Spain, a world leader in kidney and lung transplants

In 2025, a total of 183,896 organ transplants were performed worldwide, an increase of 4% over the previous year's activity. This record high was largely due to the expansion of living donor transplants, which rose by a further 4%, and to donation after circulatory death (DCD), which increased by 11% last year. Spain reaffirmed its international leadership in organ donation from deceased donors, accounting for 23% of donors in the European Union and 5% of those registered worldwide. Added to this is its high volume of transplant activity, which saw it take first place with 4,000 kidney transplants and 556 lung transplants in 2025. This is the conclusion drawn from the latest report by the Global Observatory on Donation and Transplantation, which is managed by the National Transplant Organisation (ONT) as a collaborating centre of the World Health Organisation (WHO) and whose data are published annually in the Council of Europe's Newsletter Transplant.

In 2025, a total of 183,896 organ transplants were performed in the 96 countries that had provided their data to the Global Registry by 26 August 2026. Of these transplants, 116,775 were kidney transplants (38% living donor); 45,566 were liver transplants (23% living donor); 10,748 were heart transplants; 8,472 were lung transplants; 2,155 were pancreas transplants; and 180 were intestine transplants. These procedures were made possible by the 49,169 people who donated their organs after their death and the 54,630 people who donated an organ whilst still alive. Transplant activity in 2025 increased by 4% compared to the previous year. By type of transplant, the largest increase was recorded in liver transplants, which rose by 5%, followed by heart transplants (4%) and kidney transplants (3%).

Transplants from living donors increased by 4% worldwide

The growth in transplant activity was largely due to the increase in the number of procedures carried out using living donors, which rose by 4% compared with 2024, with 44,241 kidney transplants, 10,355 liver transplants and 16 lung transplants.

Donations from deceased individuals also contributed to this growth, rising by 2%, albeit at the expense of donations following cardiac arrest, as donations following brain death fell. The number of DCD donors rose from 13,366 in 2024 to 14,865 in 2025, representing an increase of 11% and accounting for 30% of all deceased donors worldwide. Of the 28 countries performing this type of donation last year, Spain once again recorded the highest activity, with 1,416 DCD donors and a rate of 29.6 per million population (p.m.p.). Spain accounted for 48% of DCD donors in the European Union (EU) and 10% of those worldwide.

Spain, the only country performing intestinal transplants from donors after circulatory death

Donors after circulatory death (DCD) enabled a total of 32,175 transplants of all types; this was made possible by the introduction of preservation systems that reduce the impact of interrupted blood flow to organs and ensure successful post-transplant outcomes. Given its technical complexity, the steady rise in heart transplants from DCD donors is particularly noteworthy. While only 300 heart transplants from DCD donors were performed across six countries in 2021, that figure rose to 1,463 across twelve countries in 2025 (Argentina, Australia, Austria, Belgium, Canada, the Czech Republic, Spain, the United States, Italy, the Netherlands, the United Kingdom and Switzerland), with 137 (9%) of these procedures taking place in Spain. Spain was the only country to perform intestinal transplants from DCD donors, specifically carrying out four such procedures.

In 2025, Spain once again led the way in transplant activity involving DCD donors. The rate of organ transplants obtained from these donors was 63.5 p.m.p. in Spain, followed by the United States and the Netherlands, which performed 46.7 and 39.7 p.m.p. of such transplants, respectively.

Organ donation and transplantation on the rise in the European Union

Donation and transplant activity in the EU reached record highs again in 2025 (Table 1). With 11,044 deceased donors and 3,653 living donors, a total of 32,816 organ transplants were performed in the EU last year. Donation activity increased by nearly 2%, while transplant activity rose by just over 1% compared to 2024 levels.

Table 1: Organ donation and transplant activity in the 27 European Union member states. 2021-2025

The EU countries with the highest rate of organ donation and transplantation in 2025 are represented in Table 2:

Table 2: European Union countries with the highest donation and transplantation rates. 2025

Despite the observed growth, it is important to note that, as of 31 December 2025, 53,343 patients in the EU were on waiting lists for an organ transplant. According to data from the Global Observatory, nine patients in the EU died every day while waiting for a transplant.

Growth in Latin America

Latin America - a region with which Spain has collaborated for over 20 years through the Ibero-American Network/Council on Donation and Transplantation (RCIDT) by providing technical advice and training healthcare professionals in transplant coordination via the Programa Alianza - recorded a 5% increase in transplant activity in 2025. The region reached a total of 6,366 deceased donors (10.5 p.m.p.), a 6% increase over the previous year, and performed 18,301 organ transplants (30.1 p.m.p.). Argentina recorded the highest donation rate, with 20.8 donors per million people, followed by Brazil (18.7) and Uruguay (17.9). With 66 donors after circulatory death (DCD), Argentina also solidified its position as a regional leader in this donation model.

Spain leads the world in deceased organ donation

The Global Observatory confirms Spain's extraordinary contribution to deceased organ donation. In 2025, the country accounted for 23% of donations reported in the EU and 5% of those recorded worldwide, despite representing 11% of the European population and 0.7% of the global population. With a rate of 53.2 deceased donors per million population (p.m.p.), Spain maintained its position - held for over three decades - as the world leader in deceased-donor donation, ahead of the United States (47.7 p.m.p.), Iceland (37.5 p.m.p.) and other European countries listed in Table 2.

In terms of transplant activity, Spain performed 6,336 transplants, which meant a rate of 132.3 transplants p.m.p. in 2025, a figure only surpassed by the United States, with 143.7 transplants p.m.p. (49,920 transplants). The difference in transplant rates between the two countries is attributable to higher living-donor activity and the different profile of deceased donors in the United States, where donors tend to be younger and frequently die from preventable causes. Thus, last year, donors aged 60 years or older accounted for 60% of donors in Spain versus 30% in the United States. Regarding causes of death, 14% of donors in the United States died from trauma, 10% from drug overdoses, and 5% from firearm injuries - causes of death that are rare among organ donors in Spain. Despite this, Spain recorded the world's highest p.m.p. rates for kidney and lung transplants.

Spain has played a pivotal role in the positive evolution of this medical field, as the Spanish model is regarded as an international benchmark. As well as chairing the Council of Europe's Transplant Committee and the RCIDT, Spain has for the past two decades maintained a cooperation agreement with the WHO on transplantation and, more recently, with the Pan American Health Organisation (PAHO). Through the ONT, our country shares its experience and expertise and provides technical advice to countries across five continents to help develop and strengthen their organ donation and transplant systems.

The 2026 edition of the Newsletter Transplant, the official publication of the Council of Europe's Transplantation Committee, will soon be available on the ONT website. Activity data can also be viewed on the Global Observatory on Donation and Transplantation website.

Explanatory note: Donation and transplant rates for Spain differ slightly from those provided by the ONT in its annual report, because the Global Observatory uses the UN Fund's population figures for all participating countries. The trend data for 2024 have been calculated based on countries that provided data for both 2024 and 2025, as available in the Observatory as of 26 August 2026.

Non official translation