Download - Newsletter Europe 2011
2011
NEWSLETTERTRANSPLANT
COUNCILOF EUROPE
CONSEILDE L’EUROPE
Vol
. 16
• N
º 1
• SE
PT
EM
BE
R •
201
1
INTERNATIONAL FIGURES ONDONATION AND TRANSPLANTATION - 2010
INTERNATIONAL FIGURES ON ORGAN, TISSUE & HEMATOPOIETICSTEM CELL DONATION & TRANSPLANTATION ACTIVITIES. DOCUMENTS PRODUCED BY THE COMMITTEE OF EXPERTS ON THE ORGANISATIONAL ASPECTS OF CO-OPERATION IN ORGAN TRANSPLANTATION (2010)
Editor: Rafael Matesanz
Foot Note- For the purposes of this Newsletter the following definitions were used:An actual donor (HBD and NHBD) is a deceased person from whom at least one organ has been recovered for the purpose of solid or-gan transplantation, in contrast to a utilised donor, who is an actual donor from whom at least one solid organ has been transplanted.The number of utilised donors is therefore lower than the number of actual donors.Multiorgan donor: An actual donor from whom at least two different types of organs have been recovered for the purpose of transplantation.One double-kidney transplant (TX) and one double-lung TX are counted as 1 TX.One heart/ lung TX is counted as 1 lung TX, 1 heart TX and 1 heart/ lung TX.Absolute number: Include all figures corresponding to all donors/patients adults and children. Paediatric: Includes only paediatric activity (patients aged < 15 years).Nº TX Centres: One centre can include adult and pediatric program for each organ - type transplant.
AULA MÉDICA EDICIONES. Isabel Colbrand, 10-12 - 2ª planta. 28050 Madrid (España)Tel. 91 358 64 78. Fax 91 358 99 79. Depósito legal: M-9.990-1996. ISSN: 2171-4118.
NATIONAL DATA PROVIDED BY:
Organización Nacional de Trasplantes (ONT) – SpainRafael MatesanzBeatriz MahilloMarina Alvarez
AUSTRIAJacqueline Smits (ET)BELGIUMJacqueline Smits (ET)BULGARIATeodora DzhalevaCYPRUSStalo GroutaGeorge KyriakidesCZECH REPUBLICPavel Brezovský DENMARKFrank Pedersen (SKT)ESTONIAPeeter DmitrievFINLANDFrank Pedersen (SKT)FRANCECristelle CantrelleGERMANYBrigitte OssadnikJosephine WadewitzJacqueline Smits (ET)GREECEEfi NikolaouHUNGARYMihály Sándor IRELANDMaeve RaesideITALYAndrea RicciPaola Di CiaccioLATVIASergey TrushkovLITHUANIAVita AnulytèLUXEMBURGGérard ScharllJacqueline Smits (ET)MALTACarmel AbelaNETHERLANDSJacqueline Smits (ET)POLANDPiotr MalanowskiPORTUGALMaria Joao AguiarCatarina BolotinhaROMANIADan LuscalovSLOVAKIALudovit LacaSLOVENIAJacqueline Smits (ET)SPAINCarmen MartínManuel SerranoDavid UruñuelaSilvia MartínSWEDENFrank Pedersen (SKT)
UNITED KINGDOM Mark JonesCalire Counter
(ET) EUROTRANSPLANT Austria,Belgium, Croatia, Germany,Luxemburg, Netherlands, Slovenia
(SKT) SCANDIATRANSPLANTDenmark, Finland, Norway, Sweden,Iceland
ALGERIAMaurizio Di Fresco (MTN) Farid HaddoumAUSTRALIALee ExcellCANADABob WilliamsLiz Anne Gillham-EisenCROATIAMirela Buši Jacqueline Smits (ET)GEORGIAGia TomadzeICELANDFrank Pedersen (SKT)ISRAELTamar AshkenaziLEBANONMaurizio Di Fresco (MTN) Marwan MasriAntoine EstephanMACEDONIAGoce SpasovskiMOLDOVAIgor CodreanuNEW ZEALANDLee ExcellNORWAYFrank Pedersen (SKT)PALESTINEMaurizio Di Fresco (MTN) Mohammed AyyoubSWITZERLANDDagmar VernetSYRIAMaurizio Di Fresco (MTN) Bassam SaeedTUNISIAMaurizio Di Fresco (MTN) Mohamed Salah Ben AmmarTaieb Ben AbdallahTURKEYTürKay SeyhanUSAwww.unos.org
(MTN) MEDITERRANEANTRANSPLANT NETWORKAlgeria, Cyprus, Egypt, France,Greece, Israel, Italy, Lebanon, Lybia,Morocco, Spain, Tunisia
ARGENTINACarlos SorattiMartín Alejandro TorresRicardo Rubén Ibarwww.grupopuntacana.orgBOLIVIAOlker Calla Rivadeneirawww.grupopuntacana.orgBRASILHeder Murari Borbawww.grupopuntacana.orgCHILEwww.grupopuntacana.orgCOLOMBIAJuan Gonzalo López Casaswww.grupopuntacana.orgCOSTA RICAClive Montalbert-Smithwww.grupopuntacana.orgCUBAwww.grupopuntacana.orgDOMINICANAFernando Morales Billiniwww.grupopuntacana.orgECUADORwww.grupopuntacana.orgEL SALVADORMauricio VenturaGUATEMALAHONDURASMEXICOEnrique Martínez GutiérrezOmar Sánchez Ramírezwww.grupopuntacana.orgNICARAGUATulio René Mendieta AlonsoPANAMACesar Cuero Zambranowww.grupopuntacana.orgPARAGUAYwww.grupopuntacana.orgPERUwww.grupopuntacana.orgURUGUAYInés AlvarezRaul José Mizrajiwww.grupopuntacana.orgVENEZUELACarmen Luisa Lattuf de MilanésZoraida Pacheco Graterolwww.grupopuntacana.org
GRUPO PUNTA CANAArgentina, Bolivia, Brasil, Chile,Colombia, Costa Rica, Cuba,Dominicana, Ecuador, El Salvador,España, Guatemala, Honduras,México, Nicaragua, Panamá,Paraguay, Perú, Portugal, PuertoRico, Uruguay y Venezuelawww.grupopuntacana.org
NEWSLETTERTRANSPLANT 2011
CONTENTS• International Figures on Organ Donation and Transplantation Activity.
Year 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
• International Data on Organ Donation and Transplantation Activity, Waiting List and Family Refusals. Year 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . 31
• International Data on Tissues and Hematopoietic Stem Cell Donation and Transplantation Activity. Year 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
• The Madrid Resolution on Organ Donation and Transplantation. National Responsibility in Meeting the Needs of Patients, Guided by the WHO Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
• Cooperation Between Countries of the Black Sea Area (BSA): Development of the Activities Related to Donation and Transplantation of Organs, Tissues and Cells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
1-NEWSLETTER 2011:aula medica 04/08/11 12:37 Página 1
1-NEWSLETTER 2011:aula medica 04/08/11 12:37 Página 2
3
International Figures on Organ Donation
and Transplantation Activity. Year 2010
COUNCIL OF EUROPE
CONSEIL DE L’EUROPE
1-NEWSLETTER 2011:aula medica 04/08/11 12:37 Página 3
10.0
20.8
12.6
17.0 17
.7 14.8
13.3
15.8
13.0
16.8
15.9
19.6
23.3
20.5
30.7
3.3 2.
7
3.9
3.6
21.6
32.0
23.8
12.6
12.6
16.4
13.7
20.5
6.0
30.2
10.9
4.4
0.5
4
8.0
22.5
1.5
0.0
AC
TU
AL
DE
CE
ASE
D O
RG
AN
DO
NO
RS
–in
clu
ded
NH
BD
-A
nn
ual
Rat
e p.
m.p
. 201
0
1-NEWSLETTER 2011:aula medica 04/08/11 12:37 Página 4
16.7
53.7
39.4
32.4 30
.0 28.7
26.2
35.9
41.4
31.3
30.7
34.7
48.5
30.5
55.5
10.0
0.0
6.0
6.4
12.1
33.0
28.2
47.3
44.7
37.7
37.8
44.0
52.2
41.9
53.6
21.5
KID
NE
Y T
RA
NSP
LAN
T-i
ncl
ud
ed a
ll t
he
com
bin
atio
ns-
An
nu
al R
ate
p.m
.p. 2
010
1.8
12.0
5
35.6
17.2
19.1
1.617
.0
12.0
2.8
35.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:37 Página 5
36.7
21.5
30.4 26
.9 27.8
24.9
27.8
23.2
30.0
26.5
33.0
41.4
30.5 50
.9
5.8
1.5
0.1
4.8
9.6
5.2
17.2
25.2
42.2
40.3
23.1
32.8
27.4
23.7
37.7
48.8
19.1
DE
CE
ASE
D D
ON
OR
K
IDN
EY
TR
AN
SPLA
NT
An
nu
al R
ate
p.m
.p. 2
010
8.9
12.0
6
27.5
8.7
0.00.0
0.0
0.0
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:37 Página 6
16.7
16.9
17.9
2.0 3.
1 0.9
1.3
8.1
18.2
1.3
4.2
1.6
7.0 4.
5
4.1
6.0
1.6
2.4
27.8
3.0
5.1
4.4
14.6
5.0
16.6
28.5
4.5
4.8
2.4
LIV
ING
KID
NE
Y
TR
AN
SPLA
NT
An
nu
al R
ate
p.m
.p. 2
010
26.7
1.8
0.0
10.5
2.7
0.0
7
7.5
10.4
16.3
1.6
17.0
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 7
18.2
14.6
9.3 2.
3
6.2
15.7
8.4
6.1
4.3
9.7
16.8 11
.5
23.9
2.4 2.
0
2.2
9.2
0.2
16.9
20.7
0.2
16.9
12.8
8.3
11.5
8.1
22.5
22.9
3.9
LIV
ER
TR
AN
SPLA
NT
-in
clu
ded
all
th
e co
mb
inat
ion
s-A
nn
ual
Rat
e p.
m.p
. 201
0
6.0
8
6.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 8
6.5
6.0
4.1
0.0
2.1
4.8
3.9
3.9
2.0
6.7
8.2 9.
5
8.2
0.3 0.
7
0.4
1.1
4.5
5.2
5.8
4.5
0.7
2.0
2.8
6.3
4.7
3.0
HE
AR
T T
RA
NSP
LAN
T-i
ncl
ud
ed H
eart
/ L
un
g T
X-
An
nu
al R
ate
p.m
.p. 2
010
0.0
0.0
9
2.5
6.0
1.5
0.0
0.0
0.00.0
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 9
6.5
5.4
2.8
0.3
3.6
5.5
1.6
13.6
0.2
0.0
0.0
0.0
0.0
0.0
0.0
0.8
1.8
5.0
4.1
6.3
0.9
2.6
4.0
10.6
4.0
0.9
0.0
LUN
G T
RA
NSP
LAN
T(S
ingl
e +
Dou
ble
)-i
ncl
ud
ed H
eart
/ L
un
g T
X-
An
nu
al R
ate
p.m
.p. 2
010
10
4.3
0.00.0
0.0
0.0
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 10
3.1
2.8
0.4
0.5
2.0
1.9
3.7
0.4
0.8
2.0
1.5
1.8
1.7
3.2
1.2
2.0
1.4
PAN
CR
EA
S T
RA
NSP
LAN
T-i
ncl
ud
ed a
ll t
he
com
bin
atio
ns-
An
nu
al R
ate
p.m
.p. 2
010
0.9
1.4
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
11
0.4
0.00.0
0.0
0.0
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 11
0.2
0.1
0.0
0.1
0.1
0.1
0.1
0.3
2.0
SMA
LL B
OW
EL
TR
AN
SPLA
NT
-in
clu
ded
all
th
e co
mb
inat
ion
s-A
nn
ual
Rat
e p.
m.p
. 201
0
12
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.00.0
0.0
0.0
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 12
EU
RO
PEA
N U
NIO
N D
ATA
Kid
ney
Tra
nsp
lan
tsLiv
er
Tra
nsp
lan
tsH
eart
Tra
nsp
lan
tsLu
ng
Tra
nsp
lan
tsP
an
cre
as
Tra
nsp
lan
tsS
mall
Bo
wel
Tra
nsp
lan
tsp
pp
pTra
nsp
lan
tsTra
nsp
lan
ts
18
24
6(1
9.8
% L
D)
66
55
(3.6
% L
D)
19
84
15
05
76
95
0
92
06
DEC
EA
SED
OR
GA
ND
ON
OR
S(I
nclu
ded
NH
BD
)9
20
6 D
EC
EA
SED
OR
GA
N D
ON
OR
S (
Inclu
ded
NH
BD
)
*2
01
0 d
ata
N=
27
CO
UN
TR
IES
(5
01
.6m
illi
on
in
hab
itan
ts)
13
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 13
CA
NA
DA
US
A
AU
ST
RA
LIA
NEW
ZEA
LAN
D
Popu
lati
on (
mill
ion
in
habi
tan
ts):
34.1
Act
ual
Dec
ease
d D
onor
s -
incl
ude
d N
HB
D -
(pm
p)49
5 (1
4.5)
Dec
ease
d D
onor
Kid
ney
TX
(pm
p)74
9 (2
2.0)
Livi
ng
Kid
ney
TX
(pm
p)48
5 (1
4.2)
Live
r T
X –
in
clu
ded
all
the
com
bin
atio
ns
- (p
mp)
451
(13.
2)H
eart
TX
-in
clu
ded
Hea
rt/L
un
g T
X -
(pm
p)17
0 (5
.0)
Hea
rt/L
un
g T
X (
pmp)
2 (0
.1)
Lun
g T
X –
in
clu
ded
all
the
com
bin
atio
ns
- (p
mp)
180
(5.3
)Pa
ncr
eas
TX
– i
ncl
ude
d al
l th
e co
mbi
nat
ion
s -
(pm
p)73
(2.
1)Sm
all
Bow
el T
X –
in
clu
ded
all
the
com
bin
atio
ns
- (p
mp)
1 (0
.0)
Popu
lati
on (
mill
ion
in
habi
tan
ts):
317.
6D
ecea
sed
Org
an D
. - i
ncl
ude
d N
HB
D -
(pm
p)79
43 (
25.0
)D
ecea
sed
Don
or K
idn
ey T
X (
pmp)
1062
2 (3
3.4)
Livi
ng
Kid
ney
TX
(pm
p)62
76 (
19.8
)Li
ver
TX
– i
ncl
ude
d al
l th
e co
mbi
nat
ion
s -
(pm
p)62
91 (
19.8
)H
eart
TX
-in
clu
ded
Hea
rt/L
un
g T
X -
(pm
p)23
33 (
7.3)
Hea
rt/L
un
g T
X (
pmp)
41 (
0.1)
Lun
g T
X –
in
clu
ded
all
the
com
bin
atio
ns
- (p
mp)
1170
(5.
6)Pa
ncr
eas
TX
– i
ncl
ude
d al
l th
e co
mbi
nat
ion
s -
(pm
p)11
78 (
3.7)
Smal
l B
owel
TX
– i
ncl
ude
d al
l th
e co
mbi
nat
ion
s -
(pm
p)15
1 (0
.5)
Popu
lati
on (
mill
ion
in
habi
tan
ts):
22.3
Dec
ease
d O
rgan
D. -
in
clu
ded
NH
BD
- (
pmp)
302
(13.
5)D
ecea
sed
Don
or K
idn
ey T
X (
pmp)
548
(24.
6)Li
vin
g K
idn
eyT
X (
pmp)
293
(13.
1)Li
ver
TX
– i
ncl
ude
d al
l th
e co
mbi
nat
ion
s -
(pm
p)20
8 (9
.3)
Hea
rt T
X -
incl
ude
d H
eart
/Lu
ng
TX
- (
pmp)
68 (
3.0)
Hea
rt/L
un
g T
X (
pmp)
3 (0
.1)
Lun
g T
X –
in
clu
ded
all
the
com
bin
atio
ns
- (p
mp)
123
(5.5
)Pa
ncr
eas
TX
– i
ncl
ude
d al
l th
e co
mbi
nat
ion
s -
(pm
p)34
(1.
5)Sm
all
Bow
el T
X –
in
clu
ded
all
the
com
bin
atio
ns
- (p
mp)
1 (0
.0)
Popu
lati
on (
mill
ion
in
habi
tan
ts):
4.3
Dec
ease
d O
rgan
D. -
in
clu
ded
NH
BD
- (
pmp)
38 (
8.8)
Dec
ease
d D
onor
Kid
ney
TX
(pm
p)52
(12
.1)
Livi
ng
Kid
ney
TX
(pm
p)60
(13
.9)
Live
r T
X –
in
clu
ded
all
the
com
bin
atio
ns
- (p
mp)
36 (
8.4)
Hea
rt T
X -
incl
ude
d H
eart
/Lu
ng
TX
- (
pmp)
11 (
2.5)
Hea
rt/L
un
g T
X (
pmp)
-Lu
ng
TX
– i
ncl
ude
d al
l th
e co
mbi
nat
ion
s -
(pm
p)12
(2.
8)Pa
ncr
eas
TX
– i
ncl
ude
d al
l th
e co
mbi
nat
ion
s -
(pm
p)3
(0.7
)Sm
all
Bow
el T
X –
in
clu
ded
all
the
com
bin
atio
ns
- (p
mp)
-
14
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 14
AC
TU
AL
DE
CE
ASE
D O
RG
AN
DO
NO
RS
-in
clu
ded
NH
BD
-A
nn
ual
Rat
e p.
m.p
. 201
0
2.8
1.1
3.7
12.3
14.3
1.9
9.9
3.4
3.2
1.4
3.5
9.9
2.5
5.4
14.4
15
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 15
KID
NE
Y T
RA
NSP
LAN
T-i
ncl
ud
ed a
ll t
he
com
bin
atio
ns-
An
nu
al R
ate
p.m
.p. 2
010
20.4
4.4
5.5
11.1
18.7
26.6
4.5
23.8
7.9
9.1
27.2
10.4
1.7 11
.7
27.4
6.0
16
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 16
DE
CE
ASE
D D
ON
OR
S K
IDN
EY
TR
AN
SPLA
NT
& /
LIV
ING
K
IDN
EY
TR
AN
SPLA
NT
An
nu
al R
ate
p.m
.p. 2
010
1.6
2.8
- 5.5
7.4
3.7
3.1
2.9
17.2
1.5
21.1
5.9
1.7
2.8
15.1
8.8
2.9
5.0
6.2
2.9
7.0
20.2
9.9
0.5
0 1.7 9.
52.
226
.50.
9
4.3
16.1
17
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 17
LIV
ER
TR
AN
SPLA
NT
-in
clu
ded
all
th
e co
mb
inat
ion
s-A
nn
ual
Rat
e p.
m.p
. 201
0
0.7
0.3
4.8
8.0
7.2
0.3
1.7
2.0
3.9
3.5
0.7
18
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 18
HE
AR
T T
RA
NSP
LAN
T-i
ncl
ud
ed H
eart
/ L
un
g T
X-
An
nu
al R
ate
p.m
.p. 2
010
0.1
1.3
1.8
0.9
0.1
0.3
0.2
1.2
2.1
0.0
0.0
19
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 19
LUN
G T
RA
NSP
LAN
T(S
ingl
e +
Dou
ble
)-i
ncl
ud
ed H
eart
/ L
un
g T
X-
An
nu
al R
ate
p.m
.p. 2
010
0.1
1.0
0.3
0.50.
0
0.6
20
0.0
0.0
0.0
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 20
PAN
CR
EA
S T
RA
NSP
LAN
T-i
ncl
ud
ed a
ll t
he
com
bin
atio
ns-
An
nu
al R
ate
p.m
.p. 2
010
0.0
0.2
1.5
0.7 1.
2
21
0.0
0.0
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 21
SMA
LL B
OW
EL
TR
AN
SPLA
NT
-in
clu
ded
all
th
e co
mb
inat
ion
s-A
nn
ual
Rat
e p.
m.p
. 201
0
0.1
0.2
22
0.0
0.0
0.0
0.0
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 22
LA
TIN
AM
ER
ICA
N C
OU
NTR
IES
Kid
ney
Tra
nsp
lan
tsLiv
er
Tra
nsp
lan
tsH
eart
Tra
nsp
lan
tsLu
ng
Tra
nsp
lan
tsP
an
cre
as
Tra
nsp
lan
tsS
mall
Bo
wel
Tra
nsp
lan
tsp
pp
pTra
nsp
lan
tsTra
nsp
lan
ts
10
10
8(4
2.4
% L
D)
21
68
(7.7
% L
D)
35
01
20
21
01
3
39
50
DEC
EA
SED
OR
GA
ND
ON
OR
S(I
nclu
ded
NH
BD
)3
95
0 D
EC
EA
SED
OR
GA
N D
ON
OR
S (
Inclu
ded
NH
BD
)
*2
01
0 d
ata
N=
17
CO
UN
TR
IES
(5
45
mil
lio
n in
hab
itan
ts)
12
23
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 23
GLO
BA
L D
ATA
WH
O
Reg
ion
Kid
ney
N(p
mp
)2
Liv
er
N(p
mp
)2
Heart
N(p
mp
)2
Lu
ng
N(p
mp
)2
Pan
cre
as
N(p
mp
)2
To
tal
N(p
mp
)2R
eg
ion
(N)1
N (
pm
p)2
N (
pm
p)2
N (
pm
p)2
N(p
mp
)2N
(pm
p)2
N(p
mp
)2
AFR
LD:
323 (
0.8
)LD
: 5 (
0.0
1)
(9)
DD
: 140 (
0.3
)D
D:
37 (
0.0
9)
26 (
0.0
6)
8 (
0.0
2)
11 (
0.0
3)
550 (
1.3
)
AM
RLD
: 11036 (
12.1
)LD
: 336 (
0.4
)2784
(3.1
)1913
(2.1
)1393
(1.5
)42743
(47.0
)*(2
1)
DD
: 16692(1
8.4
)D
D:
8405 (
9.2
)2784 (
3.1
)1913 (
2.1
)1393 (
1.5
)42743 (
47.0
)
EM
R
(14
)
LD:
5032 (
10.1
)
DD
: 550 (
1.1
)
LD:
192 (
0.4
)
DD
: 223 (
0.4
)61 (
0.1
)10 (
0.0
2)
20 (
0.0
4)
6088 (
12.3
)(
)(
)(
)
EU
R
(38
)
LD:
5597 (
7.2
)
DD
: 16116 (
20.7
)
LD:
583 (
0.7
5)
DD
: 6994 (
9.0
)2239 (
2.9
)1535 (
2.0
)824 (
1.0
5)
33942 (
43.6
)**
*2
00
9 d
ata
24
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 24
GLO
BA
L D
ATA
WH
O
Reg
ion
Kid
ney
N(p
mp
)2
Liv
er
N(p
mp
)2
Heart
N(p
mp
)2
Lu
ng
N(p
mp
)2
Pan
cre
as
N(p
mp
)2
To
tal
N(p
mp
)2R
eg
ion
(N)1
N (
pm
p)2
N (
pm
p)2
N (
pm
p)2
N(p
mp
)2N
(pm
p)2
N(p
mp
)2
SEA
RLD
: 5496 (
3.1
)LD
: 403 (
0.2
3)
(9)
DD
: 305 (
0.1
7)
DD
: 105 (
0.0
6)
13 (
0.0
07)
--
6322 (
3.6
)
WP
RLD
: 5313 (
3.0
)LD
: 1760 (
1.0
)280
(0.1
6)
183
(0.1
0)
68
(0.0
4)
14420
(8.2
)***
(11
)D
D:
4818 (
2.7
)D
D:
1984 (
1.1
)280 (
0.1
6)
183 (
0.1
0)
68 (
0.0
4)
14420 (
8.2
)
TO
TA
L7
14
18
(1
1.6
)2
10
27
(3
.4)
(10
2)
()
LD
: 3
27
97
(5
.3)
DD
: 3
86
21
(6
.3)
()
LD
: 3
27
9 (
0.5
)
DD
: 1
77
48
(2
.9)
54
03
(0.9
)
36
49
(0.6
)
23
16
(0.4
)
10
40
65
(17
.0)*
**
*
1N
um
ber
ofco
untr
ies
incl
uded
inth
eanaly
sis
2Abso
lute
num
ber
(rate
pm
pbase
don
the
popula
tion
from
the
countr
ies
1 N
um
ber
of co
untr
ies
incl
uded in t
he a
naly
sis.
