Autonomous Region Of Madrid Research Articles

Enfermedad invasora neumocócica en pediatría: ¿qué puede esperarse de la nueva vacuna conjugada neumocócica 13-valente?

IntroductionThe objective was to analyse the trends of invasive pneumococcal serotypes and antimicrobial resistance patterns in children in the Madrid Autonomous Region (CAM), paying special attention to the first results obtained after the introduction in June 2010 of a 13-valent pneumococcal conjugate vaccine (PCV13). MethodsDuring 2007–2011, 100 cases (96 patients) of invasive pneumococcal disease (IPD) were identified. Susceptibilities to penicillin and cefotaxime were determined by microdilution. The strains were sent to the Madrid Regional Public Health Laboratory for serotyping. ResultsA total of 100 isolates of pneumococcus were made at the Hospital Infantil Niño Jesús, Madrid, 88 in blood and 12 in cerebrospinal fluid. Fifty percent of patients were aged <2 years. Eighteen serotypes were found. Serotype 19A was found in 29% of cases: 55% of IPD in children aged <2 years was due to 19A. Ten percent of isolates were penicillin non-susceptible (PNS) and 4% cefotaxime non-susceptible. Seven out of ten PNS strains were 19A. Serotypes 1, 5, 7F, 6A and 19A decreased after introduction of PVC13. Between 2007 and 2009, there was a progressive increase in IPD due to serotype 19A, with a predominance of penicillin-susceptible strains. This increase decreased slowly in 2010 and 2011 and in 2011 IPD was due in equal parts to susceptible and PNS 19A strains. ConclusionsPCV13 reduced the incidence of IPD due to vaccine serotypes, especially 19A. The reduction was linked to a reduction in penicillin non-susceptibility. Our findings suggest that the impact of PCV13 on pneumococcal colonization could be exercised on a predominantly susceptible population, probably due to the insufficient time after implementation of PCV7 in Madrid.

Characterization of a rapid climate shift at the MIS 8/7 transition in central Spain (Valdocarros II, Autonomous Region of Madrid) by means of the herpetological assemblages

Climate instability with high-amplitude and rapid shifts during the Middle Pleistocene is well known from pollen records and deep-ocean sediment cores. Although poorly correlatable with such long climate/environment records, the successive fossil amphibian and reptile assemblages from the Middle Pleistocene site of Valdocarros II (Autonomous Region of Madrid, central Spain) provide a unique opportunity to characterize the climatic and environmental features of such rapid (certainly less than 1000 years) shifts from cold to warm conditions in a terrestrial sequence. As the amphibians and reptiles do not differ at species level from the extant herpetofauna of the Iberian Peninsula, they can contribute to the reconstruction of the landscape and climate. In this paper, the mutual climatic range and habitat weighting methods are applied to the herpetofaunistic assemblages in order to estimate quantitative data. The difference in mean annual temperature between “cold” and “warm” periods is estimated at 3.2 °C, with a greater increase in temperature during winter (+3 °C) than during summer (+1 °C). During “cold” periods the climate was more Oceanic (although preserving some dryness during the summers), whereas during “warm” periods the climate became Mediterranean (with mild winters and a long period of dryness in the summer and early autumn). Though higher during cold periods, the continentality (or atmospheric temperature range) remained roughly similar, in accordance with the geographical location of the site in the centre of the Iberian Peninsula. A greater amount of open landscape occurred during “cold” periods, whereas during “warm” periods the wooded areas expanded from 20% to 40% of the landscape surface. Such climatic/environmental changes, together with the numeric datings of the site, suggest that this shift may correspond to the transition from MIS 8 to MIS 7, also called Termination III.

Integrated networks. A territorial planning proposal for biodiversity conservation in urban, densely populated regions. The case of the Autonomous Region of Madrid, Spain

Just like many other natural areas in urban, industrialised regions worldwide, the protected areas of the Autonomous Region of Madrid suffer from two main threats which can compromise long-term biodiversity conservation: land use changes towards artificial uses and massive tourism pressure. To address both threats and achieve effective sustainable development in the region, this paper proposes a GIS, ecology-driven, biodiversity-oriented model based on sound territorial planning whose underlying theory can be exported to other regions with similar characteristics. This model is based on three different protected networks with a decreasing degree of protection and an increasing degree of public use intensity, respectively. It underpins the conservation aims of protected areas, considers the importance of the territorial matrix and allows a wide range of recreational and economic uses across the territory.

