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EDITOR,--The success of organ transplantation in terms of survival, quality of life, and the ratio of costs to benefits has been such that ever greater numbers of patients are being referred to transplant teams. The shortage of organs remains the main obstacle to the full development of these procedures. In 1992 we reported the initial results of several integrated actions accomplished since the creation of the Spanish National Organisation of Transplants1 and proposed that this approach could be used to alleviate the lack of organ donors.
Three years later things do not seem to have got better. The number of organ donors per million population has remained stable in the United States (around 17-19 donors per million)2 and western Europe (14.7 donors per million in 1993). Furthermore, preliminary data from several European countries for 1994 showed a dramatic decrease in the
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