Spain's system for procuring organs operates in hospitals

EDITOR—In his review of renal transplantation Andrews emphasises Spain's excellent results in the procurement of cadaveric organs for transplantation.1 The transplantation organisational system there operates in hospitals, unlike the systems of other countries, which operate outside hospitals.2 We disagree with Andrews that this organisational system involves a heavy investment, and we even doubt whether it costs more than the British or German systems, to which he refers and whose cadaveric donor rates are 2.5 times lower.

The organisation and professionalism of organ procurement in hospitals has allowed Spain to increase its cadaveric donation rate progressively each year over the past 13 years,2 even despite the large reduction in deaths from traffic crashes that has occurred throughout the European Union. The increase in cadaveric kidneys for transplantation has …