Tasas de respuesta a tres estudios de opinión realizados mediante cuestionarios en línea en el ámbito sanitario

The main advantages of online questionnaires are the speed of data collection and cost savings, but response rates are usually low. This study analyzed response rates and associated factors among health professionals in three opinion surveys in the autonomous region of Madrid. The participants, length of the questionnaire and topic differed among the three surveys. The surveys were conducted by using paid Internet software. The institutional e-mail addresses of distinct groups of health professionals were used. Response rates were highest in hospitals (up to 63%) and administrative services and were lowest in primary care (less than 33%). The differences in response rates were analyzed in primary care professionals according to age, sex and professional category and only the association with age was statistically significant. None of the surveys achieved a response rate of 60%. Differences were observed according to workplace, patterns of Internet usage, and interest in the subject.

Prevalence of chronic head, neck and low back pain and associated factors in women residing in the Autonomous Region of Madrid (Spain)

ObjectiveTo compare the prevalence of chronic headache (CH), chronic neck pain (CNP) and chronic low back pain (CLBP) in the autonomous region of Madrid by analyzing gender differences and to determine the factors associated with each pain location in women in 2007. MethodsWe analyzed data obtained from adults aged 16 years or older (n = 12,190) who participated in the 2007 Madrid Regional Health Survey. This survey includes data from personal interviews conducted in a representative population residing in family dwellings in Madrid. The presence CH, CNP, and CLBP was analyzed. Sociodemographic features, self-perceived health status, lifestyle habits, psychological distress, drug consumption, use of healthcare services, the search for alternative solutions, and comorbid diseases were analyzed by using logistic regression models. ResultsThe prevalence of CH, CNP and CLBP was significantly higher (P<0.001) in women (7.3%, 8.4%, 14.1%, respectively) than in men (2.2%, 3.2%, 7.8%, respectively). In women, CH, CNP and CBLP were significantly associated with having ≥3 chronic diseases (OR 7.1, 8.5, 5.8, respectively), and with the use of analgesics and drugs for inflammation (OR: 3.5, 1.95, 2.5, respectively). In the bivariate analysis, the factors associated with pain in distinct body locations differed between men and women. ConclusionsThis study found that CH, CNP and CLBP are a major public health problem in women in central Spain. Women have a higher overall prevalence of chronic pain than men. Chronic pain was associated with a higher use of analgesics and healthcare services.

Comorbidity Patterns in Patients with Chronic Diseases in General Practice

IntroductionHealthcare management is oriented toward single diseases, yet multimorbidity is nevertheless the rule and there is a tendency for certain diseases to occur in clusters. This study sought to identify comorbidity patterns in patients with chronic diseases, by reference to number of comorbidities, age and sex, in a population receiving medical care from 129 general practitioners in Spain, in 2007.MethodsA cross-sectional study was conducted in a health-area setting of the Madrid Autonomous Region (Comunidad Autónoma), covering a population of 198,670 individuals aged over 14 years. Multiple correspondences were analyzed to identify the clustering patterns of the conditions targeted.ResultsForty-two percent (95% confidence interval [CI]: 41.8–42.2) of the registered population had at least one chronic condition. In all, 24.5% (95% CI: 24.3–24.6) of the population presented with multimorbidity.In the correspondence analysis, 98.3% of the total information was accounted for by three dimensions. The following four, age- and sex-related comorbidity patterns were identified: pattern B, showing a high comorbidity rate; pattern C, showing a low comorbidity rate; and two patterns, A and D, showing intermediate comorbidity rates.ConclusionsFour comorbidity patterns could be identified which grouped diseases as follows: one showing diseases with a high comorbidity burden; one showing diseases with a low comorbidity burden; and two showing diseases with an intermediate comorbidity burden.

¿Autogestión o autonomía de gestión? Informe SESPAS 2012

Western countries with strong primary care systems organize their health services around this healthcare modality, which serves as a gateway to the system and is characterized by multidisciplinary teamwork, management transferred to the teams and a broad services portfolio. The contractual relationship between professionals and the public health system is a useful tool to modulate the efficiency of services and their ability to meet the expectations of citizens and professionals. Some countries choose to contract professionals directly, either individually or through a professional organization, an option known as a self-management system. Others opt to contract public or private entities, which in turn recruit health professionals as employees.In the latter countries, the concept of management decentralization and managerial autonomy has arisen. In Spain, only Catalonia has enabled professional entities to be hired to provide public health services, through commercial formulas, i.e. in a competitive market relationship. This relationship allows the use of corporate governance mechanisms that are not subject to public control through state intervention. The other forms of management promoted in Spain to avoid the controls of state intervention - foundations or associations - have been unsuccessful, except in the autonomous region of Valencia and some models in the autonomous region of Madrid.

