There is a feeling that Britain has a real problem of donor shortagees

Professor Rafael Martesanz

The increase cannot be explained by accident rates, as both road accidents and cerebral haemorrhages - another source of donors - has declined in Spain as well as in Britain.

Health Secretary Alan Milburn made a commitment in March to double the number of people on the organ donation register.

He announced a �3m investment scheme, and said he also wanted to see the number of kidney transplants double, and the number of heart, lung and liver transplants increase by 10% over the next five years.

Organ shortage

In 1989, Spain had the same problems in increasing the number of donor organs available for transplants as the UK does now.

A law of presumed consent - where it is assumed people will opt in to a donor scheme unless they state otherwise was considered by Spanish transplant experts.

It is also an idea that has been put forward as a solution to the British shortage.

But Spain decided instead to create the National Transplant Organization (ONT).

Professor Rafael Martesanz, founder of the ONT visited London last week to show how, over the last 12 years, Spain has become the only country in the world to show continuous improvement in the number of organs taken from hospital patients who had died.

He told a summit of transplant experts in London that the key to the increase was identifying suitable donors.

To do that, the ONT introduced a network of transplant co-ordinators who were based in hospital intensive care units, rather than the UK model, which has linked them to the transplant units.

The co-ordinator network now extends across 139 hospitals.

The number of donors rose from 550 in 1989 to 1,334 in 1999 - a 142% increase.

Kidney transplants rose from 1,021 in 1989 to 2,005 in 1999 - a 96% increase.

Professor Andrew Rees, president of Britain's Renal Association, said Spain had achieved its success by having a much better system of co-ordinated organ retrieval.

"What they have done, in a really effective way, is to make sure that potential organ donors are identified.

"It's taken Spain 10 years to go from where they were to where they are now. What we really have to do is increase faster than that.

"We need to improve donor co-ordination, and make them more co-ordinated."

He said Britain needed to also learn from Norway's example, and increase the number of live donors.