The 40 donors per million population plan: an action plan for improvement of organ donation and transplantation in Spain.
BACKGROUND
Spain has been showing the highest rate of deceased donor organ recovery in the world for a whole country, namely, 33-35 donors per million population (pmp) during the last years. This activity is attributed to the so-called Spanish Model of organ donation, an integrated approach to improve organ donation since the start of the Organización Nacional de Trasplantes (ONT) in 1989. However, in 2007 there were 7/17 regions with >40 donors pmp and a marked regional variability. Thus, ONT has set a large-scale, comprehensive strategy to achieve a substantial improvement in donation and transplantation in Spain in the coming years: The 40 Donors pmp Plan.


OBJECTIVE
The overall objective is to increase the average rate of deceased donors to 40 pmp between 2008 and 2010. The areas of improvement, specific objectives, and actions have come from deep reflection on the data and the material generated from multidisciplinary discussions and open consultation with the donation and transplantation community.
Detection and management of brain-dead donors, with 4 specific subareas: access to intensive care units, new forms of hospital management, foreigners and ethnic minorities, and evaluation/maintenance of thoracic organ donors. Expanded criteria donors, with 3 subareas: aging, donors with positive tests to certain viral serologies, and donors with rare diseases. Special surgical techniques. Donation after cardiac death.
Matesanz
R
R
Organización Nacional de Trasplantes, Sinesio Delgado 4., 29029 Madrid, Spain. rmatesanz@msps.es
Marazuela
R
R
Domínguez-Gil
B
B
Coll
E
E
Mahillo
B
B
de la Rosa
G
G
D001926:Brain Death; D002102:Cadaver; D002423:Cause of Death; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D006801:Humans; D011156:Population Density; D012955:Societies, Medical / Q000458:organization & administration; D013030:Spain; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data* / Q000639:trends; D014180:Transplantation / Q000706:statistics & numerical data; D014850:Waiting Lists