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Spain leads the way -

On January 17, 2024, Spanish anesthesiologist and politician Mónica García (left), together with the director general of the National Transplant Organization, Beatriz Domínguez-Gil, presented the balance of donation and transplantation activity in Madrid, Spain. It was announced that Spain had reached 5,861 organ transplants in 2023, representing a rate of 122.1 transplants per million population from both living and deceased donors.

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Record numbers -

This high level of activity was achieved thanks to the 2,346 people who donated their organs after death, explained García. This translates as 48.9 deceased donors per million population.

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Organ donation success -

Spain has been the acknowledged leader in donations for a number of years. But more countries are hoping to emulate Spain's organ donation success.

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What is organ donation? -

Organ donation is when you decide to give an organ to save or transform the life of someone else.

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Organ donor criteria -

You can donate at any age. The health of your organs is more important than your birth date. However, living organ donors must be at least 18 years old. Anyone younger than age 18 needs to have the consent of a parent or guardian.

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Laws governing organ donation -

Most organ and tissue donations come from people who have died. The laws of different countries allow potential donors to permit or refuse donation, or give this choice to relatives.

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Common transplantations -

Common transplantations include kidneys, heart, liver, pancreas, and intestines.

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Other organs that can be transplanted -

Lungs, bones, bone marrow, blood vessels, cardiac valves, skin, hands, and corneas can also be transplanted.

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How to register -

Those wishing to donate their organs can do so by registering their decision. This is usually done online via a national healthcare website, for example the National Health Service in the UK. Assuming all medical criteria has been met, the donor is then issued with an organ donor card.

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Organ donation in Europe -

Within the European Union, organ donation is regulated by member states. After Spain, Portugal ranks second across the continent, with an organ donation rate of 31.5 deceased donors per million population, according to data published by Statista.

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United States organ donor rates -

In the United States, Donate Life America manages the National Donate Life Registry. The United States' organ donation rate is 44.5 deceased donors per million population, placing it second in world rankings.

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Organ procurement organizations -

Each state has its own organ procurement organization (OPO)—not-for-profit organizations responsible for recovering organs from deceased donors for transplantation. Mandated by federal law, OPOs fall under the United Network for Organ Sharing umbrella. Pictured is the OneLegacy facility in Azusa, California. Staffers are lining the hallway to the operating room to honor a soon-to-be organ donor.

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France and Sweden -

France ranks third overall, with 25.8 deceased donors per million population, with Sweden taking fourth place, averaging 20.9 deceased donors per million population.

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United Kingdom -

The number of individuals on the NHS organ donor register in the United Kingdom currently stands at around 28.6 million. It ranks sixth, with 20.6 deceased donors per million population.

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Switzerland, Australia, and Poland -

In seventh place is Switzerland, with 18.6 deceased donors per million population. Next is Australia, with 17.4. In ninth place is Poland, with 11.8 deceased donors per million population.

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Germany -

Germany ranks 10th, with the rate of deceased organ donors numbering 10.4 per million population.

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OptInk initiative -

In Germany, 84% of people support organ donation, yet just 0.001% actually become organ donors, according to TrendWatching. To address this disparity, potential donors can opt for a free tattoo that signifies their intent to have their organs and tissues donated after death. Recently introduced and created by OptInk the tattoo, which forms the letters "O" and "D" for "organ donor," serves as a reminder of the bearer's wishes to donate. While it doesn't hold any legal recognition, it's hoped the tattoo might foster a more open dialogue with family members and boost organ donor rates across the nation.

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First transplants -

It was in the early 1950s that the first successful kidney transplants were carried out.

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Progress in the 1960s and 1970s -

By the late 1960s, liver, heart, and pancreas transplants had been successfully performed.

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Breakthrough in lung transplantation -

Lung and intestinal organ transplant procedures came later, beginning in the 1980s.

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Human tissue for transplant -

Meanwhile, experiments with tissue transplants were recorded as early as the 1920s.

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The first full face transplant -

In 2005, the first full face transplant was carried out, performed on a French woman who'd been mauled by a dog.

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Medical challenge -

One of the great challenges facing transplant surgeons is the specific timeframe in which an organ must be transplanted after it has been recovered. Thoracic organs, for example the heart and lungs, can only remain viable for transplant after being outside the body for four to six hours. Other organs can survive longer. The liver can function for up to 12 hours, while kidneys can last up to 36 hours. Packing donor organs in ice while in transit (pictured) helps, but it's a race against the clock.

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Mimicking human physiology -

Fortunately, technology has been deployed to extend the life of organs while outside the body. One example is the TransMedics Organ Care System, a fully portable, multi-organ, normothermic preservation and assessment technology that mirrors human physiology. This machine allows donor organs to be maintained for longer periods of time prior to transplant because they are connected to a device that mimics blood flow and/or heartbeat.

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Pioneers of the organ transplant program -

There are several noted individuals whose work in the field of organ transplantation deserves mention.

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Emil Theodor Kocher (1841–1917) -

Swiss physician and medical researcher Emil Theodor Kocher is credited with performing the first transplant in the modern sense, a thyroid tissue implant in 1883. Kocher received the 1909 Nobel Prize in Physiology or Medicine and is recognized as a pioneer of organ transplantation.

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Eduard Zirm (1863–1944) -

Eduard Zirm (1863–1944) was an Austrian ophthalmologist who on December 7, 1905, performed the first successful human full-thickness corneal transplant.

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Alexis Carrel (1873–1944) -

French surgeon and biologist Alexis Carrel was awarded the Nobel Prize in Physiology or Medicine in 1912 for pioneering vascular suturing techniques. Together with Charles Lindbergh, better known for his exploits in aviation, Carrel invented the profusion pump, opening the way to organ transplantation.

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Richard H. Lawler (1895–1982) -

On June 17, 1950, American surgeon Richard H. Lawler led the team that carried out the very first kidney transplant. However, the transplanted organ only functioned for a few months.

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Joseph Murray (1919–2012) -

A little over four years later, American plastic surgeon Joseph Murray performed the first successful human kidney transplant on identical twins on December 23, 1954. Pictured is Richard Herrick being wheeled out by his twin brother Ronald as he leaves the Peter Bent Brigham Hospital in Boston after acquiring fame as the "kidney twin." Ronald had donated a kidney to Richard who was suffering from nephritis. Richard died on March 14, 1963, aged 31. Ronald passed away on December 29, 2010, aged 79.

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Christiaan Barnard (1922–2001) -

South African cardiac surgeon Christiaan Barnard garnered worldwide fame after performing the world's first human-to-human heart transplant operation, on December 3, 1967.

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Thomas Starzl (1926–2017) -

Also in 1967, American physician and researcher Thomas Starzl performed the first human liver transplants. Starzl has often been referred to as "the father of modern transplantation."

Sources: (ONT) (NHS) (United Network for Organ Sharing) (TrendWatching) (TransMedics) (Sage Journals) (NIH) (Statista) 

See also: Body parts you can live without

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