ORGAN PROCUREMENT IN SPAIN - IMPACT OF TRANSPLANT COORDINATION

Organ transplantation is a well-established treatment for irreversible renal, liver, cardiac, and respiratory failure. However, there is a s hortage of organs that remains a serious obstacle to the full developm ent of these therapeutic procedures. Some solutions such as presumed c onsent laws, the use of organs from living unrelated donors, compensat ion or payment for organs or xenografting have been proposed. In Spain during the last 3 years a well-designed program of transplant organiz ation including a network of well-trained transplant coordinators has been established. In each potential donor hospital there is a transpla nt coordination team that is responsible for the whole process of orga n procurement, from the detection of the donor to the organ grafting o r tissue banking. Annual rate of cadaveric donors rose from 14.3 per m illion population (pmp) in 1989 to 21.7 donors pmp in 1992. Organ retr ieval rate increased by 81% during the same period. Renal, liver and c ardiac transplants increased by 44%, 175% and 162% respectively. We co nclude that this particular approach to the problem has been successfu l in Spain, overcoming obstacles such as untrained or undertrained req uesting staff, unidentified donors, and reluctance to approach grievin g families. This kind of approach should be considered initially befor e resorting to more controversial approaches to the problem of the org an donor shortage.