For the 18th year in a row, Spain leads the world in the number of deceased organ donors per million people -- 34.3. This is a commonly used benchmark of the effectiveness of a donor system and other countries lag far behind. The average for the European Union is 18.1 and in the US it is 26.3. In the UK, the figure is 14.7 and in Australia 12.1 donors per million. The Spanish are particularly proud of their record, which was achieved despite a steady decrease in the number of traffic deaths, a major source of organs. What is the secret of the Spanish system? Dedication and teamwork.In 1989 the government set up a national network of transplant coordinators. They work in all hospitals and closely monitor emergency wards to be aware of potential donors. When they learn of a death, they tactfully try to persuade relatives to allow the person's organs to be harvested. Only about 15% of families refuse consent nowadays, a huge drop from 40% before the system was set up.
The number of organ donors and transplantations fell last year in Spain, the country that leads the ranking in both and whose transplantations model was recently adopted by the EU. The decline—which signals a break in the increase seen in recent years—was caused largely by a sharp reduction in deaths from traffic incidents. Improved management of cerebral infarctions and a small increase in the refusal rate to donate organs among families whose relative has died have also contributed to the fall. The reluctance to donate is particularly widespread among the immigrant population. The number of organ donors in Spain dropped from 34.4 per million inhabitants in 2009 to 32 million in 2010, while the total number of registered donors fell from 1606 in 2009 and 1502 in 2010, reports the Spanish National Transplant Organisation. This reduction is the largest seen in the past 20 years.