2Abso
lute
num
ber
(rate
pm
p-
base
d o
n t
he p
opula
tion f
rom
the c
ountr
ies
with t
ransp
lanta
tion a
ctiv
ity d
ata
).
*184 s
mall
bow
el tx
incl
uded
**54 s
mall
bow
el tx
incl
uded
***14 s
mall
bow
el tx
incl
uded
****252 s
mall
bow
el tx
in
cluded
*2
00
9 d
ata
25
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 25
26
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 26
27
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 27
28
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 28
100
%V
iti
DD
Li
%V
iti
LDLi
%V
iti
Tt
lLi
80
100
%V
ariation D
D L
iver
%V
ariatio
n L
D L
iver
%V
ariation T
otal L
iver
60 40 020 -200
AF
RA
MR
EM
RE
UR
SE
AR
WP
R
29
100
%V
iti
DD
Li%
Vi
tiLD
Li%
Vi
tiT
tlL
i
80100
%V
aria
tion
DD
Live
r%
Var
iatio
n LD
Live
r%
Var
iatio
n To
tal L
iver
60 40 020 -200
AFR
AM
RE
MR
EU
RS
EA
RW
PR
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 29
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 30
International Data on Organ Donation and Transplantation Activity,
Waiting List and Family Refusals. Year 2010
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 31
DO
NAT
ION
AN
D T
RA
NSP
LAN
TATI
ON
AC
TIVI
TY
EUR
OP
EAN
UN
ION
CO
UN
TRIE
SC
OU
NTR
IES
AU
STR
IAB
ELG
IUM
BU
LGA
RIA
CY
PR
US
CZE
CH
. R.
DEN
MA
RK
ESTO
NIA
FIN
LAN
DFR
AN
CE
Pop
ulat
ion
(mill
ion
inha
bita
nts)
UN
FPA
: htt
p://
ww
w.u
nfpa
.org
/pub
lic/
8.4
10.8
7.5
0.9
10.5
5.6
1.3
5.4
64.7
DO
NAT
ION
Act
ual D
ecea
sed
Don
ors
-incl
uded
NH
BD
- (p
mp)
196
(23.
3)22
1 (2
0.5)
20 (2
.7)
4 (4
.4)
206
(19.
6)73
(13.
0)23
(17.
7)92
(17.
0)15
38 (2
3.8)
NH
B A
ctua
l Don
ors
(pm
p)-
50 (4
.6)
00
2 (0
.2)
00
062
(1.0
)%
Mul
tiorg
an d
onor
s81
.677
.980
100
58.3
706
6386
.4
TRA
NSP
LAN
TATI
ON
KID
NE
YTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)40
7 (4
8.5)
453
(41.
9)48
(6.4
)32
(35.
6)36
4 (3
4.7)
232
(41.
4)39
(30.
0)17
5 (3
2.4)
2892
(44.
7)%
(Liv
ing
TX. /
Tot
al T
X.)
14.5
10.8
2575
4.7
4410
.36.
39.
8P
aedi
atric
<15
yea
rs10
9-
22
8-
363
Dec
ease
d D
onor
TX.
(pm
p)34
8 (4
1.4)
404
(37.
7)36
(4.8
)8
(8.9
)34
7 (3
3.0)
130
(23.
2)35
(26.
9)16
4 (3
0.4)
2609
(40.
3)-S
ingl
e TX
. (pm
p)34
6 (4
1.2)
400
(37.
0)36
(4.8
)8
(8.9
)34
1 (3
2.5)
130
(23.
2)35
(26.
9)16
4 (2
.0)
2553
(39.
5)-D
oubl
e TX
. (pm
p)2
(0.2
)4
(0.4
)0
-6
(0.6
)0
00
56 (0
.9)
Livi
ng T
X. (p
mp)
59 (7
.0)
49 (4
.5)
12 (1
.6)
24 (2
6.7)
17 (1
.6)
102
(18.
2)4
(3.1
)11
(2.0
)28
3 (4
.4)
NH
B K
idne
y TX
. (pm
p)5
(0.6
)61
(5.6
)-
-4
(0.4
)-
--
79 (1
.2)
LIVE
RTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)14
1 (1
6.8)
243
(22.
5)15
(2.0
)-
102
(9.7
)47
(8.4
)3
(2.3
)50
(9.3
)10
92 (1
6.9)
Pae
diat
ric <
15 y
ears
635
3-
-10
(1.8
)-
5 (0
.9)
69S
plit
Live
r TX
. (pm
p)3
(0.4
)3
(0.3
)13
(1.7
)-
0-
80 (1
.2)
Dom
ino
Live
r TX
. (pm
p)0
00
-1
(0.1
)0
-0
8 (0
.1)
Livi
ng L
iver
TX.
(pm
p)2
(0.2
)33
(3.0
)2
(0.3
)-
00
-0
17 (0
.3)
NH
B L
iver
TX.
(pm
p)1
(0.1
)25
(2.3
)0
-0
--
-3
(0.0
)
HE
AR
TTX
. -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)69
(8.2
)68
(6.3
)5
(0.7
)-
70 (6
.7)
22 (3
.9)
022
(4.1
)37
5 (5
.8)
Pae
diat
ric <
15 y
ears
52
--
-3
-0
12
HE
AR
T-LU
NG
Tran
spla
nts
(pm
p)-
-0
-0
0-
019
(0.3
)P
aedi
atric
<15
yea
rs-
--
--
--
-0
LUN
GTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)11
4 (1
3.6)
114
(10.
6)0
-17
(1.6
)31
(5.5
)1
(0.8
)15
(2.8
)26
3 (4
.1)
Pae
diat
ric <
15 y
ears
2-
0-
-0
-0
6S
ingl
e (p
mp)
5 (0
.6)
21 (1
.9)
0-
6 (0
.6)
7 (1
.3)
1 (0
.8)
060
(0.9
)D
oubl
e -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)10
9 (1
3.0)
93 (8
.6)
0-
11 (1
.0)
24 (4
.3)
-15
(2.8
)20
3 (3
.1)
NH
B –
doub
le +
sin
gle-
Lun
g TX
. (pm
p)-
13 (1
.2)
0-
00
-0
0
PAN
CR
EA
STX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)31
(3.7
)22
(2.0
)0
-20
(1.9
)-
-2
(0.4
)96
(1.5
)P
aedi
atric
<15
yea
rs0
00
--
--
-1
Kid
ney
- P
ancr
eas
TX. (
pmp)
27 (3
.2)
22 (2
.0)
0-
16 (1
.5)
--
2 (0
.4)
83 (1
.3)
Pan
crea
s TX
. Alo
ne (p
mp)
4 (0
.5)
-0
-4
(0.4
)-
--
12 (0
.2)
SMA
LL B
OW
EL
TX. –
incl
uded
all
the
com
bina
tions
- (p
mp)
--
0-
0-
-1
(0.2
)9
(0.1
)P
aedi
atric
<15
yea
rs-
-0
-0
--
-7
Live
r +
Sm
all B
owel
(pm
p)-
-0
-0
--
-4
(0.1
)S
mal
l Bow
el T
X. A
lone
(pm
p)-
-0
-0
--
1 (0
.2)
4 (0
.1)
MU
LTIV
ISC
ER
AL
(pm
p)-
-0
-0
--
-1
(0.0
)
32
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 32
DO
NAT
ION
AN
D T
RA
NSP
LAN
TATI
ON
AC
TIVI
TY
EUR
OP
EAN
UN
ION
CO
UN
TRIE
SC
OU
NTR
IES
GER
MA
NY
GR
EEC
EH
UN
GA
RY
IREL
AN
DIT
ALY
LATV
IALI
THU
AN
IALU
XEM
BO
UR
GM
ALT
AP
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/81
.811
.210
.04.
660
.12.
33.
30.
50.
4
DO
NAT
ION
Act
ual D
ecea
sed
Don
ors
-incl
uded
NH
BD
- (p
mp)
1296
(15.
8)44
(3.9
)15
9 (1
5.9)
58 (1
2.6)
1298
(21.
6)34
(14.
8)36
(10.
9)3
(6.0
)9
(22.
5)N
HB
Act
ual D
onor
s (p
mp)
00
00
3 (0
.1)
11 (4
.8)
00
0%
Mul
tiorg
an d
onor
s87
3943
.4-
75.4
2.5
58.3
100
100
TRA
NSP
LAN
TATI
ON
KID
NE
YTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)29
37 (3
5.9)
135
(12.
1)30
7 (3
0.7)
174
(37.
8)16
94 (2
8.2)
66 (2
8.7)
71 (2
1.5)
6 (1
2.0)
14 (3
5.0)
% (L
ivin
g TX
. / T
otal
TX.
)22
.620
13.7
13.2
10.7
3.0
11.3
021
.4P
aedi
atric
<15
yea
rs-
27
243
01
00
Dec
ease
d D
onor
TX.
(pm
p)22
72 (2
7.8)
108
(9.6
)26
5 (2
6.5)
151
(32.
8)15
12 (2
5.2)
64 (2
7.8)
63 (1
9.1)
6 (1
2.0)
11 (2
7.5)
-Sin
gle
TX. (
pmp)
2250
(27.
5)-
265
(26.
5)14
7 (3
2.0)
1386
(23.
1)64
(27.
8)63
(19.
1)6
(12.
0)11
(27.
5)-D
oubl
e TX
. (pm
p)22
(0.3
)-
04
(0.9
)12
6 (2
.1)
00
00
Livi
ng T
X. (p
mp)
665
(8.1
)27
(2.4
)42
(4.2
)23
(5.0
)18
2 (3
.0)
2 (0
.9)
8 (2
.4)
03
(7.5
)N
HB
Kid
ney
TX. (
pmp)
00
0-
017
(7.4
)0
00
LIVE
RTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)12
82 (1
5.7)
25 (2
.2)
43 (4
.3)
38 (8
.3)
1014
(16.
9)0
13 (3
.9)
3(6
.0)
0P
aedi
atric
<15
yea
rs-
13
067
00
00
Spl
it Li
ver
TX. (
pmp)
107
(1.3
)0
00
84 (1
.4)
00
00
Dom
ino
Live
r TX
. (pm
p)5
(0.1
)0
00
00
00
0Li
ving
Liv
er T
X. (p
mp)
90 (1
.1)
00
012
(0.2
)0
00
0N
HB
Liv
er T
X. (p
mp)
00
00
00
00
0
HE
AR
TTX
. -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)39
3 (4
.8)
5 (0
.4)
20 (2
.0)
3 (0
.7)
273
(4.5
)0
10 (3
.0)
3 (6
.0)
1 (2
.5)
Pae
diat
ric <
15 y
ears
-1
40
190
00
0
HE
AR
T-LU
NG
Tran
spla
nts
(pm
p)16
(0.2
)0
00
4 (0
.1)
00
00
Pae
diat
ric <
15 y
ears
-0
00
00
00
0
LUN
GTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)29
8 (3
.6)
2 (0
.2)
-4
(0.9
)10
7 (1
.8)
00
2 (4
.0)
0P
aedi
atric
<15
yea
rs-
1-
03
00
00
Sin
gle
(pm
p)44
(0.5
)-
-0
37 (0
.6)
00
2 (4
.0)
0D
oubl
e -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)25
4 (3
.1)
--
4 (0
.9)
70 (1
.2)
00
00
NH
B –
doub
le +
sin
gle-
Lun
g TX
. (pm
p)0
--
00
00
00
PAN
CR
EA
STX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)16
3 (2
.0)
-9
(0.9
)8
(1.7
)47
(0.8
)0
00
0P
aedi
atric
<15
yea
rs-
-0
01
00
00
Kid
ney
- P
ancr
eas
TX. (
pmp)
144
(1.8
)-
9 (0
.9)
8 (1
.7)
27 (0
.4)
00
00
Pan
crea
s TX
. Alo
ne (p
mp)
13 (0
.2)
-0
016
(0.3
)0
00
0
SMA
LL B
OW
EL
TX. –
incl
uded
all
the
com
bina
tions
- (p
mp)
10 (0
.1)
--
06
(0.1
)0
01
(2.0
)0
Pae
diat
ric <
15 y
ears
--
-0
30
00
0Li
ver
+ S
mal
l Bow
el (p
mp)
5 (0
.1)
--
01
(0.0
)0
00
0S
mal
l Bow
el T
X. A
lone
(pm
p)4
(0.0
)-
-0
4 (0
.1)
00
1 (2
.0)
0
MU
LTIV
ISC
ER
AL
(pm
p)5
(0.1
)-
-0
1 (0
.0)
00
00
33
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 33
DO
NAT
ION
AN
D T
RA
NSP
LAN
TATI
ON
AC
TIVI
TY
EUR
OP
EAN
UN
ION
CO
UN
TRIE
SC
OU
NTR
IES
NET
HER
LAN
DS
PO
LAN
DP
OR
TUG
AL
RO
MA
NIA
SLO
VAK
IASL
OVE
NIA
SPA
INSW
EDEN
U. K
.P
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/16
.638
.110
.721
.25.
42.
047
.09.
461
.9
DO
NAT
ION
Act
ual D
ecea
sed
Don
ors
-incl
uded
NH
BD
- (p
mp)
227
(13.
7)50
9 (1
3.3)
323
(30.
2)70
(3.3
)91
(16.
8)41
(20.
5)15
02 (3
2.0)
118
(12.
6)10
15 (1
6.4)
NH
B A
ctua
l Don
ors
(pm
p)84
(5.1
)0
00
00
130
(2.7
)0
373
(6.0
)%
Mul
tiorg
an d
onor
s76
.247
.069
.075
.054
87.8
81.0
89.0
72.3
TRA
NSP
LAN
TATI
ON
KID
NE
YTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)86
7 (5
2.2)
999
(26.
2)57
3 (5
3.6)
212
(10.
0)16
9 (3
1.3)
61 (3
0.5)
2225
(47.
3)37
0 (3
9.4)
2724
(44.
0)%
(Liv
ing
TX. /
Tot
al T
X.)
54.6
58.
941
.54.
10
10.8
45.4
37.7
Pae
diat
ric <
15 y
ears
2839
162
30
5810
101
Dec
ease
d D
onor
TX.
(pm
p)39
4 (2
3.7)
949
(24.
9)52
2 (4
8.8)
124
(5.8
)16
2 (3
0.0)
61 (3
0.5)
1985
(42.
2)20
2 (2
1.5)
1698
(27.
4)-S
ingl
e TX
. (pm
p)39
1 (2
3.5)
947
(24.
8)52
0 (4
8.6)
123
(5.8
)15
7 (2
9.1)
61 (3
0.5)
1960
(41.
7)19
9 (2
1.2)
1676
(27.
1)-D
oubl
e TX
. (pm
p)3
(0.2
)2
(0.1
)2
(0.2
)1
(0.0
)5
(0.9
)0
25 (0
.5)
3 (0
.3)
22 (0
.3)
Livi
ng T
X. (p
mp)
473
(28.
5)50
(1.3
)51
(4.8
)88
(4.1
)7
(1.3
)0
240
(5.1
)16
8 (1
7.9)
1026
(16.
6)N
HB
Kid
ney
TX. (
pmp)
129
(7.8
)0
04
(0.2
)0
015
8 (3
.4)
-58
0 (9
.4)
LIVE
RTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)13
5 (8
.1)
237
(6.2
)24
5 (2
2.9)
51 (2
.4)
33 (6
.1)
23 (1
1.5)
971
(20.
7)13
7 (1
4.6)
712
(11.
5)P
aedi
atric
<15
yea
rs23
3415
00
046
991
Spl
it Li
ver
TX. (
pmp)
8 (0
.5)
00
00
020
(0.4
)-
113
(1.8
)D
omin
o Li
ver
TX. (
pmp)
1 (0
.1)
037
(3.5
)0
00
8 (0
.2)
7 (0
.7)
4 (0
.1)
Livi
ng L
iver
TX.
(pm
p)4
(0.2
)20
(0.5
)0
9 (0
.4)
00
20 (0
.4)
8 (0
.9)
24 (0
.4)
NH
B L
iver
TX.
(pm
p)16
(1.0
)0
00
00
18 (0
.4)
-10
4 (1
.7)
HE
AR
TTX
. -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)46
(2.8
)79
(2.1
)50
(4.7
)7
(0.3
)21
(3.9
)19
(9.5
)24
3 (5
.2)
56 (6
.0)
124
(2.0
)P
aedi
atric
<15
yea
rs2
62
01
-0
630
HE
AR
T-LU
NG
Tran
spla
nts
(pm
p)1
(0.1
)0
00
0-
4 (0
.1)
05
(0.1
)P
aedi
atric
<15
yea
rs-
00
00
-0
00
LUN
GTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)67
(4.0
)12
(0.3
)10
(0.9
)0
0-
235
(5.0
)51
(5.4
)16
2 (2
.6)
Pae
diat
ric <
15 y
ears
30
00
0-
40
5S
ingl
e (p
mp)
5 (0
.3)
7 (0
.2)
5 (0
.5)
00
-10
5 (2
.2)
15 (1
.6)
26 (0
.4)
Dou
ble
-incl
uded
Hea
rt/
Lung
TX.
- (p
mp)
62 (3
.7)
5 (0
.1)
5 (0
.5)
00
-13
0 (2
.8)
36 (3
.8)
136
(2.2
)N
HB
–do
uble
+ s
ingl
e- L
ung
TX. (
pmp)
-0
00
0-
8 (0
.2)
022
(0.4
)
PAN
CR
EA
STX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)20
(1.2
)20
(0.5
)15
(1.4
)0
01
(0.5
)94
(2.0
)26
(2.8
)19
5 (3
.2)
Pae
diat
ric <
15 y
ears
00
00
00
05
Kid
ney
- P
ancr
eas
TX. (
pmp)
14 (0
.8)
19 (0
.5)
14 (1
.3)
00
1 (0
.5)
71 (1
.5)
26 (2
.8)
151
(2.4
)P
ancr
eas
TX. A
lone
(pm
p)5
(0.3
)1
(0.0
)1
(0.1
)0
00
17 (0
.4)
039
(0.6
)
SMA
LL B
OW
EL
TX. –
incl
uded
all
the
com
bina
tions
- (p
mp)
-0
00
0-
5 (0
.1)
-18
(0.3
)P
aedi
atric
<15
yea
rs-
00
00
-3
-11
Live
r +
Sm
all B
owel
(pm
p)-
00
00
--
-2
(0.0
)S
mal
l Bow
el T
X. A
lone
(pm
p)-
00
00
-1
(0.0
)-
10 (0
.2)
MU
LTIV
ISC
ER
AL
(pm
p)-
00
00
-4
(0.1
)1
6 (0
.1)
34
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 34
DO
NAT
ION
AN
D T
RA
NSP
LAN
TATI
ON
AC
TIVI
TY
OTH
ER C
OU
NTR
IES
CO
UN
TRIE
SA
LGER
IAA
UST
RA
LIA
CA
NA
DA
CR
OA
CIA
GEO
RG
IAIC
ELA
ND
ISR
AEL
LEB
AN
ON
MA
CED
ON
IAP
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/35
.422
.334
.14.
44.
50.
37.
54.
32.
0
DO
NAT
ION
Act
ual D
ecea
sed
Don
ors
-incl
uded
NH
BD
- (p
mp)
1 (0
.0)
302
(13.
5)49
5 (1
4.5)
135
(30.
7)-
3 (1
0.0)
60 (8
.0)
2 (0
.5)
0N
HB
Act
ual D
onor
s (p
mp)
1 (0
.0)
67 (3
.0)
72 (2
.1)
0-
02
(0.3
)-
0%
Mul
tiorg
an d
onor
s0
80-
85.8
-10
062
100
0
TRA
NSP
LAN
TATI
ON
KID
NE
YTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)98
(2.8
)84
1 (3
7.7)
1234
(36.
2)24
4 (5
5.5)
8 (1
.8)
5 (1
6.7)
143
(19.
1)74
(17.
2)12
(6.0
)%
(Liv
ing
TX. /
Tot
al T
X.)
97.9
34.8
39.3
8.2
100
100
54.5
94.6
100
Pae
diat
ric <
15 y
ears
2214
--
1-
110
2D
ecea
sed
Don
or T
X. (p
mp)
2 (0
.1)
548
(24.
6)74
9 (2
2.0)
224
(50.
9)-
-65
(8.7
)74
(17.
2)0
-Sin
gle
TX. (
pmp)
2 (0
.1)
542
(24.
3)73
7 (2
1.6)
214
(48.
