Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.
Department of Medicine, Dalhousie University, Halifax, NS, Canada.
Transpl Int. 2023 May 25;36:11009. doi: 10.3389/ti.2023.11009. eCollection 2023.
The organ donation and transplantation program in Spain has long been considered the gold standard worldwide. An in-depth understanding of the Spanish program may promote the development and reform of transplant programs in other countries. Here, we present a narrative literature review of the Spanish organ donation and transplantation program supplemented by expert feedback and presented according to a conceptual framework of best practices in the field. Core features of the Spanish program include its three-tiered governing structure, close and collaborative relationships with the media, dedicated professional roles, a comprehensive reimbursement strategy, and intensive tailored training programs for all personnel. Several more sophisticated measures have also been implemented, including those focused on advanced donation after circulatory death (DCD) and expanded criteria for organ donation. The overall program is driven by a culture of research, innovation, and continuous commitment and complemented by successful strategies in prevention of end-stage liver and renal disease. Countries seeking ways to reform their current transplant systems might adopt core features and may ultimately aspire to include the aforementioned sophisticated measures. Countries intent on reforming their transplant system should also introduce programs that support living donation, an area of the Spanish program with potential for further improvement.
西班牙的器官捐赠和移植项目长期以来一直被视为全球的典范。深入了解西班牙的项目可能会促进其他国家移植项目的发展和改革。在这里，我们根据该领域最佳实践的概念框架，对西班牙的器官捐赠和移植项目进行了叙述性文献综述，并附有专家反馈。该项目的核心特点包括其三级治理结构、与媒体的密切合作关系、专门的专业角色、全面的报销策略以及针对所有人员的强化定制培训计划。还实施了一些更复杂的措施，包括专注于循环死亡后高级捐赠 (DCD) 和扩大器官捐赠标准的措施。该整体项目由研究、创新和持续承诺的文化推动，并辅以预防终末期肝和肾病的成功策略。寻求改革当前移植系统的国家可能会采用核心特征，并最终可能希望包括上述复杂措施。有意改革其移植系统的国家还应引入支持活体捐赠的项目，这是西班牙项目中具有进一步改进潜力的领域。
