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The Transplantation Society and the Spanish National Transplant Organization

Prince of Asturias Award for International Cooperation 2010

Both organizations stand out for their crucial work in establishing the medical and ethical principles that govern clinical care and scientific research on organ transplantation.

The Transplantation Society (TTS)

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The Transplantation Society (TTS) was founded in 1966 at a New York Academy of Sciences conference on human tissue transplantation. One year later, TTS celebrated its first international congress in Paris, a congress since then held every two years. Currently, with over 6,700 worldwide members, TTS is the leading international organization in every aspect of human transplantation: medical care, pharmacology, education and research. TTS has provided a forum for hundreds of doctors and researchers worldwide to share findings, discuss theories, reveal new treatments, and formulate definitions and concepts crucial for progress in this field. TTS has an international office in Montreal (Canada) and its president is Australian doctor Jeremy Chapman. TTS's governance is divided into six regions spanning the globe.

TTS is responsible for establishing clinical practice guidelines, advancing training programs, and promoting ethical standards for clinical care and scientific research. Some of its ethical standards include a firm opposition to the commercialization of transplantable organs (an opposition first declared over 20 years ago), and the use of organs from executed prisoners. TTS promotes the principle that organs and tissues should be donated freely and without coercion. TTS also opposes the current phenomenon of "transplant tourism", in which people travel to developing countries to obtain organs.

TTS’s international congresses are the main forum in which scientific advances related to human transplantation are presented. These advances are also published in Transplantation Proceedings, a journal created in 1968. The official journal of TTS is Transplantation, which is published twice monthly and is the most cited and influential journal in the field (over 20,000 citations a year). TTS also publishes Transplant Infectious Disease, Transplantation Immunology and Xeno-Transplantation. TTS is in collaboration with the World Health Organization and has included under its governance other specialized associations such as the Cell Transplant Society, the International Pancreas and Islet Transplant Association, the International Society for Organ Donation and Procurement and the Intestinal Transplantation Association.

TTS has allowed doctors and scientists to do many things: formulate a definition of brain death, define the problems of immunosuppression, debate the efficiency of pharmaceuticals and therapies for improving transplant success, promote different organ transplants, and discuss ethical issues. TTS has also fought unwaveringly against organ trafficking and inequality of access to transplants.

TTS created the Global Alliance for Transplantation so that anyone who needs a transplant, in any part of the world, may obtain it. Recently, with the help of the WHO and the Spanish ONT, TTS has initiated a project to create a global dictionary of donation and transplant data that provides universal standards for information collection and analysis. ONT, which is responsible for the International Registry of Organ Donation and Transplantation, provides technical assistance to this project.

In 2008, TTS and the International Society of Nephrology held an international summit in Istanbul on transplant tourism and organ trafficking. The final Declaration, agreed to by ethical experts and the representatives of over 150 scientific and medical societies and states, is considered a milestone in the establishment of definitions, principles, and proposals helping to increase the number of available donors and preventing organ trafficking and commercialization. The WHO recommended, at the third Global Consultation on organ donation and transplants held in Madrid (2010), that every country's plan to achieve self-sufficiency in covering its patient's needs should follow the guidelines of the WHO and the Declaration of Istanbul.

The Spanish National Transplant Organization (ONT)

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The Spanish National Transplant Organization (ONT), created in 1980, is a coordinating organization belonging to the Spanish Ministry of Health. It abides by the principles of cooperation, efficacy, and solidarity, and aims to coordinate the donation, extraction, preservation, distribution, exchange, and transplantation of organs, tissues, and cells occurring in the entire Spanish health care system. The organization's goal is to maximize the number of transplants possible, allowing an organ to reach the person who needs it independently of the person's socioeconomic status, race, or religion. Since the creation of the ONT, the rate of donors in Spain has increased 280%, and over 70,000 solid organ transplants and 200,000 tissue and cell transplants have been performed.

The ONT's principal function is to act as a bridge between local, national, and European health authorities, health professionals, social agents involved in donation and transplantation, and the general public. The ONT performs the following activities: managing donation alerts; maintaining and updating waiting lists; assisting in the coordination of kidney exchanges; assisting in the coordination of organ entry and exit; keeping records of donors, receivers, and transplants of organs, tissues, and hematopoietic progenitors; receiving applications for financial support; collecting data on extraction and transplant activity; providing general information for transplantation professionals; and providing continuing education and postgraduate courses for transplantation professionals.

In addition, the ONT collaborates with other national and international entities and periodically publishes a journal and a record of recent activity. In 2007, the ONT created, with the help of the World Health Organization, the International Registry of Organ Donation and Transplantation, which is headquartered in Spain. This registry is the most complete provider of public information on transplants, with information from 98 countries and 5 billion people, or 82% of the world's population. Also, in Latin America, Spain has pushed the creation of the Latin American Network/Council of Donation, and five years ago initiated the "Alliance" program, which has allowed over 200 Latin American professionals to be trained in Spain as transplant coordinators. Thanks to this organization's intense activity in recent years, Spain continues to lead the world of donation rate (34.4 per million people, with a total of 1,606 donors in 2009), and has the lowest family refusal rate in the world (17.6%, as opposed to 30% in Italy and 40% in Holland). In 2009, 4028 interventions of this kind occurred in Spanish hospitals.

The work of the ONT has been recognized by several institutions, such as the Council of Europe, which recommended its members to adopt the guidelines of the "Spanish model" of transplantation and declared that the Spanish continuing education programs were of international interest. The ONT received the City of Madrid Medal of Social Merit (2000), and the Red Cross Gold Medal. The WHO has also recognized the work of the ONT, urging countries around the world to adopt the Spanish model of transplantation so that these practices may reach all citizens who need them, and to fight against organ selling and "transplant tourism". Following suit, in 2010 the European Union approved a directive urging member nations to set up national bodies with the same functions as the ONT. In 2007, the WHO made the ONT a partner organization.

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