6)-
-63
(8.4
)4
(0.9
)0
-Dou
ble
TX. (
pmp)
06
(0.3
)12
(0.4
)3
(0.7
)-
-2
(0.3
)-
0Li
ving
TX.
(pm
p)96
(2.7
)29
3 (1
3.1)
485
(14.
2)20
(4.5
)8
(1.8
)5
(16.
7)78
(10.
4)70
(16.
3)12
(6.0
)N
HB
Kid
ney
TX. (
pmp)
011
7 (5
.2)
80 (2
.3)
--
-3
(0.4
)-
LIVE
RTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)6
(0.2
)20
8 (9
.3)
451
(13.
2)10
5 (2
3.9)
--
46 (6
.1)
1 (0
.2)
0P
aedi
atric
<15
yea
rs0
5-
--
-5
-0
Spl
it Li
ver
TX. (
pmp)
031
(1.4
)17
(0.5
)2
(0.4
)-
-1
(0.1
)-
0D
omin
o Li
ver
TX. (
pmp)
0-
0 (0
.0)
--
--
-0
Livi
ng L
iver
TX.
(pm
p)6
(0.2
)4
(0.2
)64
(1.9
)2
(0.4
)-
-7
(0.9
)-
0N
HB
Liv
er T
X. (p
mp)
012
(0.5
)16
(0.5
)-
--
--
0
HE
AR
TTX
. -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)0
68 (3
.0)
170
(5.0
)36
(8.2
)-
-11
(1.5
)-
0P
aedi
atric
<15
yea
rs0
2-
--
-2
-0
HE
AR
T-LU
NG
Tran
spla
nts
(pm
p)0
3 (0
.1)
2 (0
.1)
--
--
-0
Pae
diat
ric <
15 y
ears
0-
--
--
--
0
LUN
GTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)0
123
(5.5
)18
0 (5
.3)
--
-32
(4.3
)-
0P
aedi
atric
<15
yea
rs0
3-
--
-2
-0
Sin
gle
(pm
p)0
10 (0
.4)
25 (0
.7)
--
-22
(2.9
)-
0D
oubl
e -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)0
113
(5.1
)15
5 (4
.5)
--
-10
(1.4
)-
0N
HB
–do
uble
+ s
ingl
e- L
ung
TX. (
pmp)
027
(1.2
)9
(0.3
)-
--
--
0
PAN
CR
EA
STX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)0
34 (1
.5)
73 (2
.1)
6 (1
.4)
--
3 (0
.4)
-0
Pae
diat
ric <
15 y
ears
0-
--
--
0-
0K
idne
y -
Pan
crea
s TX
. (pm
p)0
33 (1
.5)
50 (1
.5)
5 (1
.1)
--
3 (0
.4)
-0
Pan
crea
s TX
. Alo
ne (p
mp)
0-
23 (0
.7)
1 (0
.2)
--
0-
0
SMA
LL B
OW
EL
TX. –
incl
uded
all
the
com
bina
tions
- (p
mp)
01
(0.0
)1
(0.0
)-
--
--
0P
aedi
atric
<15
yea
rs0
--
--
--
-0
Live
r +
Sm
all B
owel
(pm
p)0
-0
(0.0
)-
--
--
0S
mal
l Bow
el T
X. A
lone
(pm
p)0
-1
(0.0
)-
--
--
0
MU
LTIV
ISC
ER
AL
(pm
p)0
1 (0
.0)
3 (0
.1)
--
--
-0
35
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 35
DO
NAT
ION
AN
D T
RA
NSP
LAN
TATI
ON
AC
TIVI
TY
OTH
ER C
OU
NTR
IES
CO
UN
TRIE
SM
OLD
OVA
NEW
ZEA
LAN
DN
OR
WAY
PALE
STIN
ESW
ITZE
RLA
ND
SYR
IATU
NIS
IATU
RK
EYU
SAP
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/3.
84.
34.
94.
57.
822
.511
.075
.731
7.6
DO
NAT
ION
Act
ual D
ecea
sed
Don
ors
-incl
uded
NH
BD
- (p
mp)
038
(8.8
)10
2 (2
0.8)
098
(12.
6)0
16 (1
.5)
272
(3.6
)79
43 (2
5.0)
NH
B A
ctua
l Don
ors
(pm
p)0
1 (0
.2)
00
00
0-
-%
Mul
tiorg
an d
onor
s0
7692
099
00
232
-
TRA
NSP
LAN
TATI
ON
KID
NE
YTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)0
112
(26.
0)26
3 (5
3.7)
7 (1
.6)
294
(37.
7)38
5 (1
7.0)
132
(12.
0)25
02 (3
3.0)
1689
8 (5
3.2)
% (L
ivin
g TX
. / T
otal
TX.
)0
53.6
31.6
100
38.8
100
87.9
84.2
37.1
Pae
diat
ric <
15 y
ears
0-
-0
824
7-
748
Dec
ease
d D
onor
TX.
(pm
p)0
52 (1
2.1)
180
(36.
7)0
180
(23.
1)0
16 (1
.5)
395
(5.2
)10
622
(33.
4)-S
ingl
e TX
. (pm
p)0
48 (1
1.2)
179
(36.
5)0
176
(22.
6)0
--
--D
oubl
e TX
. (pm
p)0
4 (0
.9)
1 (0
.2)
04
(0.5
)0
0-
-Li
ving
TX.
(pm
p)0
60 (1
3.9)
83 (1
6.9)
7 (1
.6)
114
(14.
6)38
5 (1
7.0)
116
(10.
5)21
07 (2
7.8)
6276
(19.
8)N
HB
Kid
ney
TX. (
pmp)
0-
-0
00
0-
-
LIVE
RTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)0
36 (8
.4)
89 (1
8.2)
010
0 (1
2.8)
00
695
(9.2
)62
91 (1
9.8)
Pae
diat
ric <
15 y
ears
0-
70
90
0-
560
Spl
it Li
ver
TX. (
pmp)
04
(0.9
)-
011
(1.4
)0
0-
-D
omin
o Li
ver
TX. (
pmp)
0-
00
1 (0
.1)
00
--
Livi
ng L
iver
TX.
(pm
p)0
6 (1
.4)
00
1 (0
.1)
00
486
(6.4
)28
2 (0
.9)
NH
B L
iver
TX.
(pm
p)0
1 (0
.2)
-0
00
0-
-
HE
AR
TTX
. -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)0
11 (2
.5)
32 (6
.5)
035
(4.5
)0
086
(1.1
)23
33 (7
.3)
Pae
diat
ric <
15 y
ears
0-
00
20
0-
359
HE
AR
T-LU
NG
Tran
spla
nts
(pm
p)0
-1
00
00
-41
(0.1
)P
aedi
atric
<15
yea
rs0
-0
00
00
-1
LUN
GTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)0
12 (2
.8)
32 (6
.5)
049
(6.3
)0
03
(0.0
)17
70 (5
.6)
Pae
diat
ric <
15 y
ears
0-
00
20
0-
56S
ingl
e (p
mp)
0-
1 (0
.2)
02
(0.3
)0
0-
-D
oubl
e -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)0
12 (2
.8)
31 (6
.3)
047
(6.0
)0
0-
-N
HB
–do
uble
+ s
ingl
e- L
ung
TX. (
pmp)
0-
00
00
0-
-
PAN
CR
EA
STX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)0
3 (0
.7)
15 (3
.1)
014
(1.8
)0
029
(0.4
)11
78 (3
.7)
Pae
diat
ric <
15 y
ears
0-
-0
00
0-
41K
idne
y -
Pan
crea
s TX
. (pm
p)0
2 (0
.5)
14 (2
.9)
09
(1.2
)0
0-
828
(2.6
)P
ancr
eas
TX. A
lone
(pm
p)0
1 (0
.2)
1 (0
.2)
05
(0.6
)0
0-
350
(1.1
)
SMA
LL B
OW
EL
TX. –
incl
uded
all
the
com
bina
tions
- (p
mp)
0-
-0
1 (0
.1)
00
3 (0
.0)
151
(0.5
)P
aedi
atric
<15
yea
rs0
--
00
00
--
Live
r +
Sm
all B
owel
(pm
p)0
--
00
00
--
Sm
all B
owel
TX.
Alo
ne (p
mp)
0-
-0
00
0-
-
MU
LTIV
ISC
ER
AL
(pm
p)0
--
00
00
--
36
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 36
DO
NAT
ION
AN
D T
RA
NSP
LAN
TATI
ON
AC
TIVI
TY
LATI
NA
MER
ICA
N C
OU
NTR
IES
CO
UN
TRIE
SA
RG
ENTI
NA
BO
LIVI
AB
RA
SIL
CH
ILE
CO
LOM
BIA
CO
STA
RIC
AC
UB
AD
OM
INIC
AN
A
ECU
AD
OR
Pop
ulat
ion
(mill
ion
inha
bita
nts)
UN
FPA
: htt
p://
ww
w.u
nfpa
.org
/pub
lic/
40.1
10.4
195.
417
.146
.34.
611
.210
.213
.8
DO
NAT
ION
Act
ual D
ecea
sed
Don
ors
-incl
uded
NH
BD
- (p
mp)
583
(14.
5)15
(1.4
)19
34 (9
.9)
92 (5
.4)
570
(12.
3)16
(3.5
)11
1 (9
.9)
11 (1
.1)
35 (2
.5)
NH
B A
ctua
l Don
ors
(pm
p)0
0-
00
--
-%
Mul
tiorg
an d
onor
s51
.10
7325
50-
63.3
-
TRA
NSP
LAN
TATI
ON
KID
NE
YTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)10
82 (2
6.6)
82 (7
.9)
4660
(23.
8)20
0 (1
1.7)
867
(18.
7)12
5 (2
7.2)
117
(10.
4)45
(4.4
)-
% (L
ivin
g TX
. / T
otal
TX.
)21
.863
.436
.818
.58.
074
.45.
464
.4-
Pae
diat
ric <
15 y
ears
77-
-24
698
--
-D
ecea
sed
Don
or T
X. (p
mp)
846
(21.
1)30
(2.9
)29
46 (1
5.1)
163
(9.5
)79
8 (1
7.2)
32 (7
.0)
111
(9.9
)16
(1.6
)-
-Sin
gle
TX. (
pmp)
839
(20.
9)30
(2.9
)-
162
(9.5
)79
6 (1
7.2)
32 (7
.0)
-16
(1.6
)-
-Dou
ble
TX. (
pmp)
7 (0
.2)
--
1 (0
.0)
2 (0
.0)
0-
--
Livi
ng T
X. (p
mp)
236
(5.9
)52
(5.0
)17
14 (8
.8)
37 (2
.2)
69 (1
.5)
93 (2
0.2)
6 (0
.5)
29 (2
.8)
-N
HB
Kid
ney
TX. (
pmp)
-0
--
0-
--
-
LIVE
RTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)32
2 (8
.0)
-14
04 (7
.2)
67 (3
.9)
220
(4.8
)8
(1.7
)22
(2.0
)3
(0.3
)-
Pae
diat
ric <
15 y
ears
44-
-18
28 (0
.6)
1-
--
Spl
it Li
ver
TX. (
pmp)
33 (0
.8)
--
-0
0-
--
Dom
ino
Live
r TX
. (pm
p)1
(0.0
)-
--
00
--
-Li
ving
Liv
er T
X. (p
mp)
33 (0
.8)
-10
9 (0
.6)
7 (0
.4)
2 (0
.0)
0-
--
NH
B L
iver
TX.
(pm
p)-
--
-0
0-
--
HE
AR
TTX
. -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)72
(1.8
)-
167
(0.9
)20
(1.2
)60
(1.3
)0
3 (0
.3)
--
Pae
diat
ric <
15 y
ears
5-
--
40
--
-
HE
AR
T-LU
NG
Tran
spla
nts
(pm
p)2
(0.0
)-
--
00
--
-P
aedi
atric
<15
yea
rs-
--
-0
0-
--
LUN
GTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)42
(1.0
)-
60 (0
.3)
9 (0
.5)
6 (0
.1)
0-
--
Pae
diat
ric <
15 y
ears
0-
--
00
--
-S
ingl
e (p
mp)
30 (0
.7)
--
-3
(0.1
)0
--
-D
oubl
e -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)12
(0.3
)-
--
3 (0
.1)
0-
--
NH
B –
doub
le +
sin
gle-
Lun
g TX
. (pm
p)-
--
-0
0-
--
PAN
CR
EA
STX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)61
(1.5
)-
131
(0.7
)-
12 (0
.2)
0-
--
Pae
diat
ric <
15 y
ears
--
--
00
--
-K
idne
y -
Pan
crea
s TX
. (pm
p)58
(1.4
)-
87 (0
.4)
-12
(0.2
)0
--
-P
ancr
eas
TX. A
lone
(pm
p)3
(0.1
)-
44 (0
.2)
-0
0-
--
SMA
LL B
OW
EL
TX. –
incl
uded
all
the
com
bina
tions
- (p
mp)
7 (0
.2)
--
-6
(0.1
)0
--
-P
aedi
atric
<15
yea
rs3
--
-1
0-
--
Live
r +
Sm
all B
owel
(pm
p)2
(0.0
)-
--
00
--
-S
mal
l Bow
el T
X. A
lone
(pm
p)4
(0.1
)-
--
4 (0
.1)
0-
--
MU
LTIV
ISC
ER
AL
(pm
p)3
(0.1
)-
--
2 (0
.0)
0-
--
37
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 37
DO
NAT
ION
AN
D T
RA
NSP
LAN
TATI
ON
AC
TIVI
TY
LATI
NA
MER
ICA
N C
OU
NTR
IES
CO
UN
TRIE
SEL
SA
LVA
DO
RM
EXIC
ON
ICA
RA
GU
APA
NA
MA
PAR
AG
UAY
PER
UU
RU
GU
AYVE
NEZ
UEL
AP
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/6.
211
25.
83.
56.
529
.53.
429
.0
DO
NAT
ION
Act
ual D
ecea
sed
Don
ors
-incl
uded
NH
BD
- (p
mp)
-31
5 (2
.8)
013
(3.7
)12
(1.9
)94
(3.2
)49
(14.
4)10
0 (3
.4)
NH
B A
ctua
l Don
ors
(pm
p)-
00
--
-0
0%
Mul
tiorg
an d
onor
s-
-0
--
-97
.98
TRA
NSP
LAN
TATI
ON
KID
NE
YTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)34
(5.5
)22
90 (2
0.4)
10 (1
.7)
39 (1
1.1)
29 (4
.5)
176
(6.0
)93
(27.
4)26
3 (9
.1)
% (L
ivin
g TX
. / T
otal
TX.
)10
078
.90
33.3
6248
.33.
231
.9P
aedi
atric
<15
yea
rs-
-0
0-
-3
30D
ecea
sed
Don
or T
X. (p
mp)
-48
4 (4
.3)
026
(7.4
)11
(1.7
)91
(3.1
)90
(26.
5)17
9 (6
.2)
-Sin
gle
TX. (
pmp)
--
026
(7.4
)-
-90
(26.
5)17
9 (6
.2)
-Dou
ble
TX. (
pmp)
--
0-
--
00
Livi
ng T
X. (p
mp)
34 (5
.5)
1806
(16.
1)10
(1.7
)13
(3.7
)18
(2.8
)85
(2.9
)3
(0.9
)84
(2.9
)N
HB
Kid
ney
TX. (
pmp)
-0
0-
--
00
LIVE
RTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)-
80 (0
.7)
0-
-22
(0.7
)12
(3.5
)8
(0.3
)P
aedi
atric
<15
yea
rs-
--
--
-0
4S
plit
Live
r TX
. (pm
p)-
--
--
-0
0D
omin
o Li
ver
TX. (
pmp)
--
--
--
00
Livi
ng L
iver
TX.
(pm
p)-
8 (0
.1)
--
--
08
(0.3
)N
HB
Liv
er T
X. (p
mp)
-0
--
--
00
HE
AR
TTX
. -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)-
15 (0
.1)
0-
1 (0
.1)
5 (0
.2)
7 (2
.1)
0P
aedi
atric
<15
yea
rs-
--
--
-0
-
HE
AR
T-LU
NG
Tran
spla
nts
(pm
p)-
00
--
-0
0P
aedi
atric
<15
yea
rs-
0-
--
-0
-
LUN
GTX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)-
00
--
1 (0
.0)
2 (0
.6)
0P
aedi
atric
<15
yea
rs-
0-
--
-0
-S
ingl
e (p
mp)
-0
--
--
2 (0
.6)
-D
oubl
e -in
clud
ed H
eart
/ Lu
ng T
X.-
(pm
p)-
0-
--
-0
-N
HB
–do
uble
+ s
ingl
e- L
ung
TX. (
pmp)
-0
--
--
0-
PAN
CR
EA
STX
. –in
clud
ed a
ll th
e co
mbi
natio
ns-
(pm
p)-
2 (0
.0)
0-
--
4 (1
.2)
0P
aedi
atric
<15
yea
rs-
--
--
-0
-K
idne
y -
Pan
crea
s TX
. (pm
p)-
2 (0
.0)
--
--
4 (1
.2)
-P
ancr
eas
TX. A
lone
(pm
p)-
0-
--
-0
-
SMA
LL B
OW
EL
TX. –
incl
uded
all
the
com
bina
tions
- (p
mp)
-0
0-
--
00
Pae
diat
ric <
15 y
ears
-0
--
--
0-
Live
r +
Sm
all B
owel
(pm
p)-
0-
--
-0
-S
mal
l Bow
el T
X. A
lone
(pm
p)-
0-
--
-0
-
MU
LTIV
ISC
ER
AL
(pm
p)-
0-
--
-0
-
38
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 38
WA
ITIN
G L
IST
EUR
OP
EAN
UN
ION
CO
UN
TRIE
SC
OU
NTR
IES
AU
STR
IAB
ELG
IUM
BU
LGA
RIA
CY
PR
US
CZE
CH
. R.
DEN
MA
RK
ESTO
NIA
FIN
LAN
DFR
AN
CE
Pop
ulat
ion
(mill
ion
inha
bita
nts)
UN
FPA
: htt
p://
ww
w.u
nfpa
.org
/pub
lic/
8.4
10.8
7.5
0.9
10.5
5.6
1.3
5.4
64.7
KID
NE
YN
º TX
CEN
TRES
--
41
73
11
44
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
036
048
825
019
400
204
5115
440
43
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-85
010
099
253
653
434
1165
9
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1081
091
460
010
065
133
747
267
8397
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
3934
765
255
34
193
Pat
ient
s on
dia
lyse
s on
31/
12/2
010
2521
500
--
323
--
LIVE
RN
º TX
CEN
TRES
--
2-
21
11
23
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
022
129
513
-16
44-
4115
79
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-49
-18
877
-46
2385
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1013
719
326
-66
32-
793
2
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
4047
10-
145
-0
169
HE
AR
TN
º TX
CEN
TRES
--
2-
22
-1
26
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
087
101
13-
9023
320
462
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-33
-16
931
437
766
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1074
6725
-89
172
2028
3
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
718
8-
52
04
76
LUN
GN
º TX
CEN
TRES
--
1-
11
11
13
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
011
411
56
-40
274
1727
0
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-6
-81
754
2044
8
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1058
906
-43
433
916
3
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
96
0-
209
04
21
PAN
CR
EA
SN
º TX
CEN
TRES
--
0-
10
-1
12
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
027
26-
-35
--
111
8
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
--
-71
--
127
6
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1026
39-
-41
--
014
5
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
1-
--
3-
-0
9
SMA
LL B
OW
EL
Nº
TX C
ENTR
ES-
-0
-1
--
16
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
-1
-0
--
-7
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-1
-0
--
-28
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
-1
-0
--
-12
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
0-
0-
--
3
39
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 39
WA
ITIN
G L
IST
EUR
OP
EAN
UN
ION
CO
UN
TRIE
SC
OU
NTR
IES
GER
MA
NY
GR
EEC
EH
UN
GA
RY
IREL
AN
DIT
ALY
LATV
IALI
THU
AN
IALU
XEM
BO
UR
GM
ALT
AP
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/81
.811
.210
.04.
660
.12.
33.
30.
50.
4
KID
NE
YN
º TX
CEN
TRES
40-
41
431
20
1
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
031
37-
351
224
2588
3476
040
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-12
4555
095
8623
129
9-
156
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1078
69-
771
564
7126
6515
50
95
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
2010
159
1213
010
Pat
ient
s on
dia
lyse
s on
31/
12/2
010
--
5532
1782
-50
013
9132
023
2
LIVE
RN
º TX
CEN
TRES
23-
11
221
20
-
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
018
46-
7346
1229
320
03
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-14
920
2670
355
-4
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1021
61-
8320
1297
327
02
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
165
195
07
00
HE
AR
TN
º TX
CEN
TRES
24-
2-
191
20
1
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
071
6-
209
465
512
02
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-38
2311
618
49-
3
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1098
1-
1416
726
627
01
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
12
980
50
1
LUN
GN
º TX
CEN
TRES
13-
0-
130
10
0
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
041
6-
818
219
02
0-
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-13
4552
20
5-
-
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1064
2-
333
342
02
0-
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
18
590
00
-
PAN
CR
EA
SN
º TX
CEN
TRES
24-
21
130
10
0
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
018
7-
13-
870
30
-
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-35
-32
00
25-
-
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1030
4-
19-
259
015
0-
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
20
10
00
-
SMA
LL B
OW
EL
Nº
TX C
ENTR
ES4
--
-3
00
00
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
--
813
00
0-
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
--
2533
00
--
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
--
2024
00
0-
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
-0
20
00
-
40
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 40
WA
ITIN
G L
IST
EUR
OP
EAN
UN
ION
CO
UN
TRIE
SC
OU
NTR
IES
NET
HER
LAN
DS
PO
LAN
DP
OR
TUG
AL
RO
MA
NIA
SLO
VAK
IASL
OVE
NIA
SPA
INSW
EDEN
U. K
.P
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/16
.638
.110
.721
.25.
42.
047
.09.
