With cases of Covid-19 spiraling across the country, Spanish ICUs -- which are critical for transplant surgery -- were suddenly overwhelmed with an unprecedented number of critically ill patients. But even then, Spain maintained higher numbers than other countries had before the pandemic, with 37.4 donors per million residents in 2020 compared with 29.4 in France and 36.1 in the United States in 2019. And it retained its status as world leader, carrying out five percent of all transplants worldwide, even though it only represents 0.6 percent of the global population.