MADRID – Last year was ‘the year of recovery in the field of donation and transplants in Spain’. In 2020, Covid-19 put an end to the continuous records that Spain was able to register year after year in this area.
In 2021, Spain performed 4,781 transplants. That was 8% more than in 2020 (4,425). The increase occurred despite the difficulties caused by the pandemic. This is apparent from the activity balance of the National Transplantation Organization (ONT).
World leadership transplants
After that stalemate, 2021 was the year of reconstruction and adaptation to the complex health situation the country finds itself in. Health Minister Darias said that the positive trend is recovering in an activity in which Spain remains a benchmark for its global leadership.
Donors with covid-19
In 2021, the transplantation of organs from donors who have endured Covid-19 was allowed. Also of those who had a positive PCR at death. So far, 143 patients have undergone a transplant from 61 donors who died with covid-19 and 14 recipients from 6 donors who still had a positive covid test at the time of donation.
“Based on the available scientific literature, we concluded that it did not pose a significant risk to the recipients,” explains ONT Director Beatriz Domínguez-Gil.
The transplants
Of the 4,781 transplants performed in Spain in 2021, 4,457 were due to 1,905 people who died. In addition, 324 people donated a kidney (323) or part of their liver (1) during their lives, which is an increase of 7 percent compared to 2020.
The country still finds itself in a health crisis. Despite this, the donation rate in Spain is much higher than in other countries in pre-pandemic times. In Spain, this is a doubling of the average donation percentage in the European Union (18 per million people). Moreover, almost a fourfold increase in the percentage in Germany (10.92 pmp). Spain also far outperforms other highly developed countries such as Australia (18.2), Canada (19.5), the United States (38), France (23.2), Italy (21.5), and the United Kingdom (18.4).
Type of transplants
By type of transplant, 2,950 kidney transplants were performed in 2021 (9% more than in 2020), 1,078 liver transplants (+4%), 362 lung transplants (+8%), 302 heart transplants (+9%), 82 pancreas transplants, and seven multi-intestinal transplants, five of which are in children.
Kidney Transplants in Living Donors
Living donor kidney transplant activity increased by 25% in 2021 compared to the previous year. It concerned 323 procedures performed. This means that Spain has returned to levels “very similar to 2019, before the pandemic” in this regard.
Cantabria tops the list
Domínguez-Gil emphasised the good figures of several autonomous communities in the north, such as Cantabria (42 organ donations), which received more than 70 donors p.m.p. is. (65.5 last year) and again leads the ranking. He also called the transplant activity in the Valencian Community and Murcia “very remarkable”. Precisely in Murcia, the hospital Virgen de la Arixaca saw the highest absolute number of donors. The university hospital La Fe in Valencia is notable for the total number of transplant patients.
The General University Hospital of Castellón tops the list of donors as a non-transplant hospital. The Central University Hospital of Asturias is the leading hospital in the number of donors in brain death.
The health center that has performed the most kidney transplants is the Bellvitge University Hospital. The ‘price’ for most living donor kidney transplants is shared by the same hospital and the Hospital Clinic in Barcelona.
Read also: First child kidney transplant in Spain from different blood group donor
In liver patients, it leads the University Hospital La Fe in Valencia, in heart patients the University Hospital Gregorio Marañón in Madrid, in lung cases the University Hospital Vall d’Hebrón, in pancreatic cases the hospital clinic and children the La Paz University Hospital in Madrid.
Cooperation between autonomous regions
Domínguez-Gil emphasized the importance of interregional cooperation for Spain’s success. Up to 24.8% of transplants are performed with organs donated by other autonomous communities. Specifically, the ONT estimates 1,152 transplants performed thanks to the exchange of organs between autonomous communities. On the other hand, 7.1% of the recipients were transplanted in a center outside the autonomous region where they live.
Eleven Autonomous Communities had more than 40 donors p.m.p. and six over 50 don makers p.m.p. After Cantabria comes Navarre (62.1, with 41 donations), Murcia (52.3, 79 donations), Asturias (51.5, with 52 donations), the Basque Country (50.7, 112 donations), and the Valencian Community ( 50.3, 254 donations)
Andalusia stands at 39.6, with 335 donations; Aragon 29.5 (39 donations); Balearic Islands 46.2 (54 donations); Canary Islands 44.7 (97 donations); Castilla-La Mancha 31.4 (64 donations); Castilla y Leon 41.2 (98 donations); Catalonia 37.1 (288 donations); Extremadura 45.7 (48 donations); Galicia 41.6 (112 donations); La Rioja 22.6 (7 donations); and Madrid 27.1 (183 donations).
Extraordinary numbers
“It is very relevant to highlight these extraordinary figures, as the peaks of the pandemic have created enormous difficulties for the development of donation processes. Every region of Spain far exceeds the donation rates of any country in the European Union,” the health ministry said in a statement.
Causes of Death of Donors
The number of donors who died as a result of traffic accidents remains very low at 4.7%. The leading cause of death for donors is stroke. In terms of donor age, more than half (53.7%) are over 60 years old. 27.5% are 70 and 3.8% are 80, a lower percentage than in previous years. This is “probably because of the need to be more selective at critical moments of the pandemic.” The oldest donor in 2021 was 91 years old and allowed a liver transplant.
Still a significant number of patients on the waiting list
Domínguez-Gil also explained that despite last year’s strong growth, there are still a significant number of patients on the waiting list. As of December 31, 2021, the waiting list stood at 4,762 patients. Among them, there are 66 children.
The number of patients on the waiting list is comparable to that in 2020 (4,794 patients), although there is a striking decrease in the children’s list, which stood at 92 cases that year. This improvement follows from the measures taken to facilitate access to pediatric transplantation, according to the director of the ONT.
