The

Organization National Transplant (ONT)

recorded in 2020 a total of

4,425 organ transplants

(2,700 kidney, 1,034 liver, 336 lung, 278 heart, 73 pancreas and 4 intestine) from 1,777 deceased donors and 268 live, what which places Spain at 37.4 donors per million population (pmp), according to the data released this Monday at a press conference at the Ministry of Health by the Secretary of State for Health,

Silvia Calzón

, and the Director General of the ONT,

Beatriz Domínguez-Gil

.

"This year more than ever we should talk about the success of the Spanish transplant model, which is going to emerge strengthened from the difficult situation we are experiencing," said Calzón, who pointed out the "extraordinary contribution to social cohesion" of this model .

Even in the midst of the health crisis, Calzón has stressed that Spain's donation rate is much higher than that of other countries in the pre-pandemic period.

Thus, in 2019 Spain reached 48.9 donors per million inhabitants, a figure that this year is 37.4.

In 2019 Germany registered 11.3;

Australia 21.8;

Canada 22.2;

United Kingdom 24.7;

Italy 25.3;

France 29.4;

The US 36.1 and the EU as a whole 22.5 donors per million inhabitants.

Despite the pandemic, and although the Spanish donation and transplant system has obviously been affected, in 2020 there are several milestones to highlight, as stressed by Beatriz Domínguez-Gil.

Probably best of all, 197 pediatric transplants have been registered, a maximum in ONT history.

"We want to increase

pediatric donation

."

"Fortunately in Spain infant mortality is very low," he said.

"Our goal is that when the loss of a child occurs unfortunately in circumstances compatible with donation, that option is systematically offered, not only because it helps children on the waiting list, but because it greatly comforts the family that faces a situation as dramatic and unnatural as the loss of a child. That is why we are working closely with the Spanish Association of Pediatrics and with transplant coordinators so that none of these opportunities are lost ", explained the director of the ONT.

Domínguez-Gil has highlighted other reasons for this increase in pediatric donation.

"We also have a very solid network of international cooperation, we collaborate so that none of those necessary and exceptional and much-needed donations are lost. We have put in very imaginative programs, such as the

incompatible AB0

that serves to give more options to very young children, under one year of heart transplantation, where we remove the barrier of blood group compatibility and thereby increase the probability of transplanting these children up to 50% ".

Improving child transplantation is one of the objectives set forth in the ONT's 50x22 Strategic Plan, a

plan that seeks to reach 50 donors pmp and exceed 5,500 transplants in 2022

, figures that, if it were not for the pandemic, would be more than likely to occur. they would have already reached in 2020. The coronavirus got in the way of the upward pace of donation and transplantation, especially in the first wave, due to the overload of the health system and ICUs.

"We must not forget that only between 1% and 2% of people who die in a hospital do so in a position to be donors and do so in ICUs, units that have been very saturated at the most critical moments of the pandemic , March, April and May ", Calzón recalled.

The Secretary of State added that the decrease in activity also has to do with patient safety and concern about the impact that Covid-19 infection could have on transplant recipients, who are immunosuppressed people.

The adoption of a series of measures allowed that

from June to December the monthly rhythm of donations and transplants approached the 2019 records

and even exceeded at the end of the year.

The director of the ONT has summarized the pillars on which this reconstruction program has been based: on the one hand, the ONT has issued regularly updated recommendations on the evaluation of potential donors and recipients with respect to Covid-19, with the realization PCR test, "something that at first was very complicated because there was no diagnostic capacity."

The second pillar has been based on generating evidence on the impact of the infection in transplanted patients, "immunosuppressed patients", with conclusions that have helped the management of the programs.

In the most complicated moments of the health crisis, the

transplantation of patients in zero urgency or in a very serious clinical situation

, for whom the transplant cannot wait,

has also been prioritized,

as well as patients who are difficult to transplant due to their immunological characteristics o in size: 219 patients in zero urgency, 103 hyperimmunized kidney patients, thanks to the PATHI program of the ONT, and the 197 aforementioned infant transplants.

Domínguez-Gil wanted to highlight as a fourth pillar the scientific societies that have collaborated very actively with the ONT throughout the pandemic and have generated various recommendations.

Even with all the enormous effort,

a significant number of patients

remain on the

waiting list

.

As of December 31, 2020, the figure stands at

4,794 patients

(92 of them are children).

This number, however, is lower than that registered in 2019 (4,889), something that may seem paradoxical as donation and transplantation activity has been reduced.

Domínguez-Gil has insisted on the same reasons why donation has decreased, especially the saturation of the health system and the fear of infection and the effects it could have on these patients.

This has also reduced the inclusion of patients on transplant waiting lists "and who probably saw their inclusion delayed and somehow represent collateral victims of the epidemic", in the words of the director of the ONT.

By CCAA

Although Spain has an average of 37.4 pmp donors, nine autonomous communities exceed 40 and five exceed 50 pmp: Cantabria (65.5), Navarra (53,), Canarias (51.6), Basque Country (51, 4), Murcia (51), Asturias (45.5), La Rioja (45.2), Extremadura (43.4) and Galicia (40.7).

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