Liver transplantation: The Spanish experience

Liver transplant activity started in Spain in 1984 and has reached 16,132 interventions at 31st December 2008, with a mean activity of more than 1000 transplants during the last years. There are 25 transplant teams (1/1.85 million inhabitants), two of them paediatric. The maximum activity has been recorded at the Hospital La Fe (Valencia) with 1,557 transplants (more than 100 annually). The majority were standard deceased donor transplants. Other modalities were: 222 living donors (1.4%), 89 donors after cardiac death (0.5%), 187 split (1.1%) and 100 domino (0.6%). Combined transplants made in this period of time were 309 (1.9%): 244 liver–kidney, 15 liver–pancreas, 20 liver–intestine and 30 multi-visceral. Around 5% of transplants were performed under national priority. As Spain leads the world in organ donor rate, liver transplant activity means 6% of all the interventions performed in the world, with the largest relative activity (23–25 per million population). The analysis of the results is performed by the Spanish Liver Transplant Registry jointly managed by the National Transplant Organization and the Spanish Society of Liver Transplantation. As in other international registries, patient and graft survival have been improving across time in the different categories of basic diseases and associated risk factors.