Spain led the world in organ donations in 2009 for the 18th consecutive year despite a sharp drop in road death fatalities, a key source of donated organs, Health Minister Trinidad Jimenez, said Monday.

A total of 4,028 organ transplants were carried out last year in Spain from 1,605 donors, a new record for the country, she told a news conference.

The number of deceased donors per million people -- a commonly used benchmark -- stood at 34.3 in 2009, almost double the 18.1 recorded in the entire European Union.

In the United States, which pioneered organ transplant surgery, it stood at 26.3.

"These results have enormous merit. Our numbers allow us to lead the world for 18 consecutive years," Jimenez told a news conference.

Spain has become a world leader in organ donation since it set up a network of transplant coordinators in 1989 at all hospitals in the country which closely monitor emergency wards to identify potential donors.

When they learn of a death, they tactfully talk to the grieving families to get permission to harvest organs and help save the lives of others.

The coordinators, whose work was depicted in the Oscar-winning movie "All About My Mother" by Spanish director Pedro Almodovