Main conclusion
More transplants worldwide — and the real driver of national performance hasn’t changed.
Global transplant activity grew 9.5% in 2023, reaching 172,397 procedures. Spain again recorded the highest deceased-donor rate in the world at 49.4 per million, and donation after circulatory death (DCD) continued to take a larger share of the global mix.
What separates the highest-performing countries from the rest is not the law on consent — it’s who shows up in the ICU. Countries with dedicated, hospital-based transplant coordinators and a strong family-consent culture consistently outperform countries with the same legal framework but weaker infrastructure. The next round of gains will come from building DCD pathways, training ICU coordinators, and closing the infrastructure gap in lower-income countries.
