With 40 donors per million inhabitants, Spain is the world champion in organ donation. A success linked to a unique organization and a very low refusal rate.
Spain is a model when it comes to organ donation. For the 24th consecutive year, our European neighbor is world champion in harvesting and transplantation. A success linked, in part, to the medical teams dedicated exclusively to the identification of potential donors, ensures the Spanish transplantation organization in an article published in American Journal of Transplantation.
In 2015 in Spain, 4,769 organs were removed from 1,851 donors. The same year in France, 1,769 deceased people were removed, allowing 5,746 organs to be transplanted. By simply comparing these numbers, our country seems to be doing much better. However, when we relate these data to the population, Spain’s supremacy is undeniable: this country has 40 donors per million inhabitants compared to 27.4 per million people in France.
As in most European countries, including France, the law adopted in Spain in 1979 established presumed consent. In other words, if during his lifetime the deceased person has not expressed his refusal, he is considered as a donor. But the big difference with our country is that Spain does not keep a register of refusals. Families are therefore systematically consulted to know the opinion of the deceased.
The authorities have therefore made the bet that every citizen will feel concerned and will entrust their position to their relatives. And it works: Spain has a refusal rate of around 15% while it reaches 30% in France. Information, communication and education have been the watchwords of the Spanish authorities, especially over the past 25 years. To reduce this opposition, presumed consent has been strengthened in France with new methods of refusal put in place.
Dedicated teams
The success of organ donation in Spain is also linked to the organization of the harvesting and transplantation system by professionalizing the teams. In Spanish hospitals, nursing staff devote themselves full time to organ research and the organization of transplants. And the identification of potential donors does not stop at the intensive care units, the teams also dialogue with the emergency services and other hospitalization structures, explain the authors.
“The most important success of our system is that organ donation is systematically mentioned when a patient dies, regardless of the circumstances of the death,” explains Beatriz Dominguez-Gil, co-author of the study. The professionals who take care of these patients at the end of their life consider it their duty to ask the question of organ donation ”.
Larger sources of grafts
In addition, the criteria for donation in Spain are broader than in some countries, especially with regard to age: more than 10% of donors are over 80 years old. In France, in 2015, nearly 40% of donors were over 65 years old.
Their source of grafts is also a key to their success. The number of donors who die of cardiac arrest, suddenly or after stopping palliative care, represents 10% of donations. In France, only 40 donors who died of cardiac arrest have undergone organ harvesting. In question: France has had difficulty launching sampling protocols from patients who died as a result of stopping treatment. A pilot study – Maastricht III – to assess this practice ended in December 2015.
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-1730888646.jpg "Kidney donation while alive: “It was an act of love that I did for my sister”")
