Andorra Bolsters Organ and Tissue Donation with Local Training and Protocols

Andorra has strengthened its organ and tissue donation system, with Nostra Senyora de Meritxell Hospital staff now trained to identify potential donors, support families, and maintain organ viability on-site. This allows local tissue extractions—and potentially some organs—without transferring patients to Barcelona, though full transplants remain impractical due to logistics, costs, and population size.

The Servei Andorrà d'Atenció Sanitària (SAAS) organised a technical workshop on Thursday, followed by a symposium titled "Donation as Part of Our Lives" on Friday at the Llacuna conference room. These events aim to boost public awareness and showcase Andorra's established protocols and prepared professionals.

Dr Chloë Ballesté, medical director of the DTI Foundation affiliated with Barcelona's Hospital Clínic, addressed the progress during promotional activities. Her non-profit has trained Andorran intensivists, physicians, and ICU nurses to handle donor cases psychosocially and clinically until transplant teams arrive from reference centres. "Andorra has always had close links with Catalonia," she said, noting that local patients on waiting lists are allocated to Barcelona hospitals. Under existing agreements, organs from Andorran donors would generally go to Catalonia unless required domestically.

Relations have intensified over the past two years, with 14 tissue donors last year, including corneas. Hospital protocols now cover donor detection, family guidance, and extractions. Staff recently managed one case successfully. Ballesté highlighted the motivated local team and active patient association ATIDA, stating that Andorrans have gained "a new right: the right to be a donor."

On Wednesday, ahead of the symposium, ATIDA hosted a roundtable for World Transplanted Person Day featuring David Paredes, transplant coordinator at Hospital Clínic de Barcelona. With nearly 30 years in donation, Paredes stressed discussing donation wishes openly with family in advance, as the process begins with detection, family consent, and precise coordination—not in the operating room.

He outlined key steps: donors can give in life (kidney, liver portion, blood, bone marrow, tissues) or after death via brain or circulatory criteria. Medical efforts always prioritise recovery; donation only arises after irreversible decline. Organs have tight timelines—hearts within four hours, kidneys up to 24—necessitating flawless logistics with reference hospitals like the Clínic, which handles Andorran cases.

Paredes addressed myths, costs (heart/lung transplants up to €70,000, kidneys around €40,000, plus lifelong immunosuppression), and sustainability. He praised associations like ATIDA for humanising donation's impact, showing recipients' second chances. Emerging AI aids organ assessment but cannot replace clinical judgment.

Spain leads globally at 50 donors per million inhabitants, far ahead of the costly US system. Challenges include an ageing population, with half of donors over 60, shifting focus to biological viability. Ballesté urged normalising donation talks at home, underscoring its life-extending benefits—like restoring sight or ending dialysis—and financial sense, as one year of dialysis matches a transplant's lifetime care.