One of the things that fills all of us with pride as a nation is Spain’s undisputed leadership in organ donation and transplantation. We are the country with the highest number of organ transplants in the world, and this is no coincidence: for more than three decades, we have topped this ranking. Moreover, our donation rate per million inhabitants far exceeds that of any other country. How has this been achieved? Among many factors, the impeccable management of the National Transplant Organization (ONT) stands out — and here, Iberia contributes its small but vital part.
Key Factors in the Success of Organ Donation
It may seem obvious, but to have the highest transplantation rate worldwide, there must first be an equally high rate of organ donation. In 2023, Spain recorded 47 donors per million inhabitants. The second-highest European country was Portugal, with 34 donors. In 2024, Spain performed a record-breaking 6,464 organ transplants.
The culture of donation is widespread, but the coordination among professionals and institutions is another cornerstone. The generosity of thousands would be in vain without a strong, well-organized system. The ONT operates like a finely tuned machine and ensures equitable distribution of organs throughout the country.
Furthermore, Spain’s healthcare professionals are highly trained to make this system work. You have likely seen how medical teams transport special coolers containing organs to vehicles destined to deliver them — by land if the distance is short or better covered by road; by air if the distance or urgency requires it. This is where Iberia plays a crucial role.
Iberia’s Partnership with the National Transplant Organization
Since 2013, Iberia has been part of this vital technical and healthcare network that gives thousands of people a second chance each year. Twelve years ago, our airline began facilitating the air transport of organs on an entirely altruistic basis.
How the “Magic” Happens
Such operations are coordinated down to the finest detail to ensure success. When the ONT needs to transport an organ by air, it contacts Iberia, which immediately begins the process.
The day manager, responsible for supervising the flight, alerts the crew to prepare to receive the organ. This flight receives special monitoring so the operational team is ready and coordinated. The crew on board safeguards the cooler containing the organ throughout the journey, and upon landing, a hospital representative collects it directly from the aircraft to take it to the transplant facility. The cooler always travels in the cockpit, never in the cargo hold or any other area of the plane.
Iberia’s Essential Role in Paired Kidney Exchanges
Our aircraft play a new and critical role in the case of paired or chain kidney transplants. To explain briefly:
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There may be a donor-recipient pair where the recipient is incompatible with the donor’s organ (due to blood type or other medical incompatibilities).
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When this occurs, another incompatible pair is found to exchange organs.
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This process can extend beyond two pairs: a third pair may be involved where the third donor’s organ matches the first recipient, creating a chain of multiple transplants.
Within the ONT’s National Program, altruistic donors sometimes initiate chains of five or six simultaneous transplants.
In this scenario, multiple organs must travel simultaneously to different locations than initially planned for transplantation. Precision in coordination and the speed and efficiency of transport are critical, with air transport often being the best solution.
Over 1,000 Organs Transported in Twelve Years
In the twelve years of collaboration between the ONT and the Iberia Group, more than 1,000 organs have been transported on our aircraft for transplantation. The majority are kidneys and livers, which are the most frequently transplanted organs, in that order. These organs can endure longer ischemia times (lack of oxygen and nutrients due to reduced blood flow).
We proudly recognize our role in this immense, compassionate network that places Spain at the forefront of saving lives through organ donation.