4 intestinal transplants have been performed. Live donor kidney transplants also increase by 14%, with a total of 335 (compared to 293 in 2018). This type of transplant accounts for almost 10% of total kidney transplants.

Despite the great transplant activity that we have achieved, a significant number of patients on the waiting list, pending an organ, persists. As of December 31, 2019, it stands at 4,889 patients. Of them, 93 are children.

Donor Profile

The donation in asystole is consolidated as the clearest way of expanding the number of transplants, with a total of 744 donors, which represents an increase of 18% over the previous year. Currently, 32% of donors are in asystole, that is, 1 in 3. More than 120 hospitals across the country, of 16 Autonomous Communities, are already accredited for this type of donation.

Donors who died from traffic accidents are 4.4%, one of the lowest in the last decade.

Regarding the age of donors, more than half (56.4%) are over 60 years old, 32% are over 70 and 8.5% are 80. The maximum age of an effective donor is 91 years which has allowed a liver transplant.

Family refusals are 14%. This percentage is reduced to 9.5% for donors in asystole.

Data by Autonomous Communities

10 Autonomous Communities exceed 50 donors p.m. p. Of these, one records data close to 90 donors p.m. p and two exceed 60 donors p.m. p.

Cantabria once again leads the ranking, with a rate of 89.7 donors p.m. p. They are followed, in this order, Basque Country (65), Murcia (63.8) and Balearic Islands (54.4).

Regarding the increase in the number of donors in absolute terms, Catalonia stands out, followed by Aragon, Galicia, Castilla-La Mancha and the Valencian Community. In percentage, the Communities with the highest growth in the number of donors are, in this order, Aragon (+ 47.6%), Castilla-La Mancha (+ 44.1%), Galicia (+ 17.2%) , Catalonia (+ 14.6%) and Murcia (+ 14.5%) (See attached table).

On the other hand, the ONT numbers 1,200 transplanted patients thanks to the exchange of organs between Autonomous Communities, which represents 24% of the total. In turn, 8% of those transplanted have received the organ outside their Autonomous Community of residence. Both data show the cohesive role of the Spanish Transplant System.

Activity by hospitals

By hospitals, the centers that have registered the most activity in 2019 have been the following:

  • Maximum Donors (H. Univ Virgen de la Arrixaca)
  • Maximum Donors in ME (H. Univ Virgen de la Arrixaca)
  • Maximum Donors in Asistolia (H. Clinic de Barcelona)
  • Maximum T. Renal (H. Univ. De Bellvitge)
  • Máximo T. Renal de vivo (H. Clinic de Barcelona)
  • Maximum T. Hepatic (H. Univ. La Fe)
  • Máximo T. Cardíaco (H. Univ. La Fe)
  • Maximum T. Pulmonar (H. Vall d´Hebron)
  • Maximum T. Pancreatic (H. Clinic of Barcelona)
  • Máximo T. Infantil (H. Univ. La Paz)
  • Maximum Total Transplants (H. Univ. La Fe)

Within the hospital activity in donation highlights:

  • The San Sebastian Donostia Hospital which, of the hospitals without transplanting activity, is the center with the highest donation activity, with a total of 56 donors.

Other outstanding achievements in 2019

  • Spain, together with Italy, performs the second international cross-kidney transplant in Southern Europe, in a complicated logistics operation coordinated by the ONT in which the Puigvert Foundation of Barcelona and the Kidney Transplant of Padua participate.
  • After launching the incompatible AB0 child cardiac transplant program in 2018, 6 such transplants have already been carried out in our country (2 in Br. Univ. Gregorio Marañón and 4 in Br. Univ. La Paz).
  • Our country consolidates the transplant program from donor Virus C positive to virus C negative patients. By the end of 2019, 101 HCV donor transplants had already been performed on recipients that were not infected by this virus.
  • In November, the ONT broke a new activity record, managing 19 donors in less than 24 hours. In the different operations, 27 hospitals from 13 Autonomous Communities and a French hospital participated.
  • A total of 127 hyperimmunized renal patients and therefore, with little chance of finding a compatible donor, have been able to receive a transplant in 2019 thanks to the PATHI Program (Hyperimmunized Patient Transplant Access Program). These patients had an average of 6 years on the waiting list, due to their complex immune status. In five years, 485 kidney patients have benefited from this program.
  • The ONT signs a collaboration agreement with the Spanish Private Health Association (ASPE) to strengthen and standardize the donation of organs throughout the country in private hospitals, in cooperation and under the supervision of the public sector. In 2019, 40 donors (1.7% of the total) were identified in private hospitals: 13 in Madrid, 8 in Galicia, 7 in Catalonia, 4 in Andalusia, 4 in the Valencian Community, 2 in the Balearic Islands, 1 in the Canary Islands and 1 in Navarra.

National Marrow Plan

As of January 1, 2020, our country already has 420,730 bone marrow donors registered in the Spanish Registry of Bone Marrow Donors (REDMO). Of these, 36,108 are donors who registered in 2019, representing an increase of 9.2% over the previous year. The increase in the number of donors registered in REDMO and the qualitative improvement of the registry are objectives of the third phase of the National Bone Marrow Plan.

Ministry of Health, Consumption and Social Welfare

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