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How Did Spain Get So Many Organ Donors?

VOCATIV | Alexandra Ossola
Can the U.S. learn something from the world's leader in transplants?

If you need an organ in the U.S., there’s a much better chance you’ll get one than if you lived somewhere else. In 2016 there were more than 33,000 organ transplants; a 2015 survey from the World Health Organization estimated that the U.S. ranked third in the world, though there are still 119,000 people waiting for a transplant.

The country that ranks number one, however, is Spain, with 101 transplants per million people (compared to 93 in the U.S.). It’s taken decades of concerted, continued effort for Spain to become the world’s leader. As U.S. health officials strive to increase the number of transplants that happen within its borders, some are turning to Spain as a model.

The Spanish government has been working on increasing its transplant numbers since 1989, when it created an agency called the Organizacion Nacional de Trasplantes (ONT) to coordinate donations and transplant activities. In the decades since, it has established an opt-out program in which it’s assumed people will be donating their organs — families have to explicitly tell health care staff if they want don’t want to participate.

Another major change: who donates organs. They can come not only from patients who are braindead, which is standard across the world, but they can come from “non-traditional” donors, such as patients who have died of drug overdose, certain types of cardiac death, and older patients, too. Because of these measures, Spain doubled the number organs donated from deceased donors within a decade. The agency’s successes and continued challenges are detailed in a review published last Monday in the American Journal of Transplantation. Continue reading


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