461
.9
KID
NE
YN
º TX
CEN
TRES
-18
85
4-
444
27
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
010
0013
4059
738
614
557
-32
326
30
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
2581
2708
2661
633
--
656
8603
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1089
214
5719
3524
1838
853
4434
415
7013
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
9248
5414
101
1-
229
0
Pat
ient
s on
dia
lyse
s on
31/
12/2
010
2000
090
0075
0024
00-
2334
8-
4800
0
LIVE
RN
º TX
CEN
TRES
-5
31
2-
252
7
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
016
434
520
516
265
1813
1313
144
5
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
515
338
453
95-
2092
193
1348
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1012
117
010
835
130
877
267
472
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
1734
2438
135
140
1011
5
HE
AR
TN
º TX
CEN
TRES
-5
42
1-
182
7
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
064
166
6235
2840
307
5810
4
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
242
8116
649
-39
983
301
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1067
415
2312
522
2696
2913
9
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
1155
520
54
157
24
LUN
GN
º TX
CEN
TRES
-2
10
0-
72
6
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
012
034
150
-0
276
5612
8
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
6631
0-
-45
573
468
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1021
429
220
-0
173
3325
0
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
184
10
-0
161
48
PAN
CR
EA
SN
º TX
CEN
TRES
-4
21
0-
133
10
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
028
4823
9-
113
320
200
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
8037
73-
-27
133
562
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1035
3447
58-
-16
311
313
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
33
06
--
20
14
SMA
LL B
OW
EL
Nº
TX C
ENTR
ES-
10
00
-2
14
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
20
0-
--
-29
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
20
0-
--
-43
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
20
0-
--
-19
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
-0
00
--
--
2
41
1-NEWSLETTER 2011:aula medica 04/08/11 13:19 Página 41
WA
ITIN
G L
IST
OTH
ER C
OU
NTR
IES
CO
UN
TRIE
SA
LGER
IAA
UST
RA
LIA
CA
NA
DA
CR
OA
CIA
GEO
RG
IAIC
ELA
ND
ISR
AEL
LEB
AN
ON
MA
CED
ON
IAP
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/35
.422
.334
.14.
44.
50.
37.
54.
32.
0
KID
NE
YN
º TX
CEN
TRES
1020
254
-1
67
2
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
045
--
--
-72
118
0
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
1040
0-
--
--
747
187
0
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1036
012
2323
6022
5-
-68
218
2-
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
00-
91-
-40
0-
Pat
ient
s on
dia
lyse
s on
31/
12/2
010
1400
0-
2364
740
00-
065
822
6514
00
LIVE
RN
º TX
CEN
TRES
18
93
--
31
0
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
014
--
--
-41
110
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
1096
--
--
-19
213
0
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1076
184
378
75-
-15
310
0
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
16-
74-
--
141
-
HE
AR
TN
º TX
CEN
TRES
05
112
--
32
0
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
00
--
--
-24
60
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
100
--
--
-12
78
0
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
100
8410
411
--
144
7-
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
0-
23-
-0
171
-
LUN
GN
º TX
CEN
TRES
05
60
--
2-
0
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
00
--
--
-28
-0
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
100
--
--
-98
-0
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
100
157
254
0-
-79
--
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
0-
51-
--
30-
-
PAN
CR
EA
SN
º TX
CEN
TRES
02
81
--
6-
0
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
00
--
--
-3
-0
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
100
--
--
-21
-0
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
100
3313
11
--
18-
-
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
0-
11-
--
--
-
SMA
LL B
OW
EL
Nº
TX C
ENTR
ES0
13
1-
--
-0
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
00
--
--
--
-0
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
100
--
--
--
-0
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
100
23
0-
--
--
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
0-
0-
--
--
-
42
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 42
WA
ITIN
G L
IST
OTH
ER C
OU
NTR
IES
CO
UN
TRIE
SM
OLD
OVA
NEW
ZEA
LAN
DN
OR
WAY
PALE
STIN
ESW
ITZE
RLA
ND
SYR
IATU
NIS
IATU
RK
EYU
SAP
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/3.
84.
34.
94.
57.
822
.511
.075
.731
7.6
KID
NE
YN
º TX
CEN
TRES
13
11
68
659
250
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
040
-18
2-
346
-21
346
5734
422
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
1016
0-
355
-11
71-
897
1635
735
847
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1014
066
322
330
078
0-
774
1610
389
002
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
12-
4-
26-
-34
4634
Pat
ient
s on
dia
lyse
s on
31/
12/2
010
386
--
500
-50
0085
5055
000
-
LIVE
RN
º TX
CEN
TRES
-1
10
30
234
117
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
-65
-14
3-
-14
2611
353
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-77
-25
4-
-22
0012
007
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
2810
-10
4-
-13
5416
253
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
3-
21-
--
1464
HE
AR
TN
º TX
CEN
TRES
-1
10
30
114
131
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
-24
-56
--
410
3476
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-35
-76
--
-35
26
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
1211
-31
--
-31
83
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
2-
7-
--
303
LUN
GN
º TX
CEN
TRES
-1
10
20
12
67
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
-22
-64
--
2524
21
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-77
-11
6-
--
2469
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
842
-59
--
-17
72
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
2-
5-
--
232
PAN
CR
EA
SN
º TX
CEN
TRES
-1
10
20
-4
141
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
-7
-18
--
134
2197
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
-13
-81
--
-22
89
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
84
-19
--
-35
67
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
0-
0-
--
230
SMA
LL B
OW
EL
Nº
TX C
ENTR
ES-
--
01
0-
-18
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
--
-1
--
-23
5
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
--
-1
--
-24
1
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
--
-1
--
-26
4
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
--
0-
--
15
43
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 43
WA
ITIN
G L
IST
LATI
NA
MER
ICA
N C
OU
NTR
IES
CO
UN
TRIE
SA
RG
ENTI
NA
BO
LIVI
AB
RA
SIL
CH
ILE
CO
LOM
BIA
CO
STA
RIC
AC
UB
AD
OM
INIC
AN
A
ECU
AD
OR
Pop
ulat
ion
(mill
ion
inha
bita
nts)
UN
FPA
: htt
p://
ww
w.u
nfpa
.org
/pub
lic/
40.1
10.4
195.
417
.146
.34.
611
.210
.213
.8
KID
NE
YN
º TX
CEN
TRES
510
127
-23
--
8-
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
019
590
7077
--
--
62-
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
1069
080
2262
4-
--
-92
-
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1053
830
2262
4-
932
--
--
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
761
024
05-
--
-6
-
Pat
ient
s on
dia
lyse
s on
31/
12/2
010
2603
30
7346
9-
1715
727
7-
1400
-
LIVE
RN
º TX
CEN
TRES
21-
58-
5-
-1
-
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
051
1-
1983
-24
2-
-14
-
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
1010
94-
1976
-31
6-
-45
-
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1063
2-
1976
-62
--
--
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
244
-68
1-
--
-4
-
HE
AR
TN
º TX
CEN
TRES
23-
46-
6-
--
-
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
014
3-
270
-79
--
--
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
1025
2-
231
-84
--
--
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1010
9-
231
-9
--
--
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
133
-14
8-
--
--
-
LUN
GN
º TX
CEN
TRES
11-
8-
1-
--
-
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
077
-56
-6
--
--
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
1017
8-
137
-10
--
--
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1010
1-
137
-2
--
--
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
51-
15-
2-
--
-
PAN
CR
EA
SN
º TX
CEN
TRES
13-
17-
3-
--
-
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
010
4-
55-
--
--
-
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
1022
6-
684
--
--
--
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
1012
2-
684
-2
--
--
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
10-
9-
0-
--
-
SMA
LL B
OW
EL
Nº
TX C
ENTR
ES2
-0
-2
--
--
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
019
-0
-3
--
--
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
1027
-0
-5
--
--
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
108
-0
-0
--
--
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
3-
0-
1-
--
-
44
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 44
WA
ITIN
G L
IST
LATI
NA
MER
ICA
N C
OU
NTR
IES
CO
UN
TRIE
SEL
SA
LVA
DO
RM
EXIC
ON
ICA
RA
GU
APA
NA
MA
PAR
AG
UAY
PER
UU
RU
GU
AYVE
NEZ
UEL
AP
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/6.
211
25.
83.
56.
529
.53.
429
.0
KID
NE
YN
º TX
CEN
TRES
-20
43
1-
-4
10
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
--
96-
-10
536
3
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
--
228
--
516
1074
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
7240
-17
1-
-41
354
2
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
-2
--
1026
Pat
ient
s on
dia
lyse
s on
31/
12/2
010
3653
-60
015
0268
3-
2490
1200
0
LIVE
RN
º TX
CEN
TRES
-53
0-
--
11
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
--
--
-17
6
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
--
--
-35
12
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
333
--
--
163
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
--
--
61
HE
AR
TN
º TX
CEN
TRES
-35
0-
--
20
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
--
--
-12
-
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
--
--
-32
-
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
39-
--
-23
-
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
--
--
2-
LUN
GN
º TX
CEN
TRES
-6
0-
--
00
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
--
--
-1
-
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
--
--
-3
-
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
3-
--
-1
-
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
--
--
0-
PAN
CR
EA
SN
º TX
CEN
TRES
-13
0-
--
10
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
--
--
-3
-
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
--
--
-18
-
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
0-
--
-14
-
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
--
--
0-
SMA
LL B
OW
EL
Nº
TX C
ENTR
ES-
30
--
-0
0
Pat
ient
s in
clud
ed o
n th
e W
L fo
r th
e fir
st t
ime
in t
he c
ours
e of
201
0-
--
--
-0
-
Tota
l num
ber
of p
atie
nts
activ
e on
the
WL
durin
g 20
10-
--
--
-0
-
Pat
ient
s aw
aitin
g fo
r a
tran
spla
nt (o
nly
activ
e ca
ndid
ates
) on
31/1
2/20
10-
0-
--
-0
-
Pat
ient
s w
ho d
ied
whi
le o
n th
e W
L du
ring
2010
--
--
--
0-
45
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 45
FAM
ILY
REF
USA
LS
EUR
OP
EAN
UN
ION
CO
UN
TRIE
SC
OU
NTR
IES
AU
STR
IAB
ELG
IUM
BU
LGA
RIA
CY
PR
US
CZE
CH
. R.
DEN
MA
RK
ESTO
NIA
FIN
LAN
DFR
AN
CE
Pop
ulat
ion
(mill
ion
inha
bita
nts)
UN
FPA
: htt
p://
ww
w.u
nfpa
.org
/pub
lic/
8.4
10.8
7.5
0.9
10.5
5.6
1.3
5.4
64.7
Num
ber
of in
terv
iew
s, a
skin
g fo
r co
nsen
t to
don
atio
n-
-24
727
8-
30-
-N
umbe
r of
fam
ily r
efus
als
(%)
--
4 (1
6.7)
3 (4
2.9)
13 (4
.7)
-7
(23.
3)-
559
CO
UN
TRIE
SG
ERM
AN
YG
REE
CE
HU
NG
AR
YIR
ELA
ND
ITA
LYLA
TVIA
LITH
UA
NIA
LUX
EMB
OU
RG
MA
LTA
Pop
ulat
ion
(mill
ion
inha
bita
nts)
UN
FPA
: htt
p://
ww
w.u
nfpa
.org
/pub
lic/
81.8
11.2
10.0
4.6
60.1
2.3
3.3
0.5
0.4
Num
ber
of in
terv
iew
s, a
skin
g fo
r co
nsen
t to
don
atio
n-
-24
311
922
8919
757
10N
umbe
r of
fam
ily r
efus
als
(%)
--
14 (5
.8)
23 (1
9.3)
722
(31.
5)9
(47.
4)25
(33.
3)3
(42.
9)1
(10.
0)
CO
UN
TRIE
SN
ETH
ERLA
ND
SP
OLA
ND
PO
RTU
GA
LR
OM
AN
IASL
OVA
KIA
SLO
VEN
IASP
AIN
SWED
ENU
. K.
Pop
ulat
ion
(mill
ion
inha
bita
nts)
UN
FPA
: htt
p://
ww
w.u
nfpa
.org
/pub
lic/
16.6
38.1
10.7
21.2
5.4
2.0
47.0
9.4
61.9
Num
ber
of in
terv
iew
s, a
skin
g fo
r co
nsen
t to
don
atio
n-
587
-11
798
-18
55-
2348
Num
ber
of f
amily
ref
usal
s (%
)-
51 (8
.7)
-35
(29.
9)7
(7.1
)-
353
(19.
0)-
1009
(43.
0)
OTH
ER C
OU
NTR
IES
CO
UN
TRIE
SA
LGER
IAA
UST
RA
LIA
CA
NA
DA
CR
OA
CIA
GEO
RG
IAIC
ELA
ND
ISR
AEL
LEB
AN
ON
MA
CED
ON
IAP
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/35
.422
.334
.14.
44.
50.
37.
54.
32.
0
Num
ber
of in
terv
iew
s, a
skin
g fo
r co
nsen
t to
don
atio
n-
--
167
--
122
218
-N
umbe
r of
fam
ily r
efus
als
(%)
--
-32
(19.
2)-
-62
(50.
8)18
1 (8
3.0)
-
CO
UN
TRIE
SM
OLD
OVA
NEW
ZEA
LAN
DN
OR
WAY
PALE
STIN
ESW
ITZE
RLA
ND
SYR
IATU
NIS
IATU
RK
EYU
SAP
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/3.
84.
34.
94.
57.
822
.511
.075
.731
7.6
Num
ber
of in
terv
iew
s, a
skin
g fo
r co
nsen
t to
don
atio
n-
--
--
-48
--
Num
ber
of f
amily
ref
usal
s (%
)-
--
--
-32
(66.
7)-
-
LATI
NA
MER
ICA
N C
OU
NTR
IES
CO
UN
TRIE
SA
RG
ENTI
NA
BO
LIVI
AB
RA
SIL
CH
ILE
CO
LOM
BIA
CO
STA
RIC
AC
UB
AD
OM
INIC
AN
A
ECU
AD
OR
Pop
ulat
ion
(mill
ion
inha
bita
nts)
UN
FPA
: htt
p://
ww
w.u
nfpa
.org
/pub
lic/
40.1
10.4
195.
417
.146
.34.
611
.210
.213
.8
Num
ber
of in
terv
iew
s, a
skin
g fo
r co
nsen
t to
don
atio
n12
5250
6979
--
--
28-
Num
ber
of f
amily
ref
usal
s (%
)58
2 (4
6.5)
35 (7
0.0)
1800
(25.
8)(3
7.0)
(25.
5)-
(22.
0)15
(53.
6)-
CO
UN
TRIE
SEL
SA
LVA
DO
RM
EXIC
ON
ICA
RA
GU
APA
NA
MA
PAR
AG
UAY
PER
UU
RU
GU
AYVE
NEZ
UEL
AP
opul
atio
n (m
illio
n in
habi
tant
s)U
NFP
A: h
ttp:
//w
ww
.unf
pa.o
rg/p
ublic
/6.
211
25.
83.
56.
529
.53.
429
.0
Num
ber
of in
terv
iew
s, a
skin
g fo
r co
nsen
t to
don
atio
n-
--
27-
-19
319
8N
umbe
r of
fam
ily r
efus
als
(%)
--
-10
(37.
0)-
-31
(16.
1)54
(27.
3)
46
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 46
International Data on Tissue and Hematopoeitic Stem Cell
Donation and Transplantation Activity. Year 2010
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 47
Data recorded & prepared by: EUROCET - European Network of Competent Authorities for Tissues and Cells - Team (www.eurocet.org)
TISSUE & HEMATOPOIETIC STEM CELL NATIONAL DATA PROVIDED BY:
48
AUSTRIABELGIUMBULGARIAIordan PeevCYPRUSCarolina StylianouCZECH REPUBLICPavel B ezovskýEva K emenováDENMARKESTONIAPille HarrisonEliisa LukkFINLANDFRANCEArnaud De GuerraGERMANYJohanna StrobelRalf R. TönjesGREECEHUNGARYIRELANDITALYFiorenza BarianiLetizia LombardiniLATVIAAnita DaugavvanagaLITHUANIADainora MedeisieneLUXEMBURGMALTARichard ZammitMiriam VellaNETHERLANDSPOLANDArtur KaminskiIzabela Uhrynowska-TyszkiewiczPORTUGALMargarida Amil DiazCatarina BolotinhaROMANIARosana TurcuAndrei NicaSLOVAKIAJan KollerSLOVENIADanica AvsecLea LampretSPAINBibiana RamosMarina AlvarezRosario MarazuelaSWEDENHelena StrömMona HanssonUNITED KINGDOM Christiane Niederlaender Lucy Sahota
CROATIAVanja NikolacKristina StankoviSandra TomljenoviICELANDMACEDONIANORWAYSWITZERLANDTURKEYHalil Yilmaz SurNuran Erden
ARGENTINACarlos SorattiMartín Alejandro TorresRicardo Rubén IbarBOLIVIAOlker Calla RivadeneiraBRASILHeder Murari BorbaCOLOMBIAJuan Gonzalo López CasasCOSTA RICAClive Montalbert-SmithDOMINICANAFernando Morales BilliniMEXICOEnrique Martínez GutiérrezOmar Sánchez RamírezNICARAGUATulio René Mendieta AlonsoPANAMACesar Cuero ZambranoURUGUAYInés AlvarezRaul José MizrajiVENEZUELACarmen Luisa Lattuf de MilanésZoraida Pacheco Graterol
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 48
PR
ELIM
INA
RY
DAT
A O
N T
ISSU
ES -
YEA
R 2
010
EUR
OP
EAN
UN
ION
CO
UN
TRIE
S C
ou
ntr
yA
US
TR
IAB
EL
GIU
MB
UL
GA
RIA
CY
PR
US
CZ
EC
H R
.D
EN
MA
RK
ES
TO
NIA
FIN
LA
ND
FR
AN
CE
Po
pu
lati
on
(F
on
t: e
uro
sta
t)8.3
75.2
90
10.8
39.9
05
7.5
63.7
10
803.1
47
10.5
06.8
13
5.5
29.4
49
1.3
40.1
27
5.3
51.4
27
64.7
16.3
10
TY
PE
OF
TIS
SU
ET
YP
E O
F D
ATA
NO
DA
TAN
O D
ATA
NO
DA
TAN
O D
ATA
CO
RN
EA
N.
of
tiss
ue d
onatio
ns
133
0589
34
4.8
90
Tis
sue d
onatio
n P
MP
17,6
0,0
56,1
25,4
75,6
N°
of
tis
sue r
etr
ieve
d0
01.1
81
40
9.7
90
N°
tiss
ue p
rocess
ed
(units)
133
0918
40
9.7
90
N°
tiss
ue d
istr
ibute
d (
units)
95
0852
40
4.0
37
N°
tiss
ue i
mp
ort
ed
(units)
25
00
0N
° tiss
ue e
xpo
rted
(units)
0289
0204
N°
of
tiss
ues
transp
lante
d0
25
040
2.8
48
N°
of
patients
tra
nsp
lante
d0
24
564
40
NR
N°
of
transp
lants
025
564
40
2.8
48
SK
INN
. o
f tiss
ue d
onatio
ns
42
047
0184
Tis
sue d
onatio
n P
MP
5,6
0,0
4,5
0,0
2,8
N°
of
tis
sue r
etr
ieve
d (
cm
2)
00
95.3
20
0374.0
60
N°
tiss
ue p
rocess
ed
(units)
42
032
0398.4
13
N°
tiss
ue d
istr
ibute
d (
units)
29
0903
0237977 c
m2
N°
tiss
ue i
mp
ort
ed
(units)
00
055.6
30
N°
tiss
ue e
xpo
rted
(units)
29
903
00
N°
of
tiss
ues
transp
lante
d0
00
0N
RN
° o
f p
atients
tra
nsp
lante
d0
00
0N
RN
° o
f tr
ansp
lants
00
00
NR
CA
RD
IAC
TIS
SU
EN
. o
f tiss
ue d
onatio
ns
00
60
147
Tis
sue d
onatio
n P
MP
0,0
0,0
0,6
0,0
2,3
N°
of
tis
sue r
etr
ieve
d0
0113
0417
N°
tiss
ue p
rocess
ed
(units)
00
56
0417
N°
tiss
ue d
istr
ibute
d (
units)
00
89
0178
N°
tiss
ue i
mp
ort
ed
(units)
00
60
N°
tiss
ue e
xpo
rted
(units)
35
00
N°
of
tiss
ues
transp
lante
d0
00
0N
RN
° o
f p
atients
tra
nsp
lante
d0
054
0N
RN
° o
f tr
ansp
lants
00
54
0N
R
BLO
OD
VE
SS
EL
N.
of
tiss
ue d
onatio
ns
00
74
9277
Tis
sue d
onatio
n P
MP
0,0
0,0
7,0
6,7
4,3
N°
of
tis
sue r
etr
ieve
d0
010
16
0N
° tiss
ue p
rocess
ed
(units)
00
416
3.8
07
N°
tiss
ue d
istr
ibute
d (
units)
00
414
1.0
93
N°
tiss
ue i
mp
ort
ed
(units)
00
40
N°
tiss
ue e
xpo
rted
(units)
00
14
N°
of
tiss
ues
transp
lante
d0
00
16
NR
N°
of
patients
tra
nsp
lante
d0
04
30
NR
N°
of
transp
lants
00
431
NR
MU
SC
ULO
SK
ELE
TAL
N.
of
tiss
ue d
onatio
ns
3.1
90
0750
159
60
Tis
sue d
onatio
n P
MP
421,8
0,0
71,4
118,6
0,9
N°
of
tis
sue r
etr
ieve
d0
01.8
44
159
19.3
29
N°
tiss
ue p
rocess
ed
(units)
3.0
32
2.0
39
228
678
N°
tiss
ue d
istr
ibute
d (
units)
2.9
82
2.0
22
135
229
N°
tiss
ue i
mp
ort
ed
(units)
00
014
N°
tiss
ue e
xpo
rted
(units)
2.9
72
39
00
N°
of
tiss
ues
transp
lante
d0
00
84
NR
N°
of
patients
tra
nsp
lante
d0
01.9
93
0N
RN
° o
f tr
ansp
lants
00
1.9
93
135
NR
PLA
CE
NTA
/AM
NIO
TIC
N
. o
f tiss
ue d
onatio
ns
00
14
24
NE
ME
MB
RA
NE
Tis
sue d
onatio
n P
MP
0,0
0,0
1,3
17,9
NE
N°
of
tis
sue r
etr
ieve
d0
014
24
77
N°
tiss
ue p
rocess
ed
(units)
29
0765
55
2.4
50
N°
tiss
ue d
istr
ibute
d (
units)
31
0602
48
2.3
31
N°
tiss
ue i
mp
ort
ed
(units)
00
0N
° tiss
ue e
xpo
rted
(units)
28
00
N°
of
tiss
ues
transp
lante
d0
00
0N
RN
° o
f p
atients
tra
nsp
lante
d0
0574
48
NR
N°
of
transp
lants
00
574
48
NR
OT
HE
RS
N.
