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Donation's nation

The Spanish donor-rate is the highest on the planet and our transplant system is, by far, the best.

Why do we have such a marvelous healthcare system?

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The director of the ONT, Beatriz Domínguez-Gil, and the founder of the organization, Rafael Matesanz l EFE

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The ALCER foundation promotes the project ‘La donación da mucha vida’   l Miguel Santiago

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The EU countries with the highest rate of donation

Regarding Spain and organ donation, this branch of medicine has been the leader in the world ranking for 25 years. For 23 years, Spain has been the world leader in the number of donors in relation to its population. In our country, it is really easy to find someone who has donated an organ. Surely, one of your relatives is a donor or a recipient. That’s why our donation-rate is astonishingly high: 47 organ donors per million people and over 5200 annual transplants (14 every day). Last year, 3,269 kidney, 1,247 liver, 304 heart, 363 lung, 70 pancreas and 8 intestine transplants were performed.

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In Spain, organ transplantation is becoming really vital and viral. Rafael Matesanz, the director of the National Transplant Organization (ONT), and various of his coworkers have written an article for the American Journal of Transplantation that explains the reasons why this achievement is  globally envied:

 

Firstly, the election of appropriate professionals (not only doctors) to manage the immediate donation at the time of the death of the patient who donates their organs. In our country, specialists are always supported by the ONT (National Transplant Organization) and by several coordination offices that guarantee the quality of our public healthcare system.

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Moreover, another factor that improves the quality of our healthcare system is the identification of potential donors. The government and many associations usually make campaigns to raise awareness, support organ donation and increase the number of transplants. In addition, very few potential donors and their families say no to donation: in 2014, 25% of people refused to donate their relatives’ organs. That rate is now 15%.

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Here anyone at any age can give their name and sign to be a donor (of course, you must pass some health tests to donate). In our country, 54.6% of donors are over 60 years of age, whereas in other countries the elderly-donor-rate is very low. For example, 25.5% in  Australia and 12.5% in the USA .

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The ONT thinks that one of the most important causes of the Spanish predominance is its relationship with the social-media. They are concerned with improving people’s knowledge about donation and transplantation. In 1989 the Ministry of Health started some projects and it only took a decade to increase the number of donors from 15 donors per million to more than 30. These numbers continue growing and in 2018 broke their record: 2,183 donors (47 per million). This March of 2019, in the National Transplant Day, the ONT explained that in this first quarter of the year donations have increased a 11% and transplants a 10%. The ONT is working on the ‘Plan 50x22’, which aim is to achieve 50 donor per million and 5,500 transplants by 2022. This plan considers the consolidation of strategies as well as the possibility to try new methods to attract potential donors.

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Finally, in many countries, donation is only considered in case of brain death, in which brain functions have finished, or in case of circulatorydeath, in which blood circulation, herth beats or breathing stopped. In Spain, this method of choosing donors is different and more people have the opportunity to donate.

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Finally, we contacted  Dr. Julia  Tainijoki-Seyer (julia.seyer@wma.net) from The World Medical Association. She claimed that Spain has a presumed consent for organ donation with opt-out policy. We also contacted Karen Massey <karen.massey1@hse.ie>, the Clinical Nurse Manager of the Irish Organ Donation Association, and she said that “Spain is widely acknowledged as the outstanding example of a transplantation system that has increased the number available organs and we use an Irish version of the Spanish model”.

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In Europe, the upward trend of donors continues very slowly. In 2017, the donation-rate of the 28 countries that make up the EU (European Union) increased minimally to 22.3 donors per one million people. Given that all the nations would like to be part of the donation revolution, some countries are changing their laws to be as advanced as Spain. For instance, on the 5th of August 2018, the English government announced plans to change the organ donation law. In 2020, a new ‘opt-out’ system will probably renew the English NHS (National Healthcare Service). The legislation (Max’s Law) says that everyone will consent to donate their organs unless they register their decision to reject the donation.

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Furthermore, in 2017, the Spanish autonomous communities broke records by surpassing the rate of 35 donors per one million people. 4 communities represent rates above 70 donors: Cantabria (74.2), La Rioja (71), the Basque Country (70.3) and Navarre (70.3).

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Doctor Nicolás García, medical director of the University Clinic of Navarre, said that the results of  liver, heart and kidney transplants in Navarre present one of the highest survival-rates in Spain. Likewise, a couple of years ago, Health Councillor Marta Vera highlighted how the generosity of Navarrese people has always been translated into good results in organ transplant. She underlined that “the good clinical results obtained guarantee the quality of the sanitary teams, to whom I thank for their work.” Vera also wanted to encourage the Navarrese society to continue with its altruism, since that makes offering another life opportunity to other people possible.

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300th heart transplant in our autonomous community l Manuel Castells

With regard to the activities that are organized to popularise organ donation in Spain, every first Wednesday of June, there are some projects due to the National Donor Day. For example, in 2017 Atehna (Asociación de Transplantados y Enfermos Hepáticos de Navarra) organized a music gala, and ALCER Navarra set up a few information points in order to spread the importance of donation and its repercussion in society. There are more remarkable days that improve the quality of the Spanish donation-system, such as the National Transplant Day (last Wednesday of March), the World Kidney Day (second Thursday of March) and the World Marrow Donor Day (third Saturday of September). The World Kidney Day 2019 was a great spectacle: hundreds of events took place around the world, from public detection campaigns in Argentina to massive zumba classes in Malaysia. They did all that to raise awareness about preventive behaviors, risk factors and how to live with a kidney disease.

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In order to increase the number of donations in the future, scientist are starting to design organs with 3D printers. The dream of creating organs does not seem impossible to Dr. Anthony Atala, director of the Wake Forest School of Medicine (Institute of Regenerative Medicine in North Carolina). Atala designs detailed organs, such as kidneys, although nowadays they are prototypes. He is convinced that in some decades, it will be possible to make fully functional vital structures.

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Every year, ALCER Navarra goes to the streets on Donor Day  | DN & Karkara aldizkaria

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