Intended for healthcare professionals


Spain's high rate of organ donation may hinge on local use

BMJ 2006; 332 doi: (Published 25 May 2006) Cite this as: BMJ 2006;332:1274
  1. Graham Brack, community pharmacist (graham.meagher{at}
  1. 10 Frances Street, Truro TR1 3DN

    EDITOR—Barber et al draw attention to the high refusal rates in the UK as a major reason for poor transplantation rates in the UK, and contrasts these with the Spanish rate for 2004 of 33.0 per million population (comparable figure for 2005 is 35.1/1000 000).1 A similar comparison for the refusal rate may be helpful. The UK transplant team's figure of 41% refusals must be contrasted with an average for Spain of 16.8%, with regional data varying from 9.6% to 30.5%.2

    Historically transplantation rates in Spain have been high in areas with a strong regional identity and lower in central rural Spain, although these differences are declining. Anecdotally, one reason for Spain's low refusal rate may be a public belief that organs will be used locally and will therefore benefit people “like the donor.” One wonders whether the perception in Britain is that organs may be used at a distance as a result of central coordination, whereas the Spanish system ripples the offer of organs in a cascade.

    By contrast, the suggestion that UK coordinators are not as active as their Spanish equivalents in asking relatives for permission to use organs now seems unfounded.


    • Competing interests None declared.


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