Benchmarking in organ donation after brain death in Spain

The Lancet


Monthly evolution of interannual absolute number of deceased organ donors in Spain after implementation of good practice guidelines
Interannual absolute number of deceased organ donors=number of deceased organ donors within past 12 months at a given date.1

Rafael Matesanz a, Beatriz Domínguez-Gil a, Rosario Marazuela a, Elisabeth Coll a, Gloria de la Rosa a

Spain is widely known to be the only example of a large country (47 million inhabitants) that has seen a continuous increase in deceased organ donation over 20 years (from 14·3 donors per million population in 1989 to 33—35 donors per million population since 1999),1 and a parallel increase in the number of solid organ transplantations (from 1300 per year in 1989 to more than 4200 per year in 2011).1 The sustained increase in deceased donation follows the implementation of a set of measures, mainly of an organisational nature, internationally known as the Spanish model.2

Despite this outstanding activity, our country is still far from satisfying transplant needs. Additionally, the potential for donation after brain death is decreasing owing to a reduction in mortality relevant to organ donation and to changes in patterns of neurocritical care. Moreover, the co-existence of different cultures has set a new challenge for family liaison in deceased donation. These common trends in developed countries necessitate a comprehensive strategy to maintain or increase organ availability.

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