of
tiss
ue d
onatio
ns
00
00
0T
issu
e d
onatio
n P
MP
0,0
0,0
0,0
0,0
0,0
N°
of
tis
sue r
etr
ieve
d0
00
0161
N°
tiss
ue p
rocess
ed
(units)
00
00
161
N°
tiss
ue d
istr
ibute
d (
units)
00
00
20
N°
tiss
ue i
mp
ort
ed
(units)
00
0N
° tiss
ue e
xpo
rted
(units)
00
0N
° o
f tiss
ues
transp
lante
d0
00
0N
RN
° o
f p
atients
tra
nsp
lante
d0
00
0N
RN
° o
f tr
ansp
lants
00
00
NR
49
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 49
PR
ELIM
INA
RY
DAT
A O
N T
ISSU
ES -
YEA
R 2
010
EUR
OP
EAN
UN
ION
CO
UN
TRIE
S C
ou
ntr
yG
ER
MA
NY
GR
EE
CE
HU
NG
AR
YIR
EL
AN
DIT
ALY
LA
TV
IAL
ITH
UA
NIA
LU
XE
MB
OU
RG
MA
LTA
Po
pu
lati
on
(F
on
t: e
uro
sta
t)81.8
02.2
57
11.3
05.1
18
10.0
14.3
24
4.4
67.8
54
60.3
40.3
28
2.2
48.3
74
3.3
29.0
39
502.0
66
414.3
72
TY
PE
OF
TIS
SU
ET
YP
E O
F D
ATA
NO
DA
TAN
O D
ATA
NO
DA
TAN
O D
ATA
CO
RN
EA
N.
of
tiss
ue d
onatio
ns
6.5
21
6.7
76
23
22
5T
issu
e d
onatio
n P
MP
79,7
112,3
10,2
6,6
12,1
N°
of
tis
sue r
etr
ieve
d0
13.3
41
36
44
9N
° tiss
ue p
rocess
ed
(units)
013.1
07
36
44
9N
° tiss
ue d
istr
ibute
d (
units)
06.6
94
36
48
9N
° tiss
ue i
mp
ort
ed
(units)
480
25
00
0N
° tiss
ue e
xpo
rted
(units)
252
353
00
0N
° o
f tiss
ues
transp
lante
d3.8
90
NO
DA
TA36
48
9N
° o
f p
atients
tra
nsp
lante
d0
NO
DA
TA36
47
9N
° o
f tr
ansp
lants
05.1
84
36
48
9
SK
INN
. o
f tiss
ue d
onatio
ns
NO
DA
TA379
00
0T
issu
e d
onatio
n P
MP
0,0
6,3
0,0
0,0
0,0
N°
of
tis
sue r
etr
ieve
d (
cm
2)
74.5
04
1.1
79.8
62
00
0N
° tiss
ue p
rocess
ed
(units)
00
00
0N
° tiss
ue d
istr
ibute
d (
units)
00
00
0N
° tiss
ue i
mp
ort
ed
(units)
189.9
70
00
00
N°
tiss
ue e
xpo
rted
(units)
5.0
70
00
00
N°
of
tiss
ues
transp
lante
d196.4
41
00
00
N°
of
patients
tra
nsp
lante
d0
00
00
N°
of
transp
lants
01.6
40
00
0
CA
RD
IAC
TIS
SU
EN
. o
f tiss
ue d
onatio
ns
175
199
00
0T
issu
e d
onatio
n P
MP
2,1
3,3
0,0
0,0
0,0
N°
of
tis
sue r
etr
ieve
d0
371
00
0N
° tiss
ue p
rocess
ed
(units)
0388
00
0N
° tiss
ue d
istr
ibute
d (
units)
0181
00
0N
° tiss
ue i
mp
ort
ed
(units)
80
00
0N
° tiss
ue e
xpo
rted
(units)
00
00
0N
° o
f tiss
ues
transp
lante
d7
00
00
N°
of
patients
tra
nsp
lante
d0
00
00
N°
of
transp
lants
0216
00
0
BLO
OD
VE
SS
EL
N.
of
tiss
ue d
onatio
ns
16
837
00
0T
issu
e d
onatio
n P
MP
0,2
13,9
0,0
0,0
0,0
N°
of
tis
sue r
etr
ieve
d0
1.1
33
00
0N
° tiss
ue p
rocess
ed
(units)
01.1
33
00
0N
° tiss
ue d
istr
ibute
d (
units)
0520
00
0N
° tiss
ue i
mp
ort
ed
(units)
415
00
0N
° tiss
ue e
xpo
rted
(units)
00
00
0N
° o
f tiss
ues
transp
lante
d19
00
00
N°
of
patients
tra
nsp
lante
d0
00
00
N°
of
transp
lants
0313
00
0
MU
SC
ULO
SK
ELE
TAL
N.
of
tiss
ue d
onatio
ns
5.6
28
3.0
36
66
93
0T
issu
e d
onatio
n P
MP
68,8
50,3
29,4
27,9
0,0
N°
of
tis
sue r
etr
ieve
d0
7.0
89
66
93
0N
° tiss
ue p
rocess
ed
(units)
00
179
112
0N
° tiss
ue d
istr
ibute
d (
units)
033.8
23
179
87
1N
° tiss
ue i
mp
ort
ed
(units)
907
00
00
N°
tiss
ue e
xpo
rted
(units)
687
570
00
0N
° o
f tiss
ues
transp
lante
d3.7
69
0180
83
1N
° o
f p
atients
tra
nsp
lante
d0
0161
79
1N
° o
f tr
ansp
lants
06.5
37
180
83
1
PLA
CE
NTA
/AM
NIO
TIC
N
. o
f tiss
ue d
onatio
ns
469
228
73
11
0M
EM
BR
AN
ET
issu
e d
onatio
n P
MP
5,7
3,8
32,5
3,3
0,0
N°
of
tis
sue r
etr
ieve
d0
228
73
11
0N
° tiss
ue p
rocess
ed
(units)
0244
73
172
0N
° tiss
ue d
istr
ibute
d (
units)
00
61
79
0N
° tiss
ue i
mp
ort
ed
(units)
00
00
0N
° tiss
ue e
xpo
rted
(units)
75
36
00
0N
° o
f tiss
ues
transp
lante
d2.3
81
00
79
0N
° o
f p
atients
tra
nsp
lante
d0
00
68
0N
° o
f tr
ansp
lants
01.0
78
73
79
0
OT
HE
RS
N.
of
tiss
ue d
onatio
ns
236
00
00
Tis
sue d
onatio
n P
MP
2,9
0,0
0,0
0,0
0,0
N°
of
tis
sue r
etr
ieve
d0
00
00
N°
tiss
ue p
rocess
ed
(units)
00
00
0N
° tiss
ue d
istr
ibute
d (
units)
00
00
0N
° tiss
ue i
mp
ort
ed
(units)
00
00
0N
° tiss
ue e
xpo
rted
(units)
00
00
0N
° o
f tiss
ues
transp
lante
d157
00
00
N°
of
patients
tra
nsp
lante
d0
00
00
N°
of
transp
lants
00
00
0
50
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 50
PR
ELIM
INA
RY
DAT
A O
N T
ISSU
ES -
YEA
R 2
010
EUR
OP
EAN
UN
ION
CO
UN
TRIE
S C
ou
ntr
yN
ET
HE
RLA
ND
SP
OL
AN
DP
OR
TU
GA
LR
OM
AN
IAS
LO
VA
KIA
SL
OV
EN
IAS
PA
INS
WE
DE
NU
. K
.P
op
ula
tio
n (
Fo
nt:
eu
rost
at)
16.5
74.9
89
38.1
67.3
29
10.6
37.7
13
21.4
62.1
86
5.4
24.9
25
2.0
46.9
76
45.9
89.0
16
9.3
40.6
82
62.0
08.0
48
TY
PE
OF
TIS
SU
ET
YP
E O
F D
ATA
NO
DA
TA
CO
RN
EA
N.
of
tiss
ue d
onatio
ns
480
520
13
114
63
3.5
56
202
0T
issu
e d
onatio
n P
MP
12,6
48,9
0,6
21,0
30,8
77,3
21,6
0,0
N°
of
tis
sue r
etr
ieve
d716
1.0
02
26
216
123
5.1
82
403
12.4
23
N°
tiss
ue p
rocess
ed
(units)
831
1.0
02
26
216
123
3.4
26
403
7.1
00
N°
tiss
ue d
istr
ibute
d (
units)
638
828
26
175
72
3.5
82
364
2.6
99
N°
tiss
ue i
mp
ort
ed
(units)
0109
00
05
0489
N°
tiss
ue e
xpo
rted
(units)
00
00
06
02.6
99
N°
of
tiss
ues
transp
lante
d0
937
26
00
0364
0N
° o
f p
atients
tra
nsp
lante
d0
937
26
176
72
3.3
15
00
N°
of
transp
lants
0937
26
072
0364
0
SK
INN
. o
f tiss
ue d
onatio
ns
40
111
15
45
266
60
0T
issu
e d
onatio
n P
MP
1,0
0,1
0,5
2,8
22,0
5,8
6,4
0,0
N°
of
tis
sue r
etr
ieve
d (
cm
2)
104.3
64
1.2
00
16.0
69
84.4
31
0704.8
50
00
N°
tiss
ue p
rocess
ed
(units)
945
11
00
60
060
569
N°
tiss
ue d
istr
ibute
d (
units)
405
00
010
020
742
N°
tiss
ue i
mp
ort
ed
(units)
04.7
53cm
20
00
00
3.2
27
N°
tiss
ue e
xpo
rted
(units)
00
00
08
0742
N°
of
tiss
ues
transp
lante
d0
4.2
05 c
m2
00
0195.2
99
20
0N
° o
f p
atients
tra
nsp
lante
d0
35
20
60
00
N°
of
transp
lants
03
50
10
00
0
CA
RD
IAC
TIS
SU
EN
. o
f tiss
ue d
onatio
ns
151
18
014
0227
244
0T
issu
e d
onatio
n P
MP
4,0
1,7
0,0
2,6
0,0
4,9
26,1
0,0
N°
of
tis
sue r
etr
ieve
d302
36
022
0344
244
1.2
07
N°
tiss
ue p
rocess
ed
(units)
151
10
022
0251
244
1.0
28
N°
tiss
ue d
istr
ibute
d (
units)
133
60
40
179
154
486
N°
tiss
ue i
mp
ort
ed
(units)
00
00
00
0121
N°
tiss
ue e
xpo
rted
(units)
21
00
00
91
0511
N°
of
tiss
ues
transp
lante
d0
60
00
177
151
0N
° o
f p
atients
tra
nsp
lante
d0
NO
DA
TA0
40
56
00
N°
of
transp
lants
0N
O D
ATA
00
00
00
BLO
OD
VE
SS
EL
N.
of
tiss
ue d
onatio
ns
9190
02
0235
60
Tis
sue d
onatio
n P
MP
0,2
17,9
0,0
0,4
0,0
5,1
0,6
0,0
N°
of
tis
sue r
etr
ieve
d10
190
02
0396
6394
N°
tiss
ue p
rocess
ed
(units)
10
00
20
333
6154
N°
tiss
ue d
istr
ibute
d (
units)
20
02
0255
318
N°
tiss
ue i
mp
ort
ed
(units)
00
00
00
0596
N°
tiss
ue e
xpo
rted
(units)
00
00
039
045
N°
of
tiss
ues
transp
lante
d0
24
00
0245
30
N°
of
patients
tra
nsp
lante
d0
NO
DA
TA0
00
112
00
N°
of
transp
lants
0N
O D
ATA
00
00
00
MU
SC
ULO
SK
ELE
TAL
N.
of
tiss
ue d
onatio
ns
432
47
32
747
02.2
04
1.6
59
0T
issu
e d
onatio
n P
MP
11,3
4,4
1,5
137,7
0,0
47,9
177,6
0,0
N°
of
tis
sue r
etr
ieve
d3.1
53
403
29
1.7
53
013.0
43
1.6
59
12.8
20
N°
tiss
ue p
rocess
ed
(units)
9.2
28
404
29
1.0
04
44
13.3
56
1.6
59
1.2
59
N°
tiss
ue d
istr
ibute
d (
units)
9.3
70
1.2
97
19
342
57
9.7
64
1.0
13
7.7
90
N°
tiss
ue i
mp
ort
ed
(units)
0718
00
03
013.7
20
N°
tiss
ue e
xpo
rted
(units)
00
04.0
12
075
57.9
64
N°
of
tiss
ues
transp
lante
d0
349
29
00
9.5
79
1.0
13
0N
° o
f p
atients
tra
nsp
lante
d0
NO
DA
TA14
342
09.5
04
00
N°
of
transp
lants
0N
O D
ATA
14
057
00
0
PLA
CE
NTA
/AM
NIO
TIC
N
. o
f tiss
ue d
onatio
ns
80
102
012
049
70
ME
MB
RA
NE
Tis
sue d
onatio
n P
MP
2,1
9,6
0,0
2,2
0,0
1,1
0,7
0,0
N°
of
tis
sue r
etr
ieve
d80
103
012
049
70
N°
tiss
ue p
rocess
ed
(units)
860
402
00
02.3
72
418
99
N°
tiss
ue d
istr
ibute
d (
units)
817
169
00
01.4
51
364
246
N°
tiss
ue i
mp
ort
ed
(units)
00
00
00
0128
N°
tiss
ue e
xpo
rted
(units)
00
00
04
0246
N°
of
tiss
ues
transp
lante
d0
169
00
01.4
93
364
0N
° o
f p
atients
tra
nsp
lante
d0
NO
DA
TA0
119
01.3
65
00
N°
of
transp
lants
0N
O D
ATA
00
00
00
OT
HE
RS
N.
of
tiss
ue d
onatio
ns
01
00
00
40
0T
issu
e d
onatio
n P
MP
0,0
0,1
0,0
0,0
0,0
0,0
4,3
0,0
N°
of
tis
sue r
etr
ieve
d16
10
749
00
40
8.9
31
N°
tiss
ue p
rocess
ed
(units)
01
00
00
08.4
28
N°
tiss
ue d
istr
ibute
d (
units)
032
00
00
016
N°
tiss
ue i
mp
ort
ed
(units)
08
00
00
01.1
38
N°
tiss
ue e
xpo
rted
(units)
00
00
00
016
N°
of
tiss
ues
transp
lante
d0
90
00
00
0N
° o
f p
atients
tra
nsp
lante
d0
NO
DA
TA0
00
00
0N
° o
f tr
ansp
lants
0N
O D
ATA
00
00
00
51
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 51
PR
ELIM
INA
RY
DAT
A O
N T
ISSU
ES -
YEA
R 2
010
OTH
ER C
OU
NTR
IES
Co
un
try
CR
OA
TIA
ICE
LA
ND
MA
CE
DO
NIA
NO
RW
AY
SW
ITZ
ER
LA
ND
TU
RK
EY
Po
pu
lati
on
(F
on
t: e
uro
sta
t)4.4
25.7
47
317.6
30
2.0
52.7
22
4.8
58.1
99
7.7
85.8
06
72.5
61.3
12
TY
PE
OF
TIS
SU
ET
YP
E O
F D
ATA
NO
DA
TAN
O D
ATA
NO
DA
TAN
O D
ATA
CO
RN
EA
N.
of
tiss
ue d
onatio
ns
64
870
Tis
sue d
onatio
n P
MP
14,5
12,0
N°
of
tis
sue r
etr
ieve
d126
1.7
35
N°
tiss
ue p
rocess
ed
(units)
126
1.7
35
N°
tiss
ue d
istr
ibute
d (
units)
92
1.5
42
N°
tiss
ue i
mp
ort
ed
(units)
58
0N
° tiss
ue e
xpo
rted
(units)
00
N°
of
tiss
ues
transp
lante
d153
0N
° o
f p
atients
tra
nsp
lante
d149
0N
° o
f tr
ansp
lants
153
1.5
42
SK
INN
. o
f tiss
ue d
onatio
ns
80
Tis
sue d
onatio
n P
MP
1,8
0,0
N°
of
tis
sue r
etr
ieve
d (
cm
2)
24
0N
° tiss
ue p
rocess
ed
(units)
00
N°
tiss
ue d
istr
ibute
d (
units)
00
N°
tiss
ue i
mp
ort
ed
(units)
00
N°
tiss
ue e
xpo
rted
(units)
00
N°
of
tiss
ues
transp
lante
d27
0N
° o
f p
atients
tra
nsp
lante
d1
0N
° o
f tr
ansp
lants
20
CA
RD
IAC
TIS
SU
EN
. o
f tiss
ue d
onatio
ns
018
Tis
sue d
onatio
n P
MP
0,0
0,2
N°
of
tis
sue r
etr
ieve
d0
0N
° tiss
ue p
rocess
ed
(units)
00
N°
tiss
ue d
istr
ibute
d (
units)
00
N°
tiss
ue i
mp
ort
ed
(units)
00
N°
tiss
ue e
xpo
rted
(units)
00
N°
of
tiss
ues
transp
lante
d0
18
N°
of
patients
tra
nsp
lante
d0
18
N°
of
transp
lants
018
BLO
OD
VE
SS
EL
N.
of
tiss
ue d
onatio
ns
00
Tis
sue d
onatio
n P
MP
0,0
0,0
N°
of
tis
sue r
etr
ieve
d0
0N
° tiss
ue p
rocess
ed
(units)
00
N°
tiss
ue d
istr
ibute
d (
units)
00
N°
tiss
ue i
mp
ort
ed
(units)
00
N°
tiss
ue e
xpo
rted
(units)
00
N°
of
tiss
ues
transp
lante
d0
0N
° o
f p
atients
tra
nsp
lante
d0
0N
° o
f tr
ansp
lants
00
MU
SC
ULO
SK
ELE
TAL
N.
of
tiss
ue d
onatio
ns
161
0T
issu
e d
onatio
n P
MP
36,4
0,0
N°
of
tis
sue r
etr
ieve
d161
0N
° tiss
ue p
rocess
ed
(units)
335
0N
° tiss
ue d
istr
ibute
d (
units)
263
0N
° tiss
ue i
mp
ort
ed
(units)
00
N°
tiss
ue e
xpo
rted
(units)
00
N°
of
tiss
ues
transp
lante
d280
0N
° o
f p
atients
tra
nsp
lante
d235
0N
° o
f tr
ansp
lants
235
0
PLA
CE
NTA
/AM
NIO
TIC
N
. o
f tiss
ue d
onatio
ns
00
ME
MB
RA
NE
Tis
sue d
onatio
n P
MP
0,0
0,0
N°
of
tis
sue r
etr
ieve
d0
0N
° tiss
ue p
rocess
ed
(units)
00
N°
tiss
ue d
istr
ibute
d (
units)
00
N°
tiss
ue i
mp
ort
ed
(units)
31
0N
° tiss
ue e
xpo
rted
(units)
00
N°
of
tiss
ues
transp
lante
d31
0N
° o
f p
atients
tra
nsp
lante
d18
0N
° o
f tr
ansp
lants
31
0
OT
HE
RS
N.
of
tiss
ue d
onatio
ns
00
Tis
sue d
onatio
n P
MP
0,0
0,0
N°
of
tis
sue r
etr
ieve
d0
0N
° tiss
ue p
rocess
ed
(units)
00
N°
tiss
ue d
istr
ibute
d (
units)
00
N°
tiss
ue i
mp
ort
ed
(units)
00
N°
tiss
ue e
xpo
rted
(units)
00
N°
of
tiss
ues
transp
lante
d0
0N
° o
f p
atients
tra
nsp
lante
d0
0N
° o
f tr
ansp
lants
00
52
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 52
PR
ELIM
INA
RY
DAT
A O
N T
ISSU
ES -
YEA
R 2
010
LATI
NA
MER
ICA
N C
OU
NTR
IES
Co
un
try
ARG
ENTI
NABO
LIVI
ABR
ASIL
COLO
MBI
ACO
STA
RICA
DOM
INIC
ANA
MEX
ICO
NICA
RAG
UAPA
NAM
AUR
UGUA
YVE
NEZU
ELA
Po
pu
lati
on
(F
on
t: U
NF
PA
)40,1
10,4
195,4
46,3
4,6
10,2
112,0
5,8
3,5
3,4
29,0
TY
PE
OF
TIS
SU
ET
YP
E O
F D
ATA
CO
RN
EA
N.
of
tiss
ue d
onatio
ns
712
011.7
50
1.4
05
114
0774
048
62
64
Tis
sue d
onatio
n P
MP
17,8
0,0
60,1
30,9
25,3
0,0
6,9
0,0
13,7
18,8
2,3
N°
of
tis
sue r
etr
ieve
dN
° tiss
ue p
rocess
ed
(units)
1.4
26
019.7
51
2.6
97
227
0-
096
120
122
N°
tiss
ue d
istr
ibute
d (
units)
N°
tiss
ue i
mp
ort
ed
(units)
N°
tiss
ue e
xpo
rted
(units)
N°
of
tiss
ues
transp
lante
dN
° o
f p
atients
tra
nsp
lante
d943
012.9
23
2.3
32
187
162
2.1
75
094
107
122
N°
of
transp
lants
SK
INN
. o
f tiss
ue d
onatio
ns
29
023
24
50
26
00
90
Tis
sue d
onatio
n P
MP
0,7
0,0
0,1
0,5
1,1
0,0
0,2
0,0
0,0
2,7
0,0
N°
of
tis
sue r
etr
ieve
d (
cm
2)
N°
tiss
ue p
rocess
ed
(units)
21.9
45
022.5
48
24
5.0
60
0-
00
11.5
00
0N
° tiss
ue d
istr
ibute
d (
units)
N°
tiss
ue i
mp
ort
ed
(units)
N°
tiss
ue e
xpo
rted
(units)
N°
of
tiss
ues
transp
lante
dN
° o
f p
atients
tra
nsp
lante
d33
019
33
10
-0
014
0N
° o
f tr
ansp
lants
CA
RD
IAC
TIS
SU
EN
. o
f tiss
ue d
onatio
ns
10
048
10
00
03
9T
issu
e d
onatio
n P
MP
0,0
20,0
0,0
1,1
0,2
0,0
0,0
0,0
0,0
0,9
0,3
N°
of
tis
sue r
etr
ieve
dN
° tiss
ue p
rocess
ed
(units)
10
064
20
00
06
18
N°
tiss
ue d
istr
ibute
d (
units)
N°
tiss
ue i
mp
ort
ed
(units)
N°
tiss
ue e
xpo
rted
(units)
N°
of
tiss
ues
transp
lante
dN
° o
f p
atients
tra
nsp
lante
d1
00
48
00
00
03
0N
° o
f tr
ansp
lants
BLO
OD
VE
SS
EL
N.
of
tiss
ue d
onatio
ns
303
072
00
00
00
14
0T
issu
e d
onatio
n P
MP
7,6
0,0
0,4
0,0
0,0
0,0
0,0
0,0
0,0
4,2
0,0
N°
of
tis
sue r
etr
ieve
dN
° tiss
ue p
rocess
ed
(units)
651
0137
00
00
00
27
0N
° tiss
ue d
istr
ibute
d (
units)
N°
tiss
ue i
mp
ort
ed
(units)
N°
tiss
ue e
xpo
rted
(units)
N°
of
tiss
ues
transp
lante
dN
° o
f p
atients
tra
nsp
lante
d216
072
00
00
00
18
0N
° o
f tr
ansp
lants
MU
SC
ULO
SK
ELE
TAL
N.
of
tiss
ue d
onatio
ns
1.4
54
087
255
00
160
10
023
0T
issu
e d
onatio
n P
MP
36,3
0,0
0,4
5,6
0,0
0,0
1,4
1,7
0,0
7,0
0,0
N°
of
tis
sue r
etr
ieve
dN
° tiss
ue p
rocess
ed
(units)
1.6
45
016.6
56
4.0
48
00
-0
039
0N
° tiss
ue d
istr
ibute
d (
units)
N°
tiss
ue i
mp
ort
ed
(units)
N°
tiss
ue e
xpo
rted
(units)
N°
of
tiss
ues
transp
lante
dN
° o
f p
atients
tra
nsp
lante
d1.4
86
016.5
14
17.1
15
00
-0
0151
0N
° o
f tr
ansp
lants
PLA
CE
NTA
/AM
NIO
TIC
N
. o
f tiss
ue d
onatio
ns
ME
MB
RA
NE
Tis
sue d
onatio
n P
MP
N°
of
tis
sue r
etr
ieve
dN
° tiss
ue p
rocess
ed
(units)
N°
tiss
ue d
istr
ibute
d (
units)
N°
tiss
ue i
mp
ort
ed
(units)
N°
tiss
ue e
xpo
rted
(units)
N°
of
tiss
ues
transp
lante
dN
° o
f p
atients
tra
nsp
lante
dN
° o
f tr
ansp
lants
OT
HE
RS
N.
of
tiss
ue d
onatio
ns
Tis
sue d
onatio
n P
MP
N°
of
tis
sue r
etr
ieve
dN
° tiss
ue p
rocess
ed
(units)
N°
tiss
ue d
istr
ibute
d (
units)
N°
tiss
ue i
mp
ort
ed
(units)
N°
tiss
ue e
xpo
rted
(units)
N°
of
tiss
ues
transp
lante
dN
° o
f p
atients
tra
nsp
lante
dN
° o
f tr
ansp
lants
53
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 53
PR
ELIM
INA
RY
DAT
A O
N T
ISSU
ES -
YEA
R 2
010
EUR
OP
EAN
UN
ION
CO
UN
TRIE
S
Cou
ntry
AU
STR
IAB
ELG
IUM
BU
LGA
RIA
CY
PR
US
CZE
CH
R.
DEN
MA
RK
ESTO
NIA
FIN
LAN
DFR
AN
CE
Pop
ulat
ion
(Fon
t: eu
rost
at)
8.37
5.29
010
.839
.905
7.56
3.71
080
3.14
710
.506
.813
5.52
9.44
91.
340.
127
5.35
1.42
764
.716
.310
CAT
EGO
RY
OF
DAT
ATY
PE
OF
DAT
AN
O D
ATA
NO
DAT
AN
O D
ATA
NO
DAT
A
PO
TEN
TIA
L D
ON
ATIO
NN
° of
pot
entia
l don
ors
at 3
1.12
012
3.03
720
.199
018
7.51
9
AN
D S
EAR
CH
ING
N°
of c
oord
blo
od u
nit
at 3
1.12
839
133
3.61
20
10.9
06
IN T
HE
NAT
ION
AL
N°
of s
earc
hes
requ
este
d0
00
018
.523
REG
ISTR
IES
N°
of u
nrel
ated
don
atio
n0
00
01.
221
DO
NAT
ION
N°
of d
onat
ion
- A
utol
ogou
s63
300
293.
102
N°
of d
onat
ion
- A
lloge
nic
728
220
1.03
6
N°
of d
onat
ion
- A
lloge
nic,
rel
ated
70
00
681
N°
of d
onat
ion
- A
lloge
nic,
unr
elat
ed0
2822
035
5
BA
NK
ING
of
CO
RD
N
° of
unr
elat
ed c
oord
blo
od u
nits
col
lect
ed0
1.04
10
02.
562
BLO
OD
N°
of u
nrel
ated
coo
rd b
lood
uni
ts d
istr
ibut
ed0
114
014
6
N°
of u
nrel
ated
coo
rd b
lood
uni
ts a
t 31
.12
01.
344
140
10.9
06
N°
of r
elat
ed c
oord
blo
od u
nits
col
lect
ed1.
351
2.02
60
00
N°
of r
elat
ed c
oord
blo
od u
nits
dis
trib
uted
00
00
0
N°
of r
elat
ed c
oord
blo
od u
nits
at
31.1
20
13.6
970
00
Tota
l N°
of c
oord
blo
od u
nits
col
lect
ed1.
351
3.06
70
02.
562
Tota
l N°
of c
oord
blo
od u
nits
dis
trib
uted
01
140
146
Tota
l N°
of c
oord
blo
od u
nits
at
31.1
20
15.0
4114
010
.906
TRA
NS
PLA
NT
N°
of t
rans
plan
ts -
A
utol
ogou
s63
150
03.
047
N°
of p
atie
nts
tran
spla
nted
-
Aut
olog
ous
015
037
2.89
0
N°
of t
rans
plan
ts -
A
lloge
nic
00
00
1.67
1
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c0
00
01.
644
N°
of t
rans
plan
ts -
A
lloge
nic,
rel
ated
00
00
723
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c, r
elat
ed0
00
15N
A
N°
of t
rans
plan
ts -
A
lloge
nic,
unr
elat
ed0
00
394
8
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c, u
nrel
ated
00
012
NA
54
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 54
PR
ELIM
INA
RY
DAT
A O
N T
ISSU
ES -
YEA
R 2
010
EUR
OP
EAN
UN
ION
CO
UN
TRIE
S
Cou
ntry
GER
MA
NY
GR
EEC
EH
UN
GA
RY
IREL
AN
DIT
ALY
LATV
IALI
THU
AN
IALU
XEM
BOUR
GM
ALT
A
Pop
ulat
ion
(Fon
t: eu
rost
at)
81.8
02.2
5711
.305
.118
10.0
14.3
244.
467.
854
60.3
40.3
282.
248.
374
3.32
9.03
950
2.06
641
4.37
2
CAT
EGO
RY
OF
DAT
ATY
PE
OF
DAT
AN
O D
ATA
NO
DAT
AN
O D
ATA
NO
DAT
A
PO
TEN
TIA
L D
ON
ATIO
NN
° of
pot
entia
l don
ors
at 3
1.12
NO
DAT
A33
2.49
20
5.16
90
AN
D S
EAR
CH
ING
N°
of c
oord
blo
od u
nit
at 3
1.12
NO
DAT
A22
.772
00
0
IN T
HE
NAT
ION
AL
N°
of s
earc
hes
requ
este
dN
O D
ATA
2.68
50
00
REG
ISTR
IES
N°
of u
nrel
ated
don
atio
nN
O D
ATA
676
00
0
DO
NAT
ION
N°
of d
onat
ion
- A
utol
ogou
s14
.107
2.76
40
302
117
N°
of d
onat
ion
- A
lloge
nic
10.5
8621
.016
021
0
N°
of d
onat
ion
- A
lloge
nic,
rel
ated
1.02
51.
080
014
0
N°
of d
onat
ion
- A
lloge
nic,
unr
elat
ed9.
561
19.9
360
70
BA
NK
ING
of
CO
RD
N
° of
unr
elat
ed c
oord
blo
od u
nits
col
lect
ed3.
250
19.7
640
00
BLO
OD
N°
of u
nrel
ated
coo
rd b
lood
uni
ts d
istr
ibut
ed12
212
90
00
N°
of u
nrel
ated
coo
rd b
lood
uni
ts a
t 31
.12
NO
DAT
A32
.003
00
0
N°
of r
elat
ed c
oord
blo
od u
nits
col
lect
ed16
243
022
50
N°
of r
elat
ed c
oord
blo
od u
nits
dis
trib
uted
013
00
0
N°
of r
elat
ed c
oord
blo
od u
nits
at
31.1
2N
O D
ATA
2.16
30
552
0
Tota
l N°
of c
oord
blo
od u
nits
col
lect
ed3.
266
20.0
070
225
0
Tota
l N°
of c
oord
blo
od u
nits
dis
trib
uted
122
142
00
0
Tota
l N°
of c
oord
blo
od u
nits
at
31.1
2N
O D
ATA
34.1
660
552
0
TRA
NS
PLA
NT
N°
of t
rans
plan
ts -
A
utol
ogou
s3.
255
2.76
30
830
N°
of p
atie
nts
tran
spla
nted
-
Aut
olog
ous
2.77
62.
264
068
0
N°
of t
rans
plan
ts -
A
lloge
nic
2.52
51.
605
063
0
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c79
185
20
150
N°
of t
rans
plan
ts -
A
lloge
nic,
rel
ated
1.73
475
30
480
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c, r
elat
ed2.
431
1.52
90
590
N°
of t
rans
plan
ts -
A
lloge
nic,
unr
elat
ed73
978
90
130
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c, u
nrel
ated
1.69
274
00
460
55
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 55
PR
ELIM
INA
RY
DAT
A O
N T
ISSU
ES -
YEA
R 2
010
EUR
OP
EAN
UN
ION
CO
UN
TRIE
S
Cou
ntry
NETH
ERLA
NDS
PO
LAN
DP
OR
TUG
AL
RO
MA
NIA
SLO
VAK
IASL
OVE
NIA
SPA
INSW
EDEN
U. K
.
Pop
ulat
ion
(Fon
t: eu
rost
at)
16.5
74.9
8938
.167
.329
10.6
37.7
1321
.462
.186
5.42
4.92
52.
046.
976
45.9
89.0
169.
340.
682
62.0
08.0
48
CAT
EGO
RY
OF
DAT
ATY
PE
OF
DAT
AN
O D
ATA
NO
DAT
A
PO
TEN
TIA
L D
ON
ATIO
NN
° of
pot
entia
l don
ors
at 3
1.12
024
8.42
50
15.7
7386
.361
00
AN
D S
EAR
CH
ING
N°
of c
oord
blo
od u
nit
at 3
1.12
05.
712
00
47.3
240
0
IN T
HE
NAT
ION
AL
N°
of s
earc
hes
requ
este
d0
2.86
10
122
00
0
REG
ISTR
IES
N°
of u
nrel
ated
don
atio
n0
960
90
00
DO
NAT
ION
N°
of d
onat
ion
- A
utol
ogou
s1.
692
397
083
053
55.
052
N°
of d
onat
ion
- A
lloge
nic
6.41
518
10
250
02.
382
N°
of d
onat
ion
- A
lloge
nic,
rel
ated
6.41
411
30
80
063
2
N°
of d
onat
ion
- A
lloge
nic,
unr
elat
ed1
680
170
01.
750
BA
NK
ING
of
CO
RD
N
° of
unr
elat
ed c
oord
blo
od u
nits
col
lect
ed1
10.3
590
1.02
75.
435
620
BLO
OD
N°
of u
nrel
ated
coo
rd b
lood
uni
ts d
istr
ibut
ed0
00
052
254
N°
of u
nrel
ated
coo
rd b
lood
uni
ts a
t 31
.12
494
5.71
50
270
47.0
531.
666
N°
of r
elat
ed c
oord
blo
od u
nits
col
lect
ed6.
414
17.5
0030
.403
841
60
N°
of r
elat
ed c
oord
blo
od u
nits
dis
trib
uted
05
00
60
N°
of r
elat
ed c
oord
blo
od u
nits
at
31.1
230
.913
66.9
3269
.867
823
00
Tota
l N°
of c
oord
blo
od u
nits
col
lect
ed6.
415
27.8
5930
.403
1.86
85.
441
620
6.88
6
Tota
l N°
of c
oord
blo
od u
nits
dis
trib
uted
05
00
528
5412
3
Tota
l N°
of c
oord
blo
od u
nits
at
31.1
231
.407
72.6
4769
.867
1.09
347
.053
1.66
621
.786
TRA
NS
PLA
NT
N°
of t
rans
plan
ts -
A
utol
ogou
s0
286
083
1.68
00
5.66
6
N°
of p
atie
nts
tran
spla
nted
-
Aut
olog
ous
023
70
00
00
N°
of t
rans
plan
ts -
A
lloge
nic
012
40
2586
60
3.00
3
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c0
124
08
467
082
1
N°
of t
rans
plan
ts -
A
lloge
nic,
rel
ated
082
017
399
02.
182
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c, r
elat
ed0
760
00
00
N°
of t
rans
plan
ts -
A
lloge
nic,
unr
elat
ed0
500
00
00
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c, u
nrel
ated
048
00
00
0
56
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 56
PR
ELIM
INA
RY
DAT
A O
N T
ISSU
ES -
YEA
R 2
010
OTH
ER C
OU
NTR
IES
Cou
ntry
CR
OAT
IAIC
ELA
ND
MA
CED
ON
IAN
OR
WAY
SWIT
ZER
LAN
DTU
RK
EY
Pop
ulat
ion
(Fon
t: eu
rost
at)
4.42
5.74
731
7.63
02.
052.
722
4.85
8.19
97.
785.
806
72.5
61.3
12
CAT
EGO
RY
OF
DAT
ATY
PE
OF
DAT
AN
O D
ATA
NO
DAT
AN
O D
ATA
NO
DAT
A
PO
TEN
TIA
L D
ON
ATIO
NN
° of
pot
entia
l don
ors
at 3
1.12
19.3
150
AN
D S
EAR
CH
ING
N°
of c
oord
blo
od u
nit
at 3
1.12
1.00
40
IN T
HE
NAT
ION
AL
N°
of s
earc
hes
requ
este
d0
0
REG
ISTR
IES
N°
of u
nrel
ated
don
atio
n0
0
DO
NAT
ION
N°
of d
onat
ion
- A
utol
ogou
s15
10
N°
of d
onat
ion
- A
lloge
nic
1.29
50
N°
of d
onat
ion
- A
lloge
nic,
rel
ated
520
N°
of d
onat
ion
- A
lloge
nic,
unr
elat
ed1.
243
0
BA
NK
ING
of
CO
RD
N
° of
unr
elat
ed c
oord
blo
od u
nits
col
lect
ed1.
238
0
BLO
OD
N°
of u
nrel
ated
coo
rd b
lood
uni
ts d
istr
ibut
ed1
0
N°
of u
nrel
ated
coo
rd b
lood
uni
ts a
t 31
.12
1.40
90
N°
of r
elat
ed c
oord
blo
od u
nits
col
lect
ed21
1.41
4
N°
of r
elat
ed c
oord
blo
od u
nits
dis
trib
uted
20
N°
of r
elat
ed c
oord
blo
od u
nits
at
31.1
212
10
Tota
l N°
of c
oord
blo
od u
nits
col
lect
ed1.
259
1.41
4
Tota
l N°
of c
oord
blo
od u
nits
dis
trib
uted
30
Tota
l N°
of c
oord
blo
od u
nits
at
31.1
21.
530
0
TRA
NS
PLA
NT
N°
of t
rans
plan
ts -
A
utol
ogou
s91
851
N°
of p
atie
nts
tran
spla
nted
-
Aut
olog
ous
850
N°
of t
rans
plan
ts -
A
lloge
nic
4861
5
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c21
557
N°
of t
rans
plan
ts -
A
lloge
nic,
rel
ated
2758
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c, r
elat
ed48
0
N°
of t
rans
plan
ts -
A
lloge
nic,
unr
elat
ed21
0
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c, u
nrel
ated
270
57
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 57
PR
ELIM
INA
RY
DAT
A O
N T
ISSU
ES -
YEA
R 2
010
LATI
NA
MER
ICA
N C
OU
NTR
IES
Cou
ntry
ARG
ENTI
NABO
LIVI
ABR
ASIL
COLO
MBI
ACO
STA
RICA
DOM
INIC
ANA
MEX
ICO
NICA
RAG
UAPA
NAM
AUR
UGUA
YVE
NEZU
ELA
Pop
ulat
ion
(Fon
t: U
NFP
A)
40,1
10,4
195,
446
,34,
610
,211
2,0
5,8
3,5
3,4
29,0
TYP
E O
F D
ATA
NO
DAT
A
PO
TEN
TIA
L D
ON
ATIO
NN
° of
pot
entia
l don
ors
at 3
1.12
AN
D S
EAR
CH
ING
N°
of c
oord
blo
od u
nit
at 3
1.12
IN T
HE
NAT
ION
AL
N°
of s
earc
hes
requ
este
d
REG
ISTR
IES
N
° of
unr
elat
ed d
onat
ion
DO
NAT
ION
N
° of
don
atio
n -
Aut
olog
ous
N°
of d
onat
ion
- A
lloge
nic
N°
of d
onat
ion
- A
lloge
nic,
rel
ated
N°
of d
onat
ion
- A
lloge
nic,
unr
elat
ed
BA
NK
ING
of
CO
RD
N°
of u
nrel
ated
coo
rd b
lood
uni
ts c
olle
cted
BLO
OD
N
° of
unr
elat
ed c
oord
blo
od u
nits
dis
trib
uted
N°
of u
nrel
ated
coo
rd b
lood
uni
ts a
t 31
.12
N°
of r
elat
ed c
oord
blo
od u
nits
col
lect
ed
N°
of r
elat
ed c
oord
blo
od u
nits
dis
trib
uted
N°
of r
elat
ed c
oord
blo
od u
nits
at
31.1
2
Tota
l N°
of c
oord
blo
od u
nits
col
lect
ed
Tota
l N°
of c
oord
blo
od u
nits
dis
trib
uted
Tota
l N°
of c
oord
blo
od u
nits
at
31.1
2
TRA
NS
PLA
NT
N°
of t
rans
plan
ts -
A
utol
ogou
s45
70
4231
015
80
2168
29
N°
of p
atie
nts
tran
spla
nted
-
Aut
olog
ous
N°
of t
rans
plan
ts -
A
lloge
nic
218
032
201
146
018
2426
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c
N°
of t
rans
plan
ts -
A
lloge
nic,
rel
ated
145
018
191
-0
1821
25
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c, r
elat
ed
N°
of t
rans
plan
ts -
A
lloge
nic,
unr
elat
ed73
014
10
-0
03
1
N°
of p
atie
nts
tran
spla
nted
-
Allo
geni
c, u
nrel
ated
58
1-NEWSLETTER 2011:aula medica 04/08/11 12:38 Página 58
The Madrid Resolution on Organ Donation and Transplantation. National Responsibility
in Meeting the Needs of Patients, Guided by the WHO Principles
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 59
60
The Third Global Consultation on Organ Donation andTransplantation was organized by the WHO in collaborationwith the ONT and TTS and supported by the EuropeanCommission. The Consultation, held in Madrid on March23 to 25, 2010, brought together 140 government officials,ethicists, and representatives of international scientific andmedical bodies from 68 countries.
Participants in the Madrid Consultation urged the WHO, itsMS, and professionals in the field to regard organ donationand transplantation as a part of every nation’s responsibilityto meet the health needs of its population in a comprehensivemanner and address the conditions leading to transplantationfrom prevention to treatment. Donation from deceasedpersons, as a consequence of death determined by neurologiccriteria (brain death) or by circulatory criteria (circulatorydeath), was affirmed as the priority source of organs and ashaving a fundamental role in maximizing the therapeuticpotential of transplantation.
Every country, in light of its own level of economic andhealth system development, should progress toward the globalgoal of meeting patients’ needs based on the resources obtainedwithin the country, for that country’s population, and throughregulated and ethical regional or international cooperation
when needed. The strategy of striving for self-sufficiencyencompasses the following features: actions should (1) beginlocally, (2) include broad public health measures both todecrease the disease burden in a population and to increasethe availability of organ transplantation, (3) enhancecooperation among the stakeholders involved, and (4) becarried out based on the WHO Guiding Principles and theDeclaration of Istanbul, in particular emphasizing voluntarydonation, non-commercialization, maximization of donationfrom the deceased, support for living kidney donation, andmeeting the needs of the local population in preference to“transplant tourists.”
This new paradigm calls for the development of acomprehensive strategic framework for policy and practice,directed at the global challenges created by an increasingincidence of chronic diseases and a shortage of organs fortransplantation. Self-sufficiency advocates nationalaccountability for the establishment of an effective planningcontext for diseases treatable through organ transplantationand characterized by adequate capacity management, regulatorycontrol, and an appropriate normative environment (Fig. 1).
1. National capacity management involves: (a) developmentof an adequate and appropriate healthcare infrastructure
The Madrid Resolution on Organ Donation and Transplantation. National Responsibility in Meeting
the Needs of Patients, Guided by the WHO Principles
Figure 1. Schematic representation of the concept of national accountability in meeting the donation and transplantation needs of the popu-lation. CKD-chronic kidney disease; CVD-cardiovascular disease; COPD-chronic obstructive pulmonary disease.
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 60
61
and workforce consistent with the country’s level ofdevelopment and economic capacity; (b) adequate andappropriate financing of organ donation and transplantationprogramme; and (c) management of need by investmentin chronic disease prevention and vaccination.
2. National regulatory control consists of (a) adequatelegislation, covering declaration of death, organprocurement, fair and transparent allocation, consent,establishment of transplant organizations, and penaltiesfor organ trafficking and commercialization; (b) regulationscovering procedures for organ procurement, reimbursement,and allocation rules; and (c) systems for monitoring andevaluation, including traceability and surveillance, andfor enabling evaluation of programme performance.
3. National authorities need to lead normative change, froma perception of organ donation as a matter of the rightsof donor and recipient to one of responsibility across alllevels of society, through unambiguous legislation, committedsupport, and ongoing education and public informationcampaigns. Meeting needs of patients while avoiding theharms of transplant tourism and commercial donationfrom living persons is an ethical imperative that relies onthe assumption of a collective responsibility for donationafter death by all citizens and residents, thereby contributingto the common good of transplantation for all.
