With more than 6,400 organ transplants in 2024, Spain has been crowned world leader for the thirty-third time and has exceeded all the objectives set by the National Transplant Organization (ONT). “We are unbeatable in solidarity,” said the Minister of Health, Mónica García, this Thursday in the presentation of the balance of activity, in which the general director of the ONT, Beatriz Domínguez-Gil, also participated.
In 2024, Spain has registered its highest transplant activity to date: it reached a rate of 52.6 deceased donors per million population (pmp), greatly exceeding the objective of 50 pmp established in the ONT’s “50X22” Strategic Plan . 2,562 people donated their organs (9% more than the previous year) and a total of 6,464 transplants were performed (10% more than in 2023).
Of these, 4,047 were kidney transplants, 1,344 liver, 623 lung, 347 heart, 98 pancreatic and 5 intestinal. Lung transplantation experienced the greatest growth, with a 30% increase compared to the previous year. These figures not only represent a historical record in the total number of transplants, but also set new highs in kidney, liver and lung activities.
These achievements are difficult to achieve for the rest of the countries in the world. The only one that has come close is the United States with 48.1 pmp donors, however, its donor profile is very different: young people. In Spain we have learned to successfully transplant organs from people with an advanced age profile, since nearly 60% of donors were over 60 years old.
The Minister of Health attributes the record to the solidarity of Spanish society and our National Public Health System, but also to innovation, as she assures that in 2024 the importance of non-asystole donation has been demonstrated again. This type of donation, which is made after death due to irreversible cardiac arrest is certified, represents more than 50% of donors in Spain, with a total of 1,316 (25% more than in 2023). Although it is carried out in 25 other countries around the world, Spain remains the only country that successfully transplants all types of organs from these donors.
This is due to the widespread use in Spanish hospitals of a complex organ preservation procedure based on extracorporeal circulation devices (ECMO). Due to its special difficulty, only eight countries in the world perform asystole heart transplants, but they already contribute to 29% of the total heart transplants in Spain.
New donor profiles
Since 2021, people who request aid in dying have been able to express their desire to be donors, which has allowed 154 people in this situation to donate their organs, making 442 transplants possible until December 2024.
The Director General of the ONT has highlighted the importance of the Cross Kidney Transplant Program, which combines people to form new couples who have no genetic or emotional relationship but who are compatible. Last year, 16 living kidney transplants were performed in the form of four cycles of two transplants, a cycle of three transplants and a chain of four transplants initiated by an altruistic donor: someone willing to undergo surgery with the aim of helping a strange.
Despite these advances, the number of patients on the waiting list has grown slightly. At the end of 2024, 5,096 people were waiting for a transplant, compared to the 4,794 registered in 2023. Patients in a situation of zero urgency and children continue to be a priority for the ONT and its coordination network, which allowed 308 critical patients and 197 minors received a donation last year.
Data by Autonomous Communities
The Spanish transplant system also reinforces territorial cohesion, with 23% of operations carried out thanks to the exchange of organs between Autonomous Communities. In addition, 7% of recipients were transplanted in centers outside their Community of residence.
Regarding regional figures, Cantabria led with 94.9 pmp donors, followed by Navarra, Murcia and Extremadura. These results reflect the key role of the National Health System, which, with innovation, equity and solidarity, continues to set the standard in donation and transplants worldwide.
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