One more year, the National Transplant Organization (ONT) has again broken records. Donation figures have again marked historical highs by reaching 2,301 donors in 2019, an increase of 2.7% over last year that keeps the national transplant system in the world leadership that it has held for 28 years.

The balance of activity of the organization in 2019 reflects that, for the first time, the historical maximum of 48.9 donors per million population in Spain has been reached. However, if the data is broken down by Autonomous Communities, there is one that stands out especially: Cantabria .

The region exceeds the national average by 40 points , with 89.7 donors per million population. It is, in fact, the absolute leader, with figures far removed from the 34.2 pmp donors registered by Madrid or the 25 pmp from Melilla. Not even the following in the list of Communities with more activity (Basque Country with 65 pmp and Murcia with 63.8 pmp) are close to the figures of Cantabria.

What is the secret of your leadership? For Beatriz Domínguez-Gil, director of the ONT, there are several reasons that explain that this small region is number one. On the one hand, he explains, "there is an epidemiological component. The population of northern Spain is more aged, which somewhat increases the potential for donation." But, the main thing, he emphasizes, is that "this Autonomous Community has masterfully implemented many of the ONT's recommendations on ways to improve donation."

For example, he notes, they have encouraged cooperation between the ICU and the coordination of transplants with other hospital services; They have launched donation programs at an advanced age or have promoted donation in asystole (in deaths due to irreversible cardio-respiratory arrest), among other measures.

"The population of Cantabria is very generous, but I don't think it is more generous than the Burgos or La Rioja. I think the key to these figures is the organization," said Eduardo Miñambres, regional coordinator of Transplants in Cantabria since 2011.

"Being a donor is difficult. It is not enough to want. You have to have a whole system organized and coordinated beforehand so that any donation you want to make is not lost," he says.

In the last eight years, the region has not dropped from 60 pmp donations, but Miñambres still sees room for improvement. "A few years ago the donation in asystole was not raised. Today, 41% of donations are already being made in the Valdecilla Hospital," he says. "We must keep improving because people are still dying waiting, for example, a heart," he says.

"In Spain, around 8% or 10% of patients who are awaiting a heart transplant die. But in Germany, this percentage is much higher. In 2018, Germany had 11.6 donors per million population" , Add.

In this sense, Dominguez-Gil points out that, despite the differences that exist between regions, "none is in a bad situation. They all have figures of excellence and would be in the top positions in a ranking that compares their situation with European countries, USA. or Canada, "he remarks.

New figures

According to the new ONT data, a total of 5,449 solid organ transplants were performed in Spain last year. With this figure, the organization has been about to reach, with two years in advance, the objective that was set in 2017 in the 50x22 Strategic Plan and that proposed to reach 5,500 transplants and 50 donors per million population in the year 2022.

In the last year the numbers of renal and pulmonary transplants have risen throughout the country. Specifically, 3,423 kidney, 1,227 liver, 300 cardiac, 419 pulmonary, 76 pancreas and 4 intestinal transplants have been performed.

Beatriz Domínguez-Gil, director of the ONT, believes that the new historical figures have been achieved by "the solidarity of the Spaniards" and "the enormous effort of the coordination network" that is committed to "keep improving."

Among the measures that allow progress, explains the specialist, highlights the collaboration between different units, the enhancement of live renal donation or the promotion of asystole donation, among others. In fact, the donation in asystole has been shown in the last year as the route that has most clearly allowed to increase the number of transplants, with an increase of 18% over the previous year and 744 total donors.

Currently, says Dominguez-Gil, 32% of donors do so in circumstances of asystole. " 120 hospitals in 16 autonomous communities already have accreditation to manage this type of donations," he emphasizes.

Live donor kidney transplants have also increased by 14% compared to the previous year, with a total of 335 interventions (in 2018, 293 were performed).

Even so, on the waiting list of people pending a transplant there were, at December 31, 2019, 4,889 patients , 93 of them pediatric.

"We want to continue improving. One of the ways in which it is working is in the promotion of organ donation in the private sector. Transplants will continue to be done in the public sector, but it is necessary to ensure that all citizens who they wish they could be organ donors, regardless of the health system they choose, "says Dominguez-Gil.

According to the criteria of The Trust Project

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