Perception, use and valuation of protected areas by local populations in an economic crisis context

SUMMARYWith some exceptions, local populations’ opinions are not considered sufficiently important in developing policies related to protected areas (PAs), despite their recognized effect on conservation and management. This paper surveys the views and the activities performed by residents living inside or near the 10 PAs of the densely-populated, industrialized Autonomous Region of Madrid, with a view toward better informing their management. The degree of knowledge, perception of conservation state, activities performed inside them and stated importance were assessed, and the hypothesis that the economic valuation of PAs had decreased between 2006/2007 and 2009 as a result of Spain's economic crisis was tested using the contingency valuation method. Local populations valued PAs highly, despite their limited use of them and their moderate perception of the conservation state of these areas. The objective valuation of PAs (measured by three economic variables) remained high among the local populations at the peak of the economic crisis (assessed by the gross domestic product growth), although declared economic support for PAs had significantly shifted towards a ‘pay per use’ scheme.

Gender Mainstreaming in Spain: The Case of the 'Lidera Project' in the Autonomous Region of Madrid

Women continue to be under-represented in senior positions. The disparity is widest at the very top, where only 3% of companies have a woman directing their highest decision-making bodies (Iversen and Frances, 2010). In this paper, we present a implemented by public agents as key actors for gender mainstreaming. Gender mainstreaming as a strategy is meant to actively counteract this gender bias and to use policymakers' standing mandate to promote more equitable relations between women and men (Verloo, 2000: 13). The rationale for pursuing gender mainstreaming via the Structural Funds is as much about promoting economic efficiency as it is about promoting equity. In this paper, we analyze a specific case launched three years ago by the government of the Autonomous Community of Madrid, the Project. The main objectives pursued by this initiative are to enhance women's professional opportunities and facilitate their access to leadership positions in companies. We focus our study on the impact of the Lidera Scholarships initiative, which consists of granting scholarships for management study programs at the top business schools in Madrid. Now that several years have passed since implementation of the Lidera project, it is time to analyze its impact and effectiveness, that is, to assess the overall effectiveness of the gender mainstreaming effort through the Lidera project. We analyze the impact at the macro level of analysis and at the individual level through five constructs: Professional Improvement; Working Conditions; Labor Market Perception; Management Training; and Work and Family Balance. We can conclude that at the individual level the LIDERA EFFECT exists and that it has a positive and differential impact on three of the five constructs. At a macro level, there is some impact on female unemployment and the level of competitiveness of the Autonomous Community of Madrid. We can therefore assume that government efforts to assign structural funds to improve management education for women have exponential results. This case shows the evidence for the particular case of Madrid, but the positive results of this initiative carried out by political actors could be a best practice applicable also to Latin American countries.

Radiología urgente: lo que el clínico espera del radiólogo

We review the relations between the radiology department and the clinicians that attend emergency patients, complementing our opinions with a survey conducted in the emergency departments of hospitals in the autonomous region of Madrid. A dedicated emergency radiology section is present in 63.2% of hospitals. Radiologists are readily available to consult in the emergency department in 100%. Radiologists are involved in the initial workup in 61% of hospitals, in follow-up in 22.3%, and in both the initial workup and follow-up in 16.7%. At least one common protocol is shared by radiologists and emergency clinicians in 73.7% of hospitals. Radiologists participate in deciding which imaging tests to perform in 78.9% of hospitals. Radiologists provide a written report of the examination in 83.3% of cases. Continual assessment of the relations between the emergency department and the radiology department will enable us to understand their dynamics and to know what aspects can be improved.