The health of all populations will benefit from a comprehensiveresponse to diseases contributing to endstage organ failure,from prevention to access to effective organ transplantationprogrammes made possible by a sufficient supply of donororgans. There is also a strong economic imperative to improverates of transplantation and therefore organ donation: kidneytransplantation is less costly to provide than dialysis, andtherefore, maximizing rates of kidney transplantation wouldsignificantly reduce overall expenditure on renal replacementtherapies. Kidney transplantation also results in better survivaland quality of life outcomes and enables greater productivityand community participation. The perception of organtransplantation as an expensive and luxury clinical practiceis invalid; rather it is cost effective, mainstream, and a cardinalfeature of comprehensive health services. Beyond theunmistakable medical benefits to patients affected by end-stage organ failure, organ transplantation is a key to thechallenge facing healthcare providers worldwide ofunsustainable expenditures on dialysis services and haspotential to generate further practical consequences for healthsystems.
From a public perspective, the pursuit of self-sufficiencyrelies on a communal appreciation of the value of organdonation after death. The concept of donating human bodyparts to save the life of another as a civic gesture is one thatshould be taught at school alongside health education todecrease the need for transplants. The pursuit of self-sufficiencyin organs for transplantation exemplifies the public healthand community values of equity, transparency, reciprocity,and solidarity, while it is the only safeguard against thetemptation of yielding to trade in human organs.
In preparation for and during the meeting in Madrid, eightWorking Groups identified specific goals and challenges andproposed solutions and recommendations from a numberof perspectives. The Working Groups identified the commonchallenges faced by both developing and developed countries,the unique issues of particular societies and regions, andprovided a rich and extensive set of recommendations directedat governments, international organizations, and healthcareprofessionals regarding how to best maximize donationsfrom deceased persons (including the development of TheCritical Pathway for organ donation; Fig. 2) and how tosuccessfully progress toward meeting the needs of patients.
IMPLEMENTING SELF-SUFFICIENCY:RECOMMENDATIONS FROM THE MADRIDCONSULTATION
The human right to health and dignity includes the recognitionof all human needs for transplantation. While self-sufficiencyis conceived as a common global goal, the capacity to meetpatients’ needs should be found primarily within each country’sown resources, involving regulated regional or internationalcooperation when appropriate. The requirements of organdonation and transplantation programmes with respect toresourcing, proper organization, regulation and the oversightof procurement, processing and transplantation of humanbody components from living and deceased persons arematters that rightly come under the responsibility ofgovernments, as outlined in Resolution WHA57.18.
Consistent with the political and ethical obligations ofgovernments toward their citizens, the pursuit of self-sufficiencypromotes the health and protects the interests of populations.Although the practical implementation of self-sufficiencywill vary for different countries, influenced by economicfactors, health sector development, and existing healthpriorities, the inherent values of the self-sufficiency paradigmand the WHO Guiding Principles on human cells, tissuesand organs should guide organ donation and transplantationpolicy and practice in all contexts. The following overarchingaspects of self-sufficiency were identified during The MadridConsultation as subject to specific recommendations:
Preventing the Need for Transplantation and IncreasingOrgan Availability are National Responsibilities
• Organ donation and transplantation have a role in thenational health policies of all countries, regardless ofcurrent transplant capability.
• Of equal importance to infrastructure and professionaldevelopment in organ donation and transplantation issustained investment in prevention to reduce future needsfor transplantation, through intervention in the majorrisk factors for end-stage organ failure and the developmentof health systems able to meet the challenges of chronicdiseases such as diabetes, cardiovascular disease (CVD),and hepatitis.
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 61
62
• National transplantation legislation consistent with theWHO Guiding Principles is fundamental. It providesadequate protection from exploitation and unethical practicesand eliminates legislative impediments constraining thescience and medicine of donation from deceased persons.
• Public support for organ donation necessitates normativechange. To this end, education of the public should beginin school, emphasizing individual and community ethicalvalues such as solidarity and reciprocity. Self-sufficiencyis founded in three main ethical premises:
– The human right to health encompasses transplantationand disease prevention.
– Organs should be understood as a social resource; equitymust therefore govern both procurement and allocation.
– Organ donation should be perceived as a civic responsibility.
Donation and Transplantation Reflect ComprehensiveHealth Care
• The critical functions of oversight, maintenance ofprofessional standards and ethics, regulation, policy setting,
and monitoring and evaluation of organ donation andtransplantation programmes are most effectively managedby a National Transplant Organization (NTO).
• Data registries are necessary for operational support(waiting list management and organ allocation) and formonitoring and surveillance of practices and outcomes.
• Monitoring and surveillance should encompass thefollowing data: national prevalence and incidence ofend-stage organ failure and diseases contributing toend-stage organ failure (need); availability of relatedinfrastructure and access to organ replacement therapies;outcomes of organ replacement therapy; acceptance ontotransplant waiting lists and time to receipt of an organ;organ donation practices, standards and activities;practices, standards and activities in organ donationfrom living persons; and outcomes of transplantation(patient and graft survival). International harmonizationof such metrics would facilitate comparisons betweensystems and international benchmarking, identify regionsin need of data, guide national policy making, and enableresearch.
Figure 2. The critical pathway for organ donation. This figure was published in Transplant Int 2011; 24: 373–378. The figure has been repro-duced with permission granted by Wiley-Blackwell.
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 62
63
Opportunities to Donate Should Be Provided in as ManyCircumstances of Death as Possible
• The critical pathway provides a framework for the processof donation from deceased persons, which will aid globalharmonization of practice.
• The key to self-sufficiency is maximizing donation fromdeceased persons: facilitating donation in as manycircumstances of death as possible, maximizing the outcomesfrom each donor, and optimizing the results oftransplantation. Donation after both brain death andcirculatory death should be regarded as ethically proper.Organ donation from living persons should be encouragedas complementary to donation after death, by providingappropriate regulatory frameworks and donor care.
• Physicians and nurses involved in acute care have a centralrole in identifying possible donors and facilitating donationafter death, and therefore should be supported by thenecessary educational, technical, legal and ethical tools toassume leadership in this regard within their facility.
EXECUTIVE SUMMARY
PREAMBLE
In response to the global disparities in access to transplantation,a growing demand for organs, and the self-evident harms oftransplant tourism, a meeting of 140 representatives ofinternational scientific and medical bodies, governmentofficials, and ethicists was held in Madrid, Spain, on March23 to 25, 2010. This Third Global Consultation was organizedby the WHO, TTS and ONT, and supported by the EuropeanCommission. The purpose of the meeting was to call for aglobal goal of national responsibility in satisfying organdonation and transplantation needs, with sufficiency basedon resources obtained within a country for that country andthrough regulated and ethical regional or internationalcooperation, when needed. The concept of a nationalresponsibility encompasses the following features: (1) actionshould begin locally (not precluding international cooperation);(2) strategies should be targeted to decrease the transplantationneeds of a population and increasing organ availability, andshould enhance cooperation between stakeholders involved;(3) these strategies must be based on solid ethical principles:solidarity, voluntary donation, and non-commercialization(1); and (4) strategies should be tailored to the local realities.
The Third WHO Global Consultation carries forward theprinciples laid out in the WHO Guiding Principles for HumanCell, Tissue and Organ Transplantation, and the Declarationof Istanbul on Organ Trafficking and Transplant Tourism(1, 2). The WHO Guiding Principles articulate the importanceof pursuing national or subregional self-sufficiency in organsfor transplantation, in particular through increased effortsto promote donation after death. The Declaration of Istanbulfurther states that “Jurisdictions, countries and regions shouldstrive to achieve self-sufficiency in organ donation by providing
a sufficient number of organs for residents in need from withinthe country or through regional cooperation.” The goal ofthe Madrid consultation was to confront the self-sufficiencyparadigm from a practical perspective, developing acomprehensive strategic framework for policy and practicedirected at the global challenges of a shortage of organs fortransplantation and unmet patient needs. Therefore, theMadrid Resolution expresses both a pledge to progress insatisfying organ donation and transplantation needs, and aroadmap of how this may be achieved.
It was the intent that the consultation process should becomprehensive and holistic, encompassing different perspectivesstudied and discussed during the meeting. Eight differentworking groups were convened, with group members chosento represent a variety of different clinical experiences andgeographical regions, and to provide an interdisciplinaryunderstanding of the issues. The eight groups identifiedspecific goals and challenges, and proposed solutions andrecommendations with respect to the following topics:
1. Assessing needs for transplantation.
2. System requirements.
3. Meeting needs through donation.
4. Monitoring outcomes.
5. Fostering professional ownership in the emergencydepartment (ED) and intensive care unit (ICU).
6. The role of public health and society.
7. Ethics.
8. Measuring progress.
Each group was led by three individuals, who in advance ofthe meeting, worked together to guide the preparation of adraft document for discussion and refinement during themeeting. The outcomes of the working groups were alsodiscussed in a plenary session. The final eight documentsproduced by the working groups complete the MadridResolution on Organ Donation and Transplantation and arebased on a large body of evidence collected by participantsbefore the consultation and reflecting their particularexperiences representing 68 nations. The Madrid Resolutionidentifies the common challenges faced by both developingand developed countries, and the unique issues of particularsocieties and regions, and provides a diverse body ofrecommendations to governments, international organizations,and healthcare professionals regarding how to successfullymeet the needs of patients. This document represents animmediate resource for policy makers and guide for practicalinitiatives. It is hoped that the Madrid Resolution will alsoinspire new work in this emerging and important field.
The Resolution
Meeting the needs of patients with respect to organ donationand transplantation is a national responsibility that should bemet primarily through a country’s own resources, with specific
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 63
64
regulated and ethical regional or international cooperation whenappropriate. National accountabilities can be broadly definedas the creation of a national planning context for chronicdiseases treatable through organ transplantation thatencompasses capacity control, regulatory control, anddetermination of the appropriate ethical environments.
1. National capacity control involves: (a) development ofadequate and appropriate healthcare infrastructure andworkforce development, consistent with development leveland economic capacity; (b) adequate and appropriatefinancing of organ donation and transplantationprogrammes; and (c) management of need by investmentin chronic disease prevention and vaccination.
2. National regulatory control consists of: (a) adequatelegislation, covering declaration of death, organprocurement, fair and transparent allocation, consent,establishment of transplant organizations, penalty of organtrafficking, and commercialization; (b) regulation coveringprocedures for organ procurement, reimbursement, andallocation rules; (c) systems for monitoring and evaluation,including traceability and surveillance, and enablingevaluation of programme performance.
3. National authorities need to lead normative change, fromorgan donation as a right of donor and recipient to aresponsibility across all levels of society, through education,unambiguous legislation, and committed support. Meetingneeds of patients while avoiding the harms of transplanttourism and commercial donation from living personsis an ethical imperative that relies on collective responsibilityfor donation after death, thereby contributing to thecommon good of transplantation for all. The WHOGuiding Principles for Human Cell, Tissue and OrganTransplantation provide the foundation for all effortstoward progress in meeting transplantation needs.
Recommendations
Informing The Resolution are the detailed recommendationsof the eight working groups convened as a part of the ThirdWHO Global Consultation on organ donation andtransplantation. The key recommendations of these workinggroups are as follows:
Recommendations With Respect to Assessment of Transplantation Needs
1. True need for transplantation cannot be defined byavailability of treatment. Instead assessment of need mustbe multifactorial and take into account:
a) True incidence of end-stage organ failure, irrespectiveof treatment availability (in all age groups and for allorgans).
b) Complexity of conditions and the drivers of need.
c) Nonmedical factors (e.g., economic, cultural, attitudinal,competing health priorities) that modify actual transplantneeds within that setting.
2. Internationally consistent definitions, data, and tools needto be developed to accurately and comprehensively measuretransplantation needs, thereby enabling a broaderunderstanding of the issues facing different countries andfacilitating the identification of global solutions.
3. An international registry of organ donation andtransplantation should be established. The following nationallevel data should be made available for this purpose:
a) National prevalence and incidence of end-stage organfailure and of diseases contributing to end-stage organfailure.
b) Availability of treatment for end-stage organ failure(transplant and non-transplant).
c) Waiting-list statistics, including “true” wait times.
d) Progression and outcomes of organ dysfunction.
e) Referral to organ replacement therapy (assist devisesand transplantation).
f) Time to workup, time to acceptance onto the waitinglist, and time to receipt of an organ.
4. All countries should have the ability to assess their needsfor transplantation. Governments should:
a) Support the identification of organ failure or replacementneeds as a priority for public health improvement;
b) Allocate resources to registry development (operationaland surveillance/monitoring) and furthermore createa registry for conditions leading to the need for organtransplantation;
c) Invest in prevention programmes to reduce needs;
d) Ensure the equity principle is applied in needs assessment;
e) Create or support infrastructure and allotment ofresources for all aspects of needs assessment.
5. With respect to needs assessment in transplantation, WHOshould:
a) Identify as a resolution that all countries shall have theability to assess their needs for transplantation by 2020;
b) Identify and outline the need for the use of a coreminimum dataset by which international comparisonswill become meaningful.
6. Professional societies and healthcare providers should:
a) Ensure consistency of definitions and use of metricswith respect to registry data;
b) Support identification of organ failure as a strategicpriority;
c) Foster international enquiry, collaboration, anddevelopment in the area of needs assessment;
d) Promote and support education relating to needsassessment, including technical advice regardingmethodologies, data interpretation, and applications;
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 64
65
e) Promote scientific enquiry in the area of needs assessment,including validation studies;
f) Ensure linkages with governmental agencies and policymakers to support translation of research.
Recommendations With Respect to Systems and Organization
1. Clear and unambiguous legislative and regulatoryframeworks are the foundation on which successful systemsfor organ donation and transplantation, based on ethicaland transparent practices with respect to organ procurement,recovery, allocation and transplantation, are built.Governments should therefore:
a) Enact transplantation legislation consistent with theWHO Guiding Principles. Legislation should address:
• Standards for determining and declaring death;
• Organ procurement from deceased and living persons;
• Fair and transparent allocation to wait-listed patients,based on medical criteria;
• Respect for the wishes of the deceased concerningconsent;
• Establishment of transplant organizations;
• Prohibition of organ trafficking and commercialization.
Governments should also:
b) Incorporate donation and transplantation into nationalhealth policies as a priority;
c) Support donation after death;
d) Invest in basic infrastructure and professional training;
e) Create a national waiting list and comprehensive registryof donors and recipients;
f) Create the necessary systems for ongoing regulationand oversight to ensure transparency and facilitatereview of progress and the implementation of newstrategic policies;
g) Lead public awareness of organ transplantation andcommit to public education.
2. NTOs responsible for coordination and oversight, ethicalpractice, regulation, policy setting, maintenance of nationaldata registries, and data protection are essential. Corefunctions are to include:
a) Surveillance of practices, standards, and outcomes inorgan donation and transplantation;
b) Assurance of ethically proper organ procurement andallocation, transparency of all organ donation andtransplantation processes, and traceability of donatedhuman materials;
c) Standardization of procedures and performancemanagement of Organ Procurement Organizations(OPOs), related non-government organizations (NGOs),
individual transplantation centers, ethics committees,and transplant teams;
d) Regulation and management of the reimbursement ofreasonable and verifiable expenses incurred by theliving donor, and reimbursement of hospitals that incurcosts in donating or procuring organs;
e) Oversight of the division of responsibilities across allorganizations involved in organ donation andtransplantation;
f) Public endorsement of organ donation andtransplantation and support of the process with massmedia education and promotion.
3. When organization is based on OPOs, these organizationsmanage procurement activities independently of hospitaltransplant units, subject to government approval andregulation. The nature of OPOs will vary according todifferent national requirements and realities, although theessential functions are the same in every setting, whichare as follows:
a) Surveillance and detection of possible/potential donorsat every acute care hospital.
b) Donor management for the recovery of viable organs.
c) Coordination of procurement, through a designatedOrgan Procurement Coordinator (OPC).
4. Performance is dependent on successful integration andcoordination across systems. All countries performingtransplantation need to organize a unified coordinationthat regulates organ donation and transplantation processes.In addition, international coordination facilitates cross-border exchange of organs, information and research, andit is critical to combat organ trafficking and transplanttourism.
Recommendations with Respect to Organ Donation
1. Countries and jurisdictions should aim to maximizedonation from deceased persons, maximize the outcomefrom each deceased donor, and optimize results oftransplantation.
a) Donation from deceased persons is a requirement;transplantation activity cannot rely on living donors.
b) Both donation after brain death (DBD) and donationafter circulatory death (DCD) are to be considered.
c) Countries should enable transplants from living donors,as complementary to donation from deceased persons,by providing appropriate ethical and legal frameworksand donor care.
2. Donation after death is a process, at any stage of whichlosses of potential donors may occur. Therefore, to maximizedonation from deceased persons, an organizational approachshould be adopted with explicitly defined actions, roles,and responsibilities across the entire process. The CriticalPathway for organ donation is to be considered a general
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 65
66
framework of reference for systematizing the deceaseddonation process. The objectives of The Critical Pathwayare as follows:
a) To provide a common systematic approach to theprocess of donation from deceased persons, both forDBD and DCD.
b) To create common triggers to facilitate the prospectiveidentification and referral of the possible deceased organdonor and precipitate the deceased donation process.
c) To provide common procedures to estimate the potentialof organ donation from deceased persons and evaluateperformance in the deceased donation process.
3. With respect to organ donation from deceased persons,governments should:
a) Eliminate legislative impediments constraining themedicine and science of donation from deceased personsand organ transplantation;
b) Provide adequate support (including financial support)for organ donation from deceased persons andtransplantation programmes;
c) Ensure equitable access to transplantation therapiesand transparency of the system;
d) Through a NTO (see Recommendations with respectto Systems and Organization, number 2) provide oversightand ensure the development and implementation of thefollowing:
• The Critical Pathway;
• Protocols for all steps of the process of donation afterdeath, especially timely identification and referral;
• Appointment of trained professionals, includingdonor coordinators, who are accountable forperformance;
• A data registry for ongoing evaluation of donationprocesses, estimation of the potential of donationfrom deceased persons, evaluation of overallperformance, identification of areas for improvement,and factors critical to success;
• Professional training and promotion of a nationalculture of donation.
4. With respect to donation from deceased persons, theWHO should:
a) Promote the international implementation of TheCritical Pathway;
b) Monitor the collection of relevant data assessingperformance in organ donation for internationalbenchmarking;
c) Foster regional cooperation in organ sharing thatpreserves equity between donor and recipientpopulations, and the efficient transplantation ofotherwise discarded organs.
5. With respect to organ donation from deceased and livingpersons, healthcare professions should:
a) Make every effort to maximize the number of organsrecovered and transplanted;
b) Support and promote DCD;
c) Present the option of donation from living persons tofamilies, with all practices in the donation of organsfrom living persons consistent with the principles ofThe Declaration of Istanbul.
Recommendations with Respect to Monitoring of Outcomes in the Pursuit of Self-Sufficiency
1. The purpose of registering data on transplant activitiesand outcomes is to identify areas in need of improvement;to enable system transparency, equity, and compliance; andto monitor system improvement both longitudinally withina given system and between systems through internationalbenchmarking. Registries should be not only concernedwith donors and recipients but also with infrastructureavailability. They are a tool for quality assurance and policymaking, and registry data may furthermore be used toraise awareness of the need for organ donation amongthe lay public and policy makers.
2. In all countries/regions, data should ideally be collectedin the following areas:
a) Available infrastructure (hospital and organizational);
b) Regulatory oversight and health policy;
c) Current and likely future needs for transplantation;
d) Access to the waiting list and to transplantation;
e) Waiting-list outcomes;
f) Travel for transplantation and transplant tourism;
g) Organ donation from deceased persons;
h) Organ donation from living persons; and
i) Outcomes of transplantation (patient and graft survival).
3. Two complementary data collection systems are proposed:
a) A national/regional system, which has operationalfunctions (allocation) and monitoring and evaluation.
b) An international system with a global perspective, underan International Data Group. The International DataGroup would establish standardized definitions/metrics,provide assistance to national/regional registries, facilitatecomparisons between systems and internationalbenchmarking, identify regions in need of data, guideindividual nations and systems, and facilitate researchinto special patient groups where small patient numberswould otherwise be restrictive.
4. With respect to monitoring, governments should:
a) Support national/regional registries with infrastructureand human resources;
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 66
67
b) Establish responsibility for operation and governanceof this registry;
c) Facilitate cooperation between government and NGOsin monitoring outcomes and disseminating informationto the scientific community, the public, and policymakers; and
d) Use registry data to assess the impact of policy changeand inform the need and direction of new legislationand policy.
5. Professionals and professional societies should:
a) Provide content expertise;
b) Cooperate on the consistency of data elements acrossthe continuum of organ failure (i.e., chronic kidneydisease, dialysis, and transplantation); and
c) Facilitate development of an International Data Groupfor the ongoing collection of data that will empowerindividual countries and regions in the pursuit of self-sufficiency.
Recommendations with Respect to Fostering Emergencyand Intensive Care Department Professional Ownership of Organ Donation
1. Organ donation is a different process than organtransplantation and requires different skills and personnelto maximize its potential. Possible and potential deceaseddonors are found in the ICUs and increasingly in EDs.Physicians and nurses involved in acute care need to beaware of their critical role in identifying possible andpotential donors and to be engaged in the developmentof programmes for organ donation from deceased persons.Therefore, the pursuit of self-sufficiency requires ICU andED doctors and nurses to:
a) Be aware of the need for organ donation and thereforewant to facilitate it;
b) Know how to facilitate organ donation and have theeducational, technical, legal and ethical tools to do so;
c) Be supported by their colleagues, hospitals and healthauthorities in facilitating organ donation;
d) Be recognized as experts in this area and in educatingtheir colleagues;
e) Take the lead in enabling their facility to provide thisservice, including appropriate counseling for families.
2. To foster professional ownership of self-sufficiency in theED and ICU, governments should:
a) Under legal, ethical, and medical frameworks for practice,include:
• Standards for determining death, enacted by thelegislature, and accepted by the profession and public;
• Evidence-based tests and methods that physicianscan readily use to apply these standards in the EDand ICU;
• Clear statements, at institutional and governmentallevels, regarding the responsibility of various careproviders to donors and recipients.
b) Provide unambiguous guidance ensuring that individualmedical staff involved in acute care are not personallyor legally vulnerable when aiding the organ donationprocess.
