The Spanish model of donation and transplants is an example to follow for the rest of European countries. This has been highlighted by the European Kidney Health Association (EKHA), at the European Kidney Forum 2019, held in Brussels.
Dr. Elisabeth Coll, medical director of the National Transplant Organization (ONT), which has explained the keys of Spain's global leadership in donation and transplants.
"Our organizational model, the effort in the training of professionals and innovation in the search for new formulas to increase the availability of organs, together with the generosity of citizens and the excellence of the National Health System, are the factors that explain our high rate of transplants "Coll said during his speech in the session entitled:" Spain, a case study: what can Europe learn from a country with a high rate of transplants? "
Our country reached last year rates of 48 donors and 114 transplants per million population (p.m.p), the highest in the world. Of the total of transplants performed in Spain in 2018 (5,321), 62% (3,313) were renal. That is to say, that 6 out of 10 transplants performed in Spain are renal.
Of the kidney transplants performed in Spain in 2018, 332 (10%) were living donors. The World Health Organization (WHO) considers that the transplant must be based mainly on the donation activity of deceased persons, as it happens in our country.
The rate of renal transplantation in Spain has gone from 54.2 p.m.p in 2013 to 70.8 p.m.p in 2018, the highest historical activity in our country and in the world. This increase was mainly due to the development of the donation in asystole.
Also, in the field of kidney transplantation, Spain has achieved two milestones: on the one hand, it has reduced the waiting list for kidney transplantation in recent years. At the end of 2013, 4,328 patients were waiting for a kidney transplant, compared to 3,933 registered at the end of 2018. On the other hand, there are more transplant patients with a functioning kidney than on dialysis. As Coll said, "More than half of patients with advanced kidney disease in Spain are transplanted."
Challenges of chronic kidney disease
The European Alliance for Renal Health (EHKA) is a network of nephrologists, nurses, patients, foundations and European Transplant Organizations with the aim of proposing joint solutions to the challenges of Chronic Kidney Disease in the continent and propose strategies to facilitate the Equitable access to the different modalities of renal function substitution treatment (dialysis and transplantation). The ONT actively participates in this initiative, which has as a model to follow the Spanish transplant system.
In its 6th Annual Forum, the European Alliance for Renal Health has decided to focus this meeting on donation and transplantation, with the aim of finding formulas to improve the availability of organs for kidney transplantation in Europe. It is demonstrated that transplantation is the renal replacement treatment that offers better survival and quality of life for patients with Advanced Renal Insufficiency. In addition, it contributes to the sustainability of public health systems, due to the lower cost of transplantation compared to that of dialysis.
Kidney transplant in Europe
The latest data from the World Registry of Transplants managed by the ONT by appointment of WHO, reveal the need to increase the availability of organs for kidney transplantation in Europe. In 2017, a total of 21,102 kidney transplants were performed in the EU, with a rate of 41.5 p.m.p, well below the activity in Spain in that year (70.5 p.m.p). At the end of 2017, a total of 47,685 European patients were waiting for a transplant.
Of the kidney transplants performed in the EU, 4,206 were from living donors, which represents 20% of the total. This means that in Europe, 1 in 5 renal transplants are from a living donor.
Of the more than 21,000 kidney transplants performed in the EU in 2017, 3,269 (15.5% of the total) were performed in our country, despite the fact that our population represents only 9% of the European.
The conclusions of this forum will be incorporated into the Joint Declaration that is being prepared by the European Alliance for Renal Health to improve donation and transplantation in Europe. This Declaration will be presented in October to the European Commission, national policy makers and relevant health organizations