UPDATED: Spain leads the world in organ donation. What’s stopping other countries catching up?

PDATE: On 5 August 2018, the government announced plans to change the law on consent for organ donation in England. The new ‘opt-out’ system is expected to come into effect in 2020. The legislation, known as Max’s Law, will mean that people will be presumed to consent to donating their organs unless they register their decision to opt-out on the NHS organ donation register.

Five years ago, Sergio Cobos was just trying to stay alive. He had battled with kidney disease for years, and things were getting worse. His legs would fill with fluid and he was plagued by cramps. A previously athletic man of 36, he should have been in sound physical shape. But now he struggled to get up the stairs.

Then everything changed – he had a kidney transplant. Today, as he strolls out of a botanical glasshouse in a park by La Chopera, on the Manzanares river in Madrid, he seems healthy and relaxed, dressed in a bright tracksuit and trainers.

When Cobos’s doctor told him that his kidney disease had reached the point at which a transplant or ongoing dialysis was necessary, he asked his friends and family if any of them would offer him a kidney as a living donor. In all, 16 people said yes

“My mum was meant to be donating for me and she was the most compatible one,” he says through a translator, “but suddenly within [the donor] list there was someone who was even more compatible.” He had been on the waiting list for just 20 days.

All he knows about the person who saved his life is that she was a woman from Madrid who was ten years older than him and who died from a stroke. That a highly compatible deceased donor was available as well as so many willing living donors, including family members, is perhaps a reflection of something that makes Spain a very special country indeed: it leads the world in organ donation. And by quite a margin.

Reference:

• Earlier this year, Spain’s National Transplant Organisation (ONT) released new organ donation figures. [In Spanish]
• The ONT published this paper in 2017 summarising how it has helped Spain achieve a rate of 40 deceased organ donors per million population.
• Despite a focus on changing the law to opt-out in England, a similar scheme has so far failed to raise donations in Wales, according to these government statistics.
• The question of when death occurs is a long-running medical debate, as discussed in this 2012 paper on brain death.
• Public campaigns promoting organ donation in the UK often frame donation as a highly altruistic act, as this NHS ‘Be a hero’ poster suggests.