3. Professional bodies should:
a) Provide training and guidance for Emergency/IntensiveCare nurses and physicians, covering:
• The need for organ donation and the importanceof the role of acute care physicians and nurses;
• Identification of possible and potential donors;
• Death determination;
• Protocols on how treatment decisions (e.g., forpatients with severe neurologic injuries) relate todonor status and to alternative (circulatory/respiratoryand neurologic) bases for determining death;
• Protocols on how to manage the dying process forpatients whose deaths will be determined oncirculatory/ respiratory or neurological grounds,and on post-death maintenance of body;
• How to make donation an understandable andacceptable choice for families of dying patients;
• Effective interaction with the OPO and transplantationteam.
b) Support the development of academic and scientificresearch activity in the emergency and intensive carecommunities to create a professional investment in thebest practice approaches that emerge.
4. Hospitals should:
a) Give local ED and ICU staff “ownership” of solvingthe problems and developing protocols for managingthe care of potential donors;
b) Identify individuals within the emergency or intensivecare team who can act as role models or “champions”to increase the profile of organ donation within thatfacility and provide education to the team on all relevantissues;
c) Appoint donor coordinators within hospitals to facilitatecommunications among emergency and intensive carestaff, bereaved families and transplantation services;
d) Include the possibility or potential for organ donationin every end-of-life care pathway in the ED/ICU;
e) Improve the interface between the ED/ICU and the localtransplant team and responsible National Authority;
f) Identify strategies to minimize the effects of lack ofresources on the conversion of potential donors toactual donors;
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 67
68
g) Audit outcomes of the donation process within eachfacility to allow identification of potential areas forimprovement, set achievable targets, and formallyrecognize excellence.
Recommendations with Respect to the Role of Public Health and Society
1. Roles for public health in the pursuit of self-sufficiencyinclude:
a) Prevention of the frequent causes of end-stage organfailure (diabetes, hypertension, alcohol abuse, hepatitisB virus [HBV], hepatitis C virus [HCV], coronaryartery disease [CAD], and chronic obstructive pulmonarydisease [COPD]), including primary, secondary, andtertiary prevention;
b) Promotion of organ donation among health professionalsand the general public;
c) Development of effective healthcare systems capableof supporting efficient organ procurement, equitableallocation, safety and quality, and national diseaseprevention programmes.
2. The act of donation is itself an individual decision thatinteracts with the social setting and the institutional andregulatory framework into which an individual is embedded.Family refusal, together with failure to identify possibleand potential donors, is the most significant impedimentto increase rates of donation. Roles for society in thepursuit of self-sufficiency include:
a) Public education efforts to counter poor awareness,distrust of medicine, and misconceptions about donationand transplantation, while instilling notions ofreciprocity, solidarity, and building public willingnessto support organ donation;
b) Community funding for donation and transplantationthrough public finance and charitable sources.
3. Recommendations for public health:
a) Reduce demand for transplantation by prevention ofmajor risk factors for end-stage organ failure and bydeveloping healthcare systems able to effectively andequitably meet the challenges of chronic diseases,particularly diabetes and hypertension;
b) Develop awareness and increased willingness of medicalprofessionals to be involved in the donation andtransplantation process, encourage a stakeholder rolefor ICU/ED physicians, and develop specific educationprogrammes for primary care physicians, nurses, medicalstudents, and allied health professionals;
c) Develop culturally sensitive awareness programmes,using public health methodologies to promote trustand strengthen commitment to organ and tissuedonation in the community;
d) Increase the efficiency of healthcare systems andtransplant programmes by using private and non-
government sources of funding as appropriate, anddeveloping synergies between the government andNGOs.
4. Recommendations for society:
a) Provide regular and consistent normative changecommunication programmes and culturally sensitiveawareness programmes directed at community andfaith-based organizations;
b) Provide public recognition of donors and their familiesand actively manage adverse publicity;
c) Ensure all aspects of donation and transplantation aretransparent to the public, and develop educationalprogrammes to dispel myths and misconceptions,taking into account the range of community beliefsand values.
5. In settings where resource limitations and health sectordevelopment constrain the development of organ donationand transplantation programmes, the prevention of end-stage organ failure, within the context of wider public healthgoals, is crucial to self-sufficiency. In such settings, deliveryof transplantation therapy may be approached throughlocally relevant approaches to financing, using both privateand non-governmental sources of funding, and developingsynergies between governments, NGOs, and charities.
Recommendations with Respect to Ethics in the Pursuit of Self-Sufficiency
1. Self-sufficiency must be supported by normative change,reframing organ donation from a matter of the rights ofdonor and recipient, to a responsibility functioning at alllevels of society (individual, government, professional,etc). The self-sufficiency paradigm is based on three mainethical premises:
a) The human right to health requires that governmentsengage in prevention and providing transplantationservices. The responsible administration of scarceresources such as organs also encompasses concertedactions directed toward prevention of end-stage organfailure.
b) Organs should be understood as a social resource;therefore, equity should govern both procurement andallocation.
c) Organ donation should be perceived as a civicresponsibility toward fellow citizens; in contrast, organmarkets and transplant tourism lead to morallyunacceptable coercion and exploitation.
2. In accordance with The Declaration of Istanbul and theWHO Guiding Principles, self-sufficiency promotes thefollowing ethical principles:
a) Minimizing harm/reducing suffering—both decreasingneed for transplantation and efforts to maximize thenumber of organ available for transplantation areemphasized.
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 68
69
b) Justice—an equitable distribution of benefit and burdenand the elimination of exploitation are central to theself-sufficiency paradigm.
c) Respect for persons—self-sufficiency avoids undueincentives while appealing to solidarity and civicresponsibilities toward the community.
3. With respect to ethics and self-sufficiency:
a) Governments/health authorities should be accountablefor the ethical integrity of organ donation andtransplantation systems;
b) Health professionals should receive training in theethical aspects of organ transplantation and be vigilantconcerning unethical or illegal behavior, and professionalsocieties should foster enquiry on questions of culture,values, and ethics relating to self-sufficiency;
c) Civil society should establish an ethos of socialresponsibility and solidarity in meeting the community’stransplantation needs through participation in donationafter death, necessitating the engagement of community-and faith-based organizations and NGOs.
Overall Recommendations with Respect to EffectiveProgress in the Pursuit of Self-Sufficiency
1. The capability of individual countries/regions to meettransplantation needs is determined by economic resources,systems development, and existing health priorities. The minimum level of transplantation capability is definedas the presence of a few medical professionals who havethe capability to provide appropriate presurgical andpostsurgical management of transplant recipients andliving donors in a context of no local transplantationactivity; maximum capability is defined as a comprehensivemultiorgan transplant programme that provides an adequatesupply of transplantable organs to meet the needs of thepopulation. By defining successive levels of capability, theinclusive nature of the self-sufficiency paradigm is reinforced,and it is possible to describe a framework for evolutionand achievement in organ donation and transplantationthat is adaptable to all contexts.
2. The pursuit of self-sufficiency involves the developmentand implementation of strategies aimed at increasingnational/ regional transplantation capabilities to progressfrom one level of capability to the next, in amanner thatis consistent with local realties and does not distort existinghealth priorities. Countries/regions evolve toward greaterself-sufficiency in organ donation and transplantationthrough incremental achievements in each of the followingdomains:
a) Resources and professional development for donationand coordination;
b) Legal and regulatory frameworks;
c) Resources and professional development for transplantservices;
d) Government and other resources;
e) Community involvement;
f) Assessment and minimization need for organs.
3. To enable evolution and achievement in transplantationcapability, Governments should:
a) Acknowledge their responsibilities in managing endstageorgan failure from prevention to treatment in theirpopulation and designate a focal point/coordinatingauthority;
b) Derive an integrated strategy for the care of patients withend-stage organ failure, from prevention of organ diseaseand organ failure to replacement therapies includingtransplantation, to optimize the use of resources;
c) Include the elements of organ donation andtransplantation in their national health plan and assesstheir own level of transplantation capability;
d) Allocate resources, develop infrastructure, and strengthenhealth systems to support the achievement of these goals;
e) Report national data on organ donation andtransplantation activities to the Global Observatoryon Donation and Transplantation (GODT);
f) Participate in public education and engage professionals,professional societies, NGOs, and the community;
g) Foster regional and international cooperation in thepursuit of these goals.
4. To support national/regional efforts to pursue self-sufficiency, WHO should:
a) Urge MS to adopt and implement the principles of theMadrid Resolution;
b) Urge MS to self-assess their level of transplantationcapability, to aid the identification of areas forimprovement;
c) Monitor progress in levels of achievement in the pursuitof self-sufficiency across MS:
d) Align the range of quantifiable indicators collected bythe GODT to the framework of the Madrid Resolution;
e) Develop international standards, guidelines, and tools,in collaboration with professional organizations, for theadvancement of transplantation policy and practice;
5. To support national/regional efforts to pursue self-sufficiency, professionals and professional societies should:
a) Acknowledge their responsibilities with respect to theirown professional development, adoption of ethicalpractices, maintenance of standards, and training fordonation and procurement;
b) International societies should support the establishmentand work of the relevant national societies to furthertheir missions with respect to organ donation andtransplantation;
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 69
70
c) Provide professional advice to MS and assistance forthe development of standards for accreditation andquality assurance;
d) Participate in professional and public education andengage other professionals and the public in theadvancement of organ donation and transplantation;
e) Encourage research, especially clinical research directedat maximizing benefits, minimizing costs, and optimizingresource allocation in organ donation and transplantation.
CONCLUSIONS
The Madrid Resolution on Organ Donation and Transplantationrecognizes that donation and transplantation are more thana good gesture and a medical service. For patient needs tobe met, all citizens and residents must be involved. From apublic perspective, national attempts to meet patient needsrely on a communal appreciation of the value of organdonation. The concept of donating human body parts to savethe life of another as a civic gesture is one that should betaught at school as a part of health education along with
promotion of healthy life style. The organizational requirementsand allocation of resources necessary to maximize donationfrom deceased donors and ensure equitable access totransplantation services, and the implementation of preventiveinterventions to alleviate needs for transplants, mandate theactive commitment of Government. The benefits to be gainedextend way beyond the successful transplantation of patients.The pursuit of the goal of ensuring a national responsibilityin satisfying the donation and transplantation needs of a givenpopulation, outlined in the Madrid Declaration, has thecapacity to strengthen the public health and communityvalues of reciprocity and solidarity, while it is the only safeguard against the temptation of yielding to trade in humanorgans.
REFERENCES
1. Steering committee of the Istanbul Summit. Organ trafficking andtransplant tourism and commercialism. The Declaration of Istanbul.Lancet, 2008;372:5 (Available at: http//www.declarationofistanbul.org)
2. WHO Guiding Principles; WHA 63.22/2010 (Available at: http://www.who.int/transplantation/en/)
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 70
Cooperation between Countries of the Black SeaArea (BSA): Development of the Activities
Related to Donation and Transplantation of Organs, Tissues and Cells
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 71
72
PROJECT BACKGROUND
Human to human (allogeneic) transplantation of cells, tissuesand organs has become the best and often the only treatmentfor a wide range of end stage organ failure. However, as thenumber of transplants has grown rapidly over the past twodecades, the demand for human transplantation has alsoincreased, resulting in a continuing shortage of humanmaterial, particularly organs, with the risk of encouragingunethical practices.
The development of organ transplantation in the countriesof the Black Sea Area (BSA) dates back from the late 1970s;mainly in the form of kidney transplants from Non-HeartBeating Donors (NHBD). From the early 1990s, activities inthe field of transplantation began to decline and, in somecountries, have ceased.
Over the last few years, the Council of Europe (CoE) andWorld Health Organization (WHO) began implementingsome projects that supported the development of a commonand constructive attitude towards various transplantationissues in these countries. Efforts were mainly directed towardsthe development of effective legislative frameworks and theestablishment of national transplant authorities and nationaltransplant programmes. The cooperation with Moldova is agood example of these efforts.
It is important to note that donation and transplantation ofcells, tissues and organs raise ethical and legal issues that needto be addressed according to various cultural backgrounds.Nevertheless, it is important to identify and share experiencesfrom local initiatives which could provide models forimplementation of safe donation and transplantation processes.
The work of the Council of Europe in the area of organtransplantation started in the 1950s. The relevant committeeis the European Committee on Organ Transplantation (CD-P-TO), which focuses on the elaboration of high ethical,quality and safety standards in the field of organ, tissues andcells transplantation, promoting the principle of non-commercialisation of organ donation and strengthening themeasures to avoid organ trafficking.
THE PROJECT AND KEY PLAYERS
Based on the Council of Europe recommendations and theexperience gained by the experts from the CD-P-TO in otherprogrammes in the BSA, the CD-P-TO has now started acollaborative project through which a regional strategy willbe channeled to promote transplantation activities in the area.
The Council of Europe member states from the BSA (Armenia,Azerbaijan, Bulgaria, Georgia, Moldova, Rumania, Russia,
Turkey and Ukraine) will, through this project, start a longterm regional cooperation in order to structure, develop andstrengthen activities and programmes related to the donationand transplantation of organs, tissues and cells.
A kick-off meeting, organized regionally in Chisinau(Moldova), launched the project on 1-2 July 2011. It gatheredprofessionals from the transplantation and/or the organisationalsystem nominated by their respective Ministries of Health.Specialists in the field of transplantation from countries withestablished transplant systems, such as France, Italy andSpain, participated and met together with experts from thepartner countries of the Black Sea Area.
An Advisory Board of experts from France, Italy, Spain andGermany will follow and support the progress of the BSAPROJECT.
SPECIFIC OBJECTIVES
• to review the existing laws on transplantation of organs,tissues and cells and to promote the implementation ofan effective legislative framework;
• to contribute to the establishment of national transplantauthorities and national transplant programmes wherethese do not exist, and to support efforts in strengtheningexisting transplant services;
• to educate the public, professionals and media abouttransplantation and the need for services to be developedin the countries involved in the project;
• to establish action plans for training and to identify areaswhere additional specialist expertise or training are requiredas the basis for a training and professional developmentstrategy;
• to elaborate recommendations and documents of consensusthat are agreed upon by all the participants;
• to encourage networking and enhance international co-operation;
• to establish pilot actions to be developed in specific settings.
CONTACT
Dr. Marta López-Fraga, Scientific Administrator, EDQM,Council of Europe: [email protected] Tel. +33 (0)3 90 21 45 30; Fax +33 (0)3 88 41 27 71
Dr Igor Codreanu, Project Leader Transplant Agency, Republicof Moldova: [email protected] Tel.: +373 22 28 64 66 or mobile Tel.: +373 69 20 60 69;
Web Pages: http://www.edqm.eu & http://www.transplant.md
Cooperation between countries of the Black Sea Area(BSA): Development of the activities related to donation
and transplantation of organs, tissues and cells
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 72
73
BSA TRANSPLANT NETWORK DATA
Data related to national donation and transplantation activities
from all the BSA countries has been collected. This information
provides an updated overview of the legal and organisational
situation in the participating countries and sets ground forfuture regional priorities for action. Future data collectionswill improve the picture and allow following the trends andprogress. A summary of this information is shown in theTables below.
SECTION 1: LEGISLATIVE ASPECTS
Ukr
anie
Turk
ey
Ru
ssia
Rom
ania
Mol
dova
Geo
rgia
Bu
lgar
ia
Aze
rbai
jan
Arm
enia
Regulatory framework on organ transplantation and donation YES YES YES YES YES YES YES YES YES
Regulatory framework on death diagnosis YES NO YES YES YES YES YES YES YES
Law concerning prohibition of organ trafficking YES YES YES YES YES YES YES YES YES
Presumed consent (PC) or informed consent (IC)legislation PC PC PC IC PC IC PC IC PC
Donor or non-donor registry NO NO YES YES YES NO NO YES NO
SECTION 2: NATIONAL AUTHORITIES
Ukr
anie
Turk
ey
Ru
ssia
Rom
ania
Mol
dova
Geo
rgia
Bu
lgar
ia
Aze
rbai
jan
Arm
enia
Government recognized authorityresponsible for overseeing & supporting donation & transplantation (national level) YES NO YES YES* YES YES YES YES YES
Specific organization/institution responsiblefor national coordination of donation and transplantation activities YES NO YES NO YES YES NO YES YES
Periodic reports on donation and transplantation NO NO YES YES NO YES YES YES YES
Ethical Committee dealing with transplant activities nationally or regionally NO NO YES YES YES YES NO YES YES
* Non official.
SECTION 3: ORGANISATIONAL ASPECTS
Ukr
anie
Turk
ey
Ru
ssia
Rom
ania
Mol
dova
Geo
rgia
Bu
lgar
ia
Aze
rbai
jan
Arm
enia
Training programs to harmonize practices for staffinvolved in organ procurement NO NO YES NO NO YES YES YES YES
Training programs to harmonize practices for staffinvolved in organ transplantation NO NO YES NO NO YES YES YES YES
Adequate and continuous education campaigns NO YES YES NO NO NO NO NO YES
Educational campaigns in schools or universities NO NO YES NO NO NO NO YES NO
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 73
74
Kidney 8 2 48 8 0 212 1.037 2.502 82
Liver 0 10 15 0 0 51 209 695 12
Pancreas 0 0 0 0 0 0 8 29 0
Heart / Lung 0 0 5/0 0 0 7/0 47 89 1
SECTION 4: TRANSPLANT ACTIVITY
UkranieTurkeyRussiaRomaniaMoldovaGeorgiaBulgariaAzerbaijanArmeniaType of transplant
activity
4.1. Number of transplant centres in participating countries
4.2. Number of transplant performed in 2010 in participating countries
Kidney 8 150 915 0 0 2.661 950 17.033 900
Liver 0 20 26 0 0 453 500 1.484 0
Pancreas 0 0 0 0 0 73 100 182 0
Heart / Lung 0 0 25/0 0 0 166/25 250 218 16
4.3. Number of patients on the waiting list at the end of 2010 in participating countries
Kidney 1 2 4 2 2 5 31 59 7
Liver 0 1 2 0 2 1 11 34 2
Pancreas 0 1 0 0 0 1 3 5 0
Heart / Lung 0 0 2/0 0 1 2/1 7 14 2
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 74
LIST OF PARTICIPANTS CD-P-TO(2-3/10/09, Berlín)
LIST OF PARTICIPANTS CD-P-TO(12-13/05/2011, Strasbourg)
AUSTRIAMUEHLBACHER FerdinandBELGIUM
BULGARIA
CYPRUS
CZECH REPUBLIC
DENMARK
ESTONIADMITRIEV PeeterFINLAND
FRANCELAOUABDIA-SELLAMI KarimGERMANYNORBA DanielaGREECE
HUNGARYLANGER RobertIRELAND
ITALYCOZZI EmanueleNANNI COSTA AlessandroLATVIA
LITHUANIA
LUXEMBOURG
MALTA
NETHERLANDS
POLANDDANIELEWICZ RomanROWINSKI WojciechPOTUGALPENA Joao RodriguesROMANIA
SLOVAK REPUBLIC
SLOVENIAAVSEC- LETONJA DanicaSPAINMATESANZ RafaelMARAZUELA RosarioSWEDENERICZON Bo-GöranUNITED KINGDOM
(ET) EUROTRANSPLANT RAHMEL Axel(SKT) SCANDIATRANSPLANT
ARMENIA
BELARUS
BOSNIA AND HERZEGOVINA
CANADA
CROATIA
GEORGIATOMADZE GiaICELAND
ISRAEL
NORWAYPFEFFER PerOYEN OleREPUBLIC OF MOLDOVACODREANU IgorRUSSIAN FEDERATION
SERBIA
SWITZERLANDMOREL PhilippeTURKEY
ESOT
EUROPEAN COMMISSIONLE-BORGNE HélèneIBEROAMERICAN COUNCIL
UNOS
WHO
CDBIHARTEL Ingo
75
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 75
✍
2-NEWSLETTER 2011:aula medica 04/08/11 12:40 Página 76
Guide to the Safety and Quality Assurance for the Transplantation of Organs, Tissues and Cells
4th EditionWhy a European Guide?Transplant medicine and transplantation have progressed during the last decades, in a way that nobody would have imagined before. Organ transplantation is, in many cases, the only treatment for end-stage organ failure. The number of transplantations performed is only limited by organ availability, which is very much dependant on how criteria for organ donation can be extended in relation to functional parameters and the risks of disease transmission. The transplantation of organs, tissues and cells offers major therapeutic benefits and improvements in quality of life, but raises a number of questions of ethical principles.
The Council of Europe is the leading standard-setting institution in this field since the 1950s. It approaches organ transplantation from an ethical and human rights perspective, taking
compliance with the principles of non-commercialisation and voluntary donation of substances of human origin as the basis for all ethical
concerns in this respect. Its work includes assuring the safety and quality of organs, tissues and cells, tackling the organ shortage,
promoting living donations and preventing and minimising organ trafficking.
A priority of this work programme is the elaboration of the Guide to the Safety and Quality Assurance for the Transplantation of Organs, Tissues and Cells. The European Committee on Organ Transplantation (CD-P-TO), the Steering Committee in charge of transplantation activities for the European Directorate for the Quality of Medicines & HealthCare (EDQM, Council of Europe), assisted by leading
European experts, is responsible for producing regular updates of the guide, in addition to other projects.
Who is the guide designed for?The guide collates data and gives expert opinion to provide
transplant professionals with the most up-to-date information about the advances in their field. Its aim is to provide guidance for all those
involved in order to maximise the quality of organs, tissues and cells and to minimise risks, and thereby increase the success rate of transplants. It
includes safety and quality assurance standards for procurement, preservation, processing and distribution of organs, tissues and cells of human origin used for
transplantation purposes. In order to increase safety for patients on waiting lists and recipients of organs, it is essential that physicians in charge of identifying potential
donors, transplant co-ordinators involved in managing the donation process, and transplant physicians responsible for organ allocation, have easy access to this information.
What information is contained in the guide?The guide applies to the donation and transplantation of organs, tissues and cells of human origin for therapeutic purposes.
Publication and purchase of the guideThe 4th Edition of the guide is now available in both paper and online versions in English, French and Russian. An online version in Spanish will be available by the end of 2011. Purchase of a printed guide gives access to the online version in all the available languages.
Subscribe to our free e-NewsletterSign up today to receive the EDQM’s free e-mail newsletter, “Infopub”. Information is emailed every month on the EDQM’s activities, its publications, services and upcoming events.
For more information, please visit the EDQM website: www.edqm.eu or the EDQM Store at www.edqm.eu/store.
Editionth4