Once again, Catalonia has achieved very positive organ transplant figures, positioning the region as a world leader in this field. Last year, 1,356 transplants were performed, 0.8% more than two years ago, representing the second-highest figure on record, according to the annual report by the Catalan Transplant Organization (OCATT). Despite celebrating the continuation of this positive trend, OCATT has detected a worrying pattern in the donation process: family refusals have increased to 27.6%, the highest percentage since data has been available. This means that almost a third of Catalan families are ruling out organ donation from a loved one upon their death.

Scientists around the world have spent years developing organs in the laboratory from stem cells to study how they form and function, and to test new drugs. These are called organoids, as they are not complete organs, but they do manage to reproduce many of their main structures and functions, making them an indispensable tool for research. In the future, for example, they could be used to repair damaged tissues or improve organs before transplantation, thus reducing the likelihood of rejection by the recipient's immune system. But much more research is needed to reach this point. Now, an international team led by the Institute for Bioengineering of Catalonia (IBEC) has taken a significant step in this direction and, for the first time, has developed human kidneys in a laboratory. They have combined them with those of a pig They removed the tissue from the animal and transplanted it again, without damage or toxicity.

Seeing Beth again is thrilling. With a vibrant gaze and an infectious smile, she's already talking nonstop, goes to the pool, and plays with Berta, her younger sister. The ARA has followed her case since, at a young age, she had to spend 16 months in the pediatric ICU at Vall d'Hebron (one of the longest stays to date in this center's unit) awaiting a heart transplant. After surviving eight months connected to a ventricular assist device, Beth finally received a new heart, a journey filled with hope, fear, and uncertainty, which was successfully completed. It's been about two years since that "start over," and the family remains tirelessly dedicated to meeting the needs of the little girl and also those of Berta, who has become her sister's greatest inspiration. For the four of them, the best summer possible is simply being together, being together, and being well.

Every day in Catalonia, around 200 public health professionals perform transplants, either in the operating room or on call. This means they must be within a maximum of one hour of the hospital in case a compatible organ becomes available for a patient on the waiting list. Last year, 1,344 transplants were performed, almost four per day, and according to data from the Catalan Transplant Organization (OCATT), this is one of the highest rates in the world. These are highly complex procedures that require different profiles working in unison to ensure that organs are harvested as required, transported safely, and transplanted to those who need them. Although this work is essential, the salaries of the workers who make it possible have been frozen for more than a year and a half.

Anas was born with a heart defect: instead of two ventricles, he only had one. When he was just a few months old, he had to undergo surgery. Doctors performed up to three surgeries to ensure his quality of life and the proper blood supply to his entire body. In the final operation, they disconnected some veins from his heart and connected them to the pulmonary artery, ensuring blood flow to his lungs. This technique is known as Fontan surgery, named after the doctor who invented it. Thanks to this procedure, he was able to lead a normal life: he went to school, played with his friends, and played sports. However, at age 13, his blood flow began to slow down, he stopped going to school because he couldn't leave the house, and some organs, such as his liver and intestines, began to suffer.

The first year in which Catalonia reached the thousand-transplant benchmark was 2016, a figure that was maintained, and even surpassed – 2019 holds the record with 1,296 – until the pandemic arrived. During 2020, activity was temporarily halted for a few months, and only pediatric and life-saving emergency transplants were maintained, and the year closed with 999 transplants. The activity, however, is beginning to recover and during 2021 the thousand-transplant benchmark was attained again. There were 1,063, 6.4% more than in 2020. "We recovered a little from the drop of about 25% in 2020, the first year of covid, and we reached the thousand-transplant benchmark, which few regions can attain. This is the fourth best year," emphasises Jaume Tort, director of the Catalan Transplant Organization (OCATT). This volume of activity in the Catalan hospitals, with an average of almost three transplants per day (2.9), has made it possible to increase the rate again: 137 transplants per million population, one of the highest in the world. "These are extraordinary numbers and it is the forecast we had because in the covid scenario we work with an excess of caution, given that these are fragile patients," Tort adds. For this year, the forecasts are for continued growth. "If we do 5% or 6% more transplants it will already be a success for the system, we do not expect to recover 2019 figures," admits the director of OCATT.