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The Spanish model of organ donation for transplantation

1999; Lippincott Williams & Wilkins; Volume: 4; Issue: 2 Linguagem: Inglês

10.1097/00075200-199906000-00002

1531-7013

B Miranda, M. T. Naya, Natividad Cuende, R. Matesanz,

Organ Transplantation Techniques and Outcomes

At the end of 1989, the Organización Nacional de Trasplantes (ONT) was created within the Spanish Department of Health. It has become a common meeting place for professionals involved in all types of transplantation, the central and autonomous administrations, the media, and Spanish society in general. It has a formal but flexible management structure, which ensures that the transplant coordinators working at the grass-roots level have a sense of involvement and are accountable for performance. These coordinators are responsible for the process of organ donation and procurement within hospitals. The ONT deals with organ sharing and management of waiting lists, arranges for transplant teams or organ transport, maintains the official statistics on organ donation and transplantation activity, and keeps interested groups informed. It maintains a telephone line 24 hours a day, 7 days a week, to address any doubts or answer any questions about organ procurement or transplantation. The ONT is concerned with training programs and research in the field of organ donation and transplantation. It is the unit in charge of official reports in the field of organ donation and transplantation, and it guarantees the complete equity and transparency of the system. Spain currently has 139 hospital coordinating teams, one in each hospital, authorized to develop donation and organ procurement processes. Within this framework, the average rate of solid-organ donation increased from 14 donors per million population in 1989 to 31.5 donors per million population in 1998. The average age of donors has increased year after year, and more than 25% of current donors are older than 60 years of age. Most donors (53.5%) now die of cerebrovascular accident, and only 25% die in car accidents (in 1992, 43% died in car accidents). In Spain, the rate of family refusal of donation was 21.3% in 1998, a decrease from the 30% rate seen in the early 1990s. All of these changes are the result of efforts to overcome various obstacles, such as untrained or undertrained staff, unidentified donors, and reluctance to approach grieving families.