It seems impossible to surpass the figures each year, but once again, the Spanish people are the most generous in the world, and in 2024, 6,464 transplants were performed in our country, reaffirming Spain's global leadership in organ donation and transplantation for 33 years, according to the activity report from the National Transplant Organization (ONT) presented today by Health Minister Mónica García and ONT Director Beatriz Domínguez-Gil.
"It is another year of historic donation and transplant figures, we have broken our records, we are unbeatable in solidarity," said García, adding: "You may think it's not news because we repeat it year after year, but it still is. The solidarity of the citizens of our country and their families continues to be surprising even if it is repeated."
García recalled that the previous year had already been a record with 5,863 transplants. "They asked us what the limit was. Well, we have broken the record by 10% more than the previous year. It is a figure that moves us and makes us proud as a country and as a healthcare system."
In 2024, all possible records were broken: 6,464 organ transplants were performed, representing a rate of 132.8 per million population (p.m.p.), the highest transplant activity recorded to date in Spain, increasing by 10% compared to 2023. "These rates have exceeded the goals we had set in our national strategy," emphasized Domínguez-Gil.
This was made possible thanks to 2,562 people who donated their organs after passing away (compared to 2,346 people in 2023), resulting in a donor rate of 52.6 p.m.p., a record figure in Spain never seen in any other country (9% more than in 2023), far exceeding the ONT's goal of 50 donors p.m.p., which was slightly delayed by the COVID pandemic.
Indeed, the country that comes closest is the USA with 48.1 donors p.m.p., although the donor profile is completely different from that of Spain, with younger individuals who die from preventable causes such as accidents, firearms, or drugs like fentanyl. Italy stands at 29.4; France, 27.6; Sweden, 25.2; the UK, 22.4; Germany, 11.6; and the European Union as a whole at 22.9 donors p.m.p.
404 individuals donated a kidney (397) or part of their liver (7) while alive. The average daily donors last year were eight, and the average daily transplants performed were 17, another record (compared to 16 in 2023 and 15 in 2022). Since data has been recorded, a total of 146,000 transplants have been performed in Spain.
"Every January, we take stock, which is a way to be accountable to society for managing something of enormous value, a therapy that not only depends on the technical ability to perform transplants but also on the contribution of our society," stated Domínguez-Gil, who then reviewed the evolution of donors since the creation of the ONT in 1989.
Circulatory death, over half of donations
The ONT's general director explained that growth was achieved through donors after circulatory death (when a cardiac arrest occurs and blood stops flowing to the organs, thus racing against time). "No country reaches the number of donors after circulatory death that we do, and furthermore, we are the only country that transplants all types of organs with this type of donor, even though this type of donation is carried out in 25 countries. Hearts that stop beating and we manage to make them beat again in another patient, face transplants from circulatory death donors that no other country in the world has achieved...".
In this regard, Domínguez-Gil also mentioned the organ preservation procedure based on extracorporeal circulation devices (ECMO), also of Spanish origin for several decades.
In total, 1,316 donors after circulatory death (25% more than in 2023), representing over half of the donors in Spain. The ONT director also emphasized that half of the cardiac transplants from circulatory death donors were performed last year, consolidating this program. In 2024, 1,866 kidney transplants, 579 liver transplants, 272 lung transplants, 101 heart transplants, 24 pancreas transplants, and one face transplant from circulatory death donors were carried out.
The profile of potential organ donors in Spain is similar to previous years. They are typically older individuals with significant associated comorbidities. Deceased donors from traffic accidents accounted for only 5% of the total. The main cause of donor death was stroke (52%). Regarding age, nearly 60% of donors were over 60 years old, 31% were over 70, and 5% were over 80. The oldest donor registered in 2024 was 88 years old.
These individuals are joined by those who request euthanasia and decide to donate their organs. 63 individuals last year and 154 since the law came into effect, enabling 442 transplants. "This also requires significant training for professionals who typically speak with relatives of deceased individuals and now have to speak with people who have made this decision and will donate their organs."
Twelve regions have exceeded 50 donors p.m.p., with four of them surpassing 60. Cantabria has once again topped the ranking with 94 donors p.m.p., followed by Navarra (76.1), Murcia (69.4), and Extremadura (63.8). Among regions with populations over 5 million, the activity in Andalusia (57.5) and the Valencian Community (57.4) stands out. The regions that experienced the most growth in donation were Cantabria (+30%), Castilla y León (+26%), and Galicia (+26%).
1,428 transplants were performed thanks to organ exchanges between regions, accounting for 23% of the total. Additionally, 7% of recipients were transplanted in a center outside their residential community.
Domínguez-Gil highlighted that the Spanish donation and transplant model is an international benchmark for its excellence and mentioned that in September, the journal The Lancet dedicated an editorial to the Spanish transplant system. "When a system is well-designed and structured, society responds with solidarity." She also noted that 308 patients were transplanted with zero urgency and 197 children. Furthermore, 140 highly sensitized kidney patients were transplanted (for whom finding a compatible donor is very challenging) thanks to the ONT's PATHI program.
Another goal surpassed in 2024 was reaching 500,000 individuals registered in the Spanish Bone Marrow Donor Registry (Redmo) as outlined in the National Plan. In 2024, 30,010 donors were added, reaching a total of 505,505 bone marrow donors.
Three transplant recipients who shared their experiences were present at the presentation. Natalia, 19, was transplanted at 22 months (her mother donated part of her liver). She is pleased with the increased time between appointments and believes that with more promotion, people would be encouraged to donate more.
In Carlos's case, his mother donated a kidney to him, but his body rejected it, and thanks to the PATHI program, he got a new organ. "During dialysis, I had 14 interventions. The worst part was peritoneal dialysis, where I spent 10 hours at home connected to a machine without being able to go out or travel, and now I can do all those things." He has thanked 80% of donors: "A selfless gesture changes the lives of patients on the waiting list."
Martina was diagnosed with dilated cardiomyopathy a year and a half ago, and three months ago, she had a heart transplant. She is happy because she has not been to the emergency room for two months - "every time I went, I didn't know if I would come out of there and said goodbye to my siblings. I know I have to go back because I am immunocompromised, but I will go less often." She says that as a result of her experience, her friends now donate blood and are looking into organ donation.