2023-06-06 15:10:00
Organ, tissue and cell transplantation offers thousands of second chances each year. And the good news is that it is a practice that is increasing Worldwide. According to latest data of the Global Donation and Transplant Observatory, in 2021 a 11,3% more transplants than in 2020. Something that, after the drop in the figure during the pandemic, draws a hopeful panorama for global health.
Spain is a world leader in organ donation and transplantation, why?
The improvement in the development of this technique and the progressive cultural acceptability -which is still difficult in some more traditional societies- have improved the effectiveness of transplants. However, the demand continues to exceed the capacities of the national health systems. In Mexicofor example, the patient waiting list to receive an organ is at least double the number of functional units available. And in other countries, the lack of human resources and consolidated programs is also a barrier to the advancement of this practice.
It is not the case of spain, which leads -only surpassed by the United States- the field of transplants and donations. The data speak for themselves: in 2022, this country performed 5,385 procedures, which means 16.8% of the total number of transplants in the European Union, despite the fact that it represents 10.6% of the European population and 0.6% of the global population. That is why many governments are considering applying the model that has led Spain to the top of the list for almost 30 years.
What is the Spanish Model for Transplantation and Organ Donation?
One of the lines of activity in which Spain stands out is in the asystole donation, which is obtained from people who have already died. In this sense, the legislation Spanish considers the default procedure valid; that is to say, if the individual does not express his desire not to be a donor during life -which also happens in other countries such as Argentina or Brazil. So, in 2022 in Spain there were 47.02 deceased donors per million inhabitantswhile the European average stood at 19.25.
He public health system in Spain, which allows any patient to make use of this sophisticated health service, has been essential for the development of a qualified program in the field of transplants. In addition, since the creation of the National Transplant Organization (ONT) in 1989, Spain has built networks specialized in the coordination of transplantswhich are distributed in three levels of health administration: national, regional and hospital.
In 2021, in Spain there were 46.3 deceased donors per million inhabitants. The average in the EU was 19.5.
The teams are made up of medical staff and nursing staff, with a number of members that varies depending on the size of the hospital. However, the partial dedication of doctors makes it possible for even the smallest medical centers -with limited potential for donation- to have at least one member of the coordination staff available.
In view of these factors, the European Union, the Council of Europe and the WHO have recommended that other countries apply, totally or partially, the guidelines of the Spanish Model. And some of them are already getting similar results.
Is it possible to apply the Spanish Model in other countries?
Transferring the Spanish Model of donations and transplants to other countries is not as easy as it seems. To achieve this, it is necessary for the country to an analysis of their economic, health and cultural situationand assess whether the basic conditions proposed by the ONT are met:
- A sufficient investment in health: The percentage of GDP that the country allocates to health, or the appropriate balance between public and private service, is decisive when applying the Spanish Model.
- A universal health system: To fully transfer this program, universal coverage is required. Doing it in a health system with a high percentage of private coverage is possible, but it can be problematic.
- A significant number of doctors available: evaluating the rate of medical personnel per thousand inhabitants is essential to consider the effectiveness of the program. In Spain, the relationship between population and number of doctors is relatively high, making it easier to build and maintain transplant coordination networks.
- A large number of nursing staff available: In this case, the figure is not valued based on the inhabitants, but on the number of ICU beds; an index that translates into adequate attention from potential donors.
- A high number of ICU beds: the fundamental factor for organ donation is the availability of mechanical ventilation. For this reason, it is important to measure the relationship between ICU beds and acute care beds.
- An analysis of the demographic pyramid: Observing the percentage of the population over 60 years of age and taking into account the causes of death of the population is key to building a transplant and donation program adapted to the characteristics of the demographics.
With this, the countries that have replicated the model They have managed to reach high positions in the ranking. An example of this is Francewhich implemented the Spanish Model in 2017, and was not far behind in 2022, with the successful figure of 5,503 organ transplants.
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