A modo de presentación. El programa CEIMES: un trabajo colectivo sobre las dinámicas y las prácticas educativas en los Institutos de Enseñanza Secundaria del Madrid liberal (1845-1936)

The Development of Instructional Methods in Historic High Schools of Madrid is the result of the cooperative work of the members of the I+D activities program; Science and Education in the Historic High Schools of Madrid as Learned Through its Cultural Heritage from 1845 to 1936, financed by the Autonomous Region of Madrid. The main aim of this work is the study of the dynamics and educational practices in outstanding places of production and transmission of scientific and humanistic knowledge over a long period of time. The ten papers address the three most important aspects of those dynamics and educational practices: the regulatory context, based on legislation; the empirical context, based on teaching experiences; and the discursive context, expressed in school textbooks is also discussed.

Prevalence of Adherence to Treatment in Homebound Elderly People in Primary Health Care

Adherence to the therapeutic plan is one of the most important health issues in terms of treatment efficacy, healthcare costs and patient safety. Unfortunately, homebound elderly patients are especially vulnerable to nonadherence because they have higher morbidity rates combined with cognitive and social problems that hinder their correct use of drugs. The level of therapeutic adherence in homebound elderly people has not been adequately studied. To estimate the prevalence of therapeutic adherence, using the Morisky-Green test, in homebound elderly patients taking polypharmacy (defined as use of four or more drugs), and to study the factors associated with adherence. This was a descriptive, cross-sectional, multicentre study. A total of 327 patients were selected by random start systematic sampling from the total number of homebound patients taking four or more drugs in Healthcare Area 4 of the Madrid Autonomous Region, Spain. Through an in-home survey of patients and their caregivers, information was gathered on sociodemographic data, co-morbidities, number of hospital admissions, responsibility for purchasing and preparation of the medication, level of cognitive impairment (Pfeiffer questionnaire), functional dependence in activities of daily living (Katz Index), knowledge of the disease (Batalla test), adherence to treatment (Morisky-Green test), visual and auditory perception, and caregiver burden (Zarit interview). Of the homebound patients, 65.7% (95% CI 60.6, 70.9) had good adherence to treatment. The variables most negatively associated with therapeutic adherence, after adjustment for age, sex, number of drugs, knowledge of the disease, and cognitive function, were a large caregiver burden (odds ratio [OR] 3.09; 95% CI 1.75, 5.48) and impaired hearing (OR 2.00; 95% CI 1.17, 3.40). There was also a trend toward a positive association between nonadherence and patients aged <85 years (OR 1.57; 95% CI 0.93, 2.65) and patients who had nine or more drug prescriptions (OR 1.59; 95% CI 0.96, 2.65). Poor therapeutic adherence in homebound elderly patients receiving polypharmacy is a serious problem affecting one of every three individuals concerned, and is directly related to caregiver burden, regardless of age, sex, cognitive status or number of drugs administered.

Being physically active in old age: relationships with being active earlier in life, social status and agents of socialisation

ABSTRACTCritical reviews of the literature on the factors that influence physical activity among older adults have argued that existing theoretical frameworks should be extended by integrating those that deal with the complex processes of socialisation and social learning. This paper explores some of the social processes that influence older people's participation in physical activity (beyond that associated with everyday domestic tasks). A questionnaire with items on personal, social and environmental characteristics was completed by a random sample of older adults in the Madrid Autonomous Region (Spain). Significant relationships were found between the type of physical activity participation and: being physically active at earlier life stages, socio-economic status, the encouragement of others or social support in being active, and the knowledge and availability of local facilities. Some cases were observed of re-socialisation into physical activity among those who had been inactive earlier in life, and both appropriate environmental and supportive social conditions appeared instrumental. The findings could usefully inform the design of future social programmes to promote active lifestyles in later life, but given the complexity of the socialisation processes, it would be advisable for future studies to examine other than the four factors featured in the presented analysis, such as the role of cultural differences.

Hospitalizaciones por cáncer de cuello de útero en la Comunidad de Madrid, 1999-2002

Objective The aim of this study was to assess the frequency and characteristics of cervical cancer hospitalizations in the Autonomous Region of Madrid, and to estimate the resource consumption and costs related to hospital treatment of the disease. Methods A retrospective study was conducted by using information of the cervical cancer patients hospitalized in the Autonomous Region of Madrid from the national surveillance system for hospital data, Conjunto Mínimo Básico de Datos. Data on resource consumption for costs analysis was collected from clinical records of women admitted to Hospital Universitario 12 de Octubre of Madrid with cervical cancer. Results During the study period (1999-2002) an annual average of 667 hospitalizations with cervical cancer in the Autonomous Region of Madrid hospitals were reported. Hospitalization rate were 30.7 per 100,000 women ≥ 20 years of age and the average number of hospitalizations per patient was 2.2. A total of 126 deaths among hospitalized women were reported during the study period (average annual number of 32 deaths). The mean cost per patient of the hospital treatment was estimated in 5.247 €. Conclusion Each year more approximately 700 cervical cancer cases are notified in the Autonomous Region of Madrid hospitals. These represent an annual expenditure for the health care system of about 3,5 millions €.

