Spain has been a global leader in organ donation and transplant for almost three decades. The country’s healthcare system seems to be still performing better than other countries despite the health crisis caused by the COVID-19 pandemic. In 2020, the organ donation rate in Spain was 37 per million population (pmp) which is comprehensively higher than in other countries, even pre-pandemic. For instance, in 2019, Germany had 11 donors pmp, Australia 22, Italy 25, and France less than 30.

Last year, about 4,425 organ transplants were carried out in Spain with organs donated by 1,777 people.  Apart from that, 268 people made live donations of a kidney or a portion of their liver. In 2022, the country aims to achieve 50 donors pmp and this strategic plan of the Spanish National Transplant Organisation(Organización Nacional de Trasplantes or ONT) is called "50X22."

The Director-General of ONT, Beatriz Dominguez-Gil highlighted in a speech that the system has made organ procurement a routine activity regardless of the circumstances of death, and that is the reason behind their success.