Spain tops the table for organ donationBMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7269.1098/b (Published 04 November 2000) Cite this as: BMJ 2000;321:1098
New figures published this week by the Council of Europe show that Spain is the most successful country in Europe at obtaining cadaveric organs for transplantation.
It managed to obtain 33.6 organs per million of population in 1999, compared with only 13 per million in the United Kingdom and Germany and 16 per million in France. Its rate is almost 40 times higher than the country with the lowest rate, Turkey (0.9), and is well ahead of its closest rival Austria (26).
The BMA, which in June launched a campaign to increase the number of organs available for donation, attributes Spain's success to the setting up of its national transplantation organisation in 1989. “This led to the establishment of a nationwide transplantation co-ordination system, with regional co-ordinators in each of the 17 regions and a co-ordinator at every hospital,” said the BMA's report, Organ Donation in the 21st Century.
A variation of the Spanish system was adopted in South Australia in the 1990s, increasing the rate of donors to 19.6 per million population by 1999, compared with a national average of 8.6.
The Royal College of Surgeons recommended the establishment of a national transplant service for the United Kingdom in January 1999 to ensure that organ donation was viewed as a national rather than a local service. Its proposal was supported by the BMA but was dismissed by the Department of Health in its review of the UK Transplant Support Service Authority this year.
Meanwhile, a survey published last week shows that a majority (57%) of people in the United Kingdom are in favour of a system of presumed consent, whereby it is assumed that every patient wished to be a donor unless he or she had registered an objection on a national computer database.
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