Spain approached pre-pandemic transplant record in 2022

Spain registered 5,383 organ transplants in 2022, as reported on Thursday by the National Transplant Organization (ONT) during the presentation of its balance sheet. The number is close to the pre-pandemic record, with a rate of 113.4 per million inhabitants (pmp). On average, there were seven donors per day and 15 transplants were performed.

About 2,196 people donated their organs after death, while 355 donated a kidney or part of their liver while they were alive. These data represent a 13% growth in transplants and 15% in donations compared to 2021. The rate of deceased donors in Spain per million inhabitants is 46.3; much higher than that achieved by other countries in the world, according to data from the Global Observatory of Donations and Transplants. The average rate in Europe is 19.5.

On the way to 50 donors per million inhabitants

Last year made it possible to resume the strategic lines of the ONT’s “50X22” Plan, which aims to reach 50 donors pmp and exceed 5,500 annual transplants, a goal that would have been reached in 2020 if it weren’t for covid-19 and which it hopes to reach in 2023, if the current line of growth continue.

Asystole donation, a decisive initiative for the expansion of transplantation, grew 38% compared to 2021. With a total of 913 donors, 42% of donors in Spain are asystole donors. In addition, this type of donation is no longer exclusively renal to become multiorgan, thanks to the generalization of an innovative preservation procedure based on cardiopulmonary bypass (ECMO) devices.

Spain is the only country in the world that transplants all types of organs from non-heartbeat donors

Thus, in 2022, 1,300 kidney, 375 liver, 152 lung, 37 heart and 20 pancreas transplants were performed with organs from asystolic donors. Added to these was the world milestone of the first intestinal transplant in asystole carried out by Hospital La Paz in Madrid which, after the good results obtained, carried out a second intestinal transplant with the same characteristics. Spain is the only country in the world that transplants all types of organs from non-heartbeat donors.

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Donors who died from traffic accidents remain very low, at just 4.3%. The leading cause of donor death is stroke. Regarding age, more than half of the donors (57.3%) are over 60 years old, 28% are 70 and 5% are 80. The longest donor registered in 2022 was 90 years old.

180 patients received organs from 84 PCR-positive donors at the time of transplantation

Another necessary adaptation has been living with covid-19, including transplanting organs from donors with positive PCR for SARS-CoV-2, after individualized evaluation and adequate selection of recipients. Until December 31, 2022, there were 180 transplanted patients from 84 donors with this condition.

To the generosity of all donors, since 2021, is added that of people asking for help to die: 49 people were donors after dying in these circumstances and made transplants possible for 135 patients.

Solutions for urgent or difficult-to-transplant patients

Over the years, formulas were sought to prioritize patients in a very serious clinical situation and solutions for those with difficulties in receiving a transplant due to their characteristics. In this sense, the transplant of 253 patients with zero urgency and 188 children stands out in 2022. Likewise, 153 hyperimmunized kidney patients (for whom it is very difficult to find a compatible donor) were transplanted, thanks to the PATHI program of the ONT, which, with this number, reaches its historical record.

Despite last year’s growth and high transplant activity in Spain, a significant number of patients remain on the waiting list. As of December 31, 2022, the waiting list is 4,746 patients. Of them, 66 were children. This number of patients on the waiting list is similar to that recorded in 2021 (4,762 patients).

National Marrow Plan

As of January 1, 2023, Spain has 474,455 bone marrow donors available in the Spanish Registry of Bone Marrow Donors (REDMO). Of these, 21,903 are donors who joined in 2022. The ONT and the Autonomous Communities, together with the Josep Carreras Foundation, Scientific Societies and Patient Associations, are working to reach 500,000 registered donors.

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