The World Transplant Registry, which has been managing the Spanish National Transplant Organisation (Spanish acronym: ONT) for 11 years in partnership with the WHO, puts the total number of organ transplants performed around the world last year at 126,670. This is a record increase of 5.8% on the previous year (119,873). Of that total, 84,347 were kidney transplants (41% live-donor), 27,759 were liver transplants (21% live-donor), 7,023 were heart transplants, 5,046 were lung transplants, 2,299 were pancreas transplants and 196 were intestinal transplants.
These transplants were made possible thanks to 31,812 deceased donors. This compares with 27,397 in the previous year and represents an increase of 16.1%. This was boosted by a total of 41,086 live donors (35,257 kidney and 5,829 liver).
These data are contained in the official publication by the CoE Committee on Organ Transplantation (‘Newsletter Transplant 2017’), which will shortly be available on the ONT website (www.ont.es). Published by the ONT, ‘Newsletter Transplant’ is one of the main sources of official information in the world reflecting a large part of the data contained in the World Registry.
European Organ Donation Day will be celebrated on Saturday, 9 September in Switzerland, an initiative by the Council of Europe that seeks to raise public awareness about the need to increase organ donation in the 47 Member States involved. The Committee on Organ Transplantation of the Council of Europe selects a different city each year to remind people that organ donation saves lives. Lisbon was the chosen capital last year.
With 2,019 donors and 4,818 organs transplanted in 2016, Spain once again reaffirms its global leadership for the 25th year running at a rate of 43.8 donors per million population (p.m.p.). The World Transplant Registry works with the population figures gathered by the United Nations Fund. This explains the slight difference between the rate recorded by the ONT at the end of 2016 (43.4), being marginally lower than the 43.8 donors p.m.p. attributed to Spain by the World Transplant Registry.
Increasing the lead
The World Registry data show that Spain is increasing its lead in terms of organ donation and transplantation: with only 10.9% of the EU population and 0.6% of the global population, Spain performed 18.5% of all organ donations in the European Union last year and 6.6% of all those recorded worldwide.
Spain’s clear leadership in this field is also highlighted when analysing the organ transplants per million population indexes, in which the country maintains its global leadership. Spain posted a figure of 102.3 transplant patients p.m.p. last year, far higher than the European average (at 64 p.m.p.) and also higher than the United States (at 99.8 p.m.p.).
In Europe, the figures on organ donation and transplantation rose slightly when compared with those from 2015. In 2016, the organ donor rate in the 28 countries forming the EU rose slightly to 21.5 deceased donors per million population, with a total of 10,893 organ donations. Of those, 1,490 were non heart-beating donors.
From these figures, it is worth noting the low organ donor rate in Germany, which has remained at approximately 10 donors p.m.p. in recent years. This is offset by increasing figures in such other countries as Austria, France, Italy, Portugal and the Czech Republic. The United Kingdom is worth highlighting, where the organ donor rate has increased significantly in recent years to 21.5 donors p.m.p. at present following efforts to enhance the role played by intensive care staff and ICUs in the identification of possible donors – one of the key measures in the ‘Spanish model’.
The same has occurred in Croatia, a smaller country but where the Spanish model has been fully implemented. This led to an organ donor rate for the country of 39.5 p.m.p. in 2016.
The total number of transplants stood at 33,385 (compared with 32,707 recorded in the previous year).
As regards the waiting list, data from the World Registry put the number of European patients waiting for a transplant at 59,168 as at 31 December.
These same data estimate that 3,795 people died in the European Union over the course of the year while waiting for a transplant, slightly less than the previous year.
Spain has tried to boost the role played throughout Europe by intensive care staff and ICUs in the identification of potential donors, as well as the role played by ER professionals, as a way to increase organ availability by following the guidelines from the European ACCORD Programme being headed up by Spain.
Furthermore, Spain continues to insist on the EU-wide development of donation from non heart-beating donors, a procedure that has consolidated itself in Spain as the fastest-growing method of deceased organ donation. Donation from non heart-beating donors in the EU accounts for 13.7% of all deceased donations, while it accounted for 24% of the total in Spain last year.
Organ donor rates in other countries
The CoE publication also includes data from Australia, Canada, the United States and Latin American countries. The organ donor rate in the United States has risen to 30.8 donors p.m.p., with a total of 9,970 donors and 32,356 transplants.
Australia and Canada, which have received consultancy in this regard from Spain, have also posted improvements in their organ donor rates over recent years. Australia posted a figure of 20.7 donors p.m.p., while this figure stands at 20.1 donors p.m.p. in Canada.
Latin America, with which Spain has been working in this field for over 13 years now via the Iberoamerican Network/Council on Organ Donation and Transplantation (RCIDT) on both management consultancy and training for transplant coordination professionals, also posted an organ donor rate increase to 9.2 donors p.m.p., representing a total of 15,468 organ transplants. Since Spain began to cooperate in this regard in the region, total growth now exceeds 60%. This is the largest growth figure worldwide for a region as a whole.
Transplants in Spain continue to rise
The data from the World Transplant Registry once again confirm Spain’s global leadership in this field, where a rate of 43.8 donors p.m.p. was recorded last year. A total of 2,019 organ donors were recorded in Spain, enabling 4,818 organ transplants to be performed. In total, 2,994 kidney transplants, 1,159 liver transplants, 281 heart transplants, 307 lung transplants, 73 pancreas transplants and four intestinal transplants were performed. Asystolic donation and collaboration from ER professionals with ICU staff and transplant coordinators on the identification of potential donors have become key factors in the increasing number of donors in Spain.
Despite the fact it is difficult to maintain constant growth, the upward trend posted in Spain in the field of organ donation and transplantation in recent years has continued into the first half of 2017. The data from the ONT on the first half of this year reflect a 6.7% increase in the total number of donors. Donation from brain-dead donors remains stable, with an increase of close on 1%, while asystolic donation rose by 25.3%. Similarly, the donors found in emergency rooms now account for 24% of the total.
Were this pace to continue, Spain could reach a rate at 45 donors p.m.p. at the end of the year. Of those, approximately one out of four would by via asystolic donation. At 1 July, the year-on-year rate posted a total of 2,089 donors. All these figures highlight the strength and stability of the Spanish transplant system and support the fact that Spanish citizens needing assistance of this nature are the most likely to receive a transplant anywhere in the world.