Organ donation process: quinquennial analysis in a Spanish autonomous region

At present, transplantation of organs represents a therapeutic alternative, but the candidates for this treatment suffer from the scarcity of donors. We analyzed the process of the donation of organs in Galicia, an autonomous region in the northwest of Spain.

We summed all the potential donors in Galicia between January 1996 and December 2000 to analyze the reasons for nonconversion, the characteristics of the actual donors, and the use of the generated organs.

We found 779 potential donors of whom 443 (56%) became actual donors (annual rate 31.6 pmp), although an important interterritorial variability was observed. The main reason for not obtaining potential donors was family refusal (32%), with denial during life being given as the reason in 45% of these families. We observed a progressive aging of the donors (39% older than 60 years in 2000), who had a mean age of 46 +/- 18 years. There also was an increased percentage of deaths due to vascular causes (mean 53%), while traumatic deaths (mean 40%) showed an inverse tendency. Donation because of asystole represented 5%. Among all the retrievals, 90% were multiorgan, generating 1437 organs including 1227 that were transplanted, yielding 3.3 possible organs from each donor including 2.8 organs that were transplanted. Among donors younger than 45 years, the numbers increased to 3.7 and 3.4, respectively, and for donors older than 60 years, the numbers were 2.7 and 1.9, respectively.

Despite the increase in donors and organs, family refusal did not decrease, as this was the main reason for potential donor loss. Therefore it is necessary to create a regional program to promote donation.