EVOLUTION OF THE CHARACTERISTICS OF TRANSPLANT DONORS IN SPAIN

During the last 4 years the organ donor rate increased in Spain, from 14.3 donors per million population per year in 1989 to 22.6 in 1994. This could have been even greater, since we observed 25% of family refusal rate during this period. The average age of organ donors increased by 4 years during the last 2 years. At the same time a change in the cause was mainly cranial trauma, during the last year 46% of organ donors died due to cerebrovascular problems, and 45% due to trauma, including road traffic and other causes. Road accidents causing death have decreased by more than 20% since 1992 explaining such a change in donors characteristics. While the percentage positive for hepatitis B virus in the donor population has remained stable during last years (1.7%), the percentage of (hepatitis C virus-positive donors) increased from 1.7% to 2.7%, Six per cent of kidneys grafted in Spain during 1993 were obtained from donors with previous hypertensive problems. Current donors are older, more have concomitant problems, and most of them died due to cerebrovascular problems; thus we have to be very careful about possible influences of these factors on graft outcome, paying great attention to donor and organ maintenance, ischaemia times, the use of nephrotoxic drugs, etc. Such caution should be increased when considering organs at the limit of aceptance for transplantation.