“When you donate an organ, you donate a part of you”

by Laura Andrés Tallarda

Human bodies are like puzzles made up of trillions of pieces (cells) and of many organs. Last estimates of scientists put the number of cells at around 30 trillion. According to Live Science, the general count is 78 organs. But not every organ is necessary for survival. Only five organs — the brain, heart, liver, at least one kidney, and at least one lung are absolutely essential for living.

While most organ and tissue donations occur after the donor has died, some organs, including a kidney or part of a liver or lung, and tissues can be donated while the donor is alive. The Organ Procurement and Transplantation Network (OPTN) and other international organisms have policies that regulate how donor organs are matched and allocated to patients on the waiting list. There are some common factors in how organs are matched, such as blood type and how severe the patient’s illness is.

In 2019, Spain had the highest donor rate in the world at 46.91 per million people, followed by the US (36.88 per million), Croatia (34.63 per million), Portugal (33.8 per million), and France (33.25 per million).

The case of Spain, leader in organ donation for 28 years

Spain has been positioned as a world leader for the last 28 years, with 15 daily transplants, 20% of all donations from the European Union and 6% of world donations, according to the “Organización Nacional de Trasplantes” (ONT), despite the fact that Spain barely represents 9.1% of the European population and 0.6% of the world population.

The worldwide prestige of this system is due to the organizational model managed by the National Transplant Organization and, on the other, the solidarity of the Spanish, since 86% of the families consulted authorize organ donation. Sometimes, donations to save lives are part of a race against the clock.

“In the world, it is estimated that about 2 million people each year may need a transplant and about 140,000 are being performed. That is, the possibility of achieving it does not ex- ceed 4-5%. In Spain, anyone who needs an organ, statistically has a 94-95% chance of getting it”, explained Rafael Matesanz, founder of the National Transplant Organization in 1989, to National Geographic.

What is the situation of organ donation after death in Europe?

In Europe, except in some countries like in Germany, automatic organ donation is a common practice and in general it can only be prevented by showing the contrary intention while still alive, even, as in the case of the Netherlands and England, in an Official register.

Mari Carmen and Miguel Angel

But in practice the opinion of the family is important. In France, the family of a deceased person can refuse the donation even if he or she has a donor card. In Austria and the Czech Republic you are asked. In Denmark, the prior unequivocal consent of the person or of the family after death is required. And in Italy it can be denied if it is considered that the deceased person was not well informed. In Spain, all people are donors when they die if in life if they have not expressly stated otherwise, although in practice family members are consulted; and equality is established for recipients.

Coronavirus has affected to the process of organ transplantation. Some countries have reported a 50% reduction in transplantations due to the pandemic.

Organ donation after death is only possible when the donor dies in a hospital. Organs need a supply of oxygen-rich blood to remain suitable for transplantation. Donors are put on artificial respiration to keep their heart beating, so that oxygen-rich blood continues to circulate through their body.

A family story of donation: a life- changing act

I decided to investigate more about this topic and to write this article because my dad and my aunt were the protagonists of a successful donation themselves. They even appeared on TV once. My dad, Miguel Angel, had a kidney chronicle disease and he was supposed to do dialysis except if someone donated him the organ. He had 10 brothers and sisters, but not all of them were compatible or had the characteristics to donate. Mari Carmen, one of his younger sisters, took a step forward. “The decision was easy. In a very natural way, I felt that if I had the conditions to give it, I wanted to do so”, Mari Carmen, his sister explains. She was about to retire as a teacher from a school and the doctors decided that the best was to wait for a while so that she could finish her professional life.

Mari Carmen had to take a lot of psychological tests from the hospitals and at a European level. She felt very supported at a personal and emotional level. “I never had doubts and I think that was very helpful and positive in the donation process. I always felt strong, and I really appreciated being always very well-informed about the process”.

“I feel that when you donate an organ, you donate a part of you. Having all the information is essential to ensure that the process works out”, Miguel Angel explains. As a handicap, Mari Carmen points out that the process was very long and a bit bureaucratic, because it was important to make sure that everything is done in a legal way. It is necessary to go to court from the hospital and to make sure that she, as a donor, had received all the necessary information and that part is important but can be a bit exhausting as well.

Miguel Angel

“Everything worked perfectly but we had a surprise, because the compatibility shown in the first results with my sister was negative. However, new analysis showed that it was compatible”, Miguel Angel states. The donation and transplantation were successful and Mari Carmen gave a piece of her body and also of her life to improve the life of her brother.

They are still both going through a lot of revisions to make sure that everything is correct. “Before Covid, everything was in person, but now it is via phone. Sometimes, they change a bit the medication I need to take to avoid rejecting the kidney”, Miguel Angel explains. So far, he has been able to keep going to the gym, walking around his neighborhood and reading newspapers every day. He will feel forever grateful to his sister. “The fact that Mari Carmen gave me the kidney somehow changed my life. I would have to be connecting to a machine to do dialysis every day if she hadn’t done so”.