Coste-utilidad de la incorporación de las nuevas vacunas antineumocócicas conjugadas al programa de vacunación de la comunidad de Madrid. Impacto sobre la enfermedad neumocócica invasora

Introduction The inclusion of conjugate pneumococcal vaccines to the Regional Immunization Program avoids cases, among others, of invasive pneumococcal diseases caused by serotypes of Streptococcus pneumoniae contained in the vaccines. Objective To assess efficiency of conjugate pneumococcal vaccine- 13 valent (PCV13) versus 10 valent (PCV10), under National Health System perspective. Methods A cost-utility model was developed to estimate cost per quality adjusted life year (QALY) associated to primary bacteriemic, empyema, meningitis and bacteriemic pneumonia with vaccine administration in the Autonomous Region of Madrid. The estimation of cases to avoid and serotype coverage was based on epidemiologic information available at regional level. Additionally to direct protection, the model considers the potential indirect effect on the general population. A one-way sensitivity analyses was performed, including parameters with most uncertainty. Results PCV13 yields 224 QALYs versus 70 QALYs with PCV10. The incremental ratio is 16908 €/QALY gained. Deterministic sensitivity analysis showed that model results are robust, parameter that most influence on the results was vaccine indirect effect. Reducing PCV13 vaccine schedule from 4 to 3 doses was a dominant strategy. Conclusions The inclusion of PCV13 is a cost-effective strategy versus PCV10. The PCV13 3 doses schedule is a dominant option, being a cost-saving measure for the National Healthcare System.

Modern pollen analysis: a reliable tool for discriminating Quercus rotundifolia communities in Central Spain

The paucity of modern pollen-rain data from the Iberian Peninsula is a signifi cant barrier to understanding the Late Quaternary vegetation history of this globally important southwestern mediterranean region. The relationships between current vegetation, the available environmental data and modern pollen are examined in Central Spain for both natural and human-induced vegetation types, as an aid for palaeoenvironmental reconstructions. A set of 60 surface moss polsters was sampled from different vegetation and land-use types in the Madrid autonomous region, and analysed to obtain modern pollen analogues of ancient cultural landscapes. Hierarchical cluster analysis (HCA) was used to divide the main pollen taxa into two major groups and ten subgroups representing the anthropic and natural vegetation types and the main communities within them. Statistically distinctive taxa were identifi ed using principal components analysis (PCA). The results indicate that human-infl uenced communities have pollen assemblages that are different from those of natural vegetation types. When modern pollen assemblages are compared, the three Holm oak (Quercus rotundifolia) communities of Madrid, representing two phytogeographical provinces and three subprovinces, are easily distinguishable by their pollen spectra.

Legal aspects about construction and demolition waste (CDW) in Spain. The Autonomus Region of Madrid

Spain is the fifth country in Europe generating construction and demolition waste (CDW) and unfortunately, it is one which does the least to recuperate it, as stated in the Symonds & Ass report. This report indicates that 90% of the 13 million tons of yearly generated waste materials end up in the dump and only 5% is recycled. In our country the management of CDW depends from the Autonomous Regions with the exception of the waste originated from minor house works; therefore, the Autonomous Regions have defined their management CDW plans referring to the National Plans. Those plans have been set based on the hierarchical principle, stated in title 1.1 of the 10/1998 Law referring to waste products. This principle establishes prevention as a top priority -whenever possible- followed by reutilization and recycling and in addition, to clearly assess all that cannot be reused o recycled. The final deposit in the dump is the last option, and the least satisfactory one. In this paper, some noticeable legal actions promoted in the last years by the Autonomous Region of Madrid to improve the management of CDW in buildings are presented.

Evolution of measles, rubella and mumps from the third seroepidemiological survey in the autonomous region of Madrid, Spain

In this study results against measles, rubella and mumps obtained in the III Sero-epidemiological Survey of the Autonomous Region of Madrid, performed in 1999-2000, were related to the posterior evolution of these diseases in this Region. The prevalence of antibodies against measles, rubella and mumps was >90%, >95% and <90 %, respectively. Despite of the good results obtained for rubella and measles, in 2005 and 2006 two important outbreaks of these diseases occurred in Madrid. The rubella outbreak in 2005 (450 cases) affected especially to immigrants of both sexes (mainly from Central and South America) and Spanish adults males. The 2006 measles outbreak (174 cases) was imported, a high proportion of cases were adults and most of the patients were unvaccinated. No differences according to sex were observed. In Madrid mumps virus circulation has continued from 1999 to present. Two epidemic waves in the periods 2000-2001 and 2006-2007 have been detected. During 2006-2007, an important proportion of cases showed antecedents of vaccination. Each one of these three diseases has typical characteristics. However, the three has in common the change in the age of apparition, with a growing frequency of cases among young adults.

Emerging trends in the seroprevalence of canine leishmaniosis in the Madrid region (central Spain)

This report describes a cross-sectional serological survey of the epidemiology of canine leishmaniosis (CanL) performed in 2006 and 2007 in the Madrid region (central Spain) where the disease is endemic. The work presented here is one of the several studies conducted in different Spanish regions under the Integrated Project of the European Commission entitled Emerging Diseases in a changing European eNvironment (EDEN). The aim of this project is to identify and catalogue European ecosystems and environmental conditions that determine the spatial and temporal distributions and dynamics of several pathogenic agents including Leishmania infantum (EDEN-LEI). The study area (Madrid Autonomous Region) was selected on the grounds of its wide altitude range. This area was surveyed from NE to SW across its mountain range (Sistema Central) and plateau area. One thousand and seventy-six dogs from 32 villages were examined for clinical signs of CanL, and serum samples were obtained to determine several haematological and biochemical variables. Leishmaniosis-specific antibodies were identified using an indirect immunofluorescence antibody test (IFAT). 87 of the 1076 dogs were seropositive for the protozoan (IFAT: cut-off ≥ 1/80) indicating a seroprevalence of 8.1% (0–16.1% depending on the village). On the basis of a physical examination and the biochemical/haematological status of each dog, 32 of the 87 infected dogs were described as clinically healthy (37%). Seroprevalence showed a peak in young dogs (1–2 years) and a second larger peak among the older dogs (7–8 years). Factors correlated with a higher infection risk were age (OR = 1.15 [95% CI: 1.07–1.22]), weight (OR = 1.10 [95% CI: 1.04–1.16]), and living outdoors as opposed to in a home (OR = 3.38 [95% CI: 1.42–8.05]). According to data from studies performed in 1992 in the same area, the seroprevalence of CanL has increased 1.54-fold [95% CI: 1.04–2.29]. Given that this increasing trend cannot be attributed to differences in the sociodemographic characteristics of the dog populations, it is proposed that environmental changes could have had an impact on vector and reservoir densities and their geographical distributions. Further studies designed to explain this trend should attempt to correlate sand fly densities and CanL seroprevalences with climate, land use and human changes.

Organ Transplantation in the Madrid Autonomous Region

The Madrid Autonomous Region, a Spanish area with 6,200,000 inhabitants, has 7 hospitals authorized for organ transplantation, with 25 active programs for carrying out various transplantations: 18 for adults and 7 for children. Most of these hospitals are reference transplant centers for other Spanish regions. Between 715 and 760 transplantations are performed annually, which represents between 19% and 22% of Spanish activity. During 2007, 395 kidney, 220 liver, 55 heart, and 35 lung transplantations were performed, as well as 23 isolated or combination transplantations of other abdominal organs (pancreatic, intestinal, or multivisceral). Kidney, liver, heart, and children's intestinal transplant activity in 2007 represented 37%, 63%, 80%, and 100%, respectively, of all pediatric national activity. The Madrid Autonomous Region has a donation rate of 34.2 donors per million inhabitants. Of these, 30% are from non-heart-beating donors (NHBD), Maastrich criteria category 1 or 2. Various hospitals perform kidney, liver, and lung transplantations with these organs, representing 11% of the lung transplantations carried out in recent years, with this being a pioneer procedure worldwide. Despite the important transplant activity, we are working to increase donations, to improve organ donor detection and management protocols, as well as to reach a consensus on criteria to decrease the nonviability rates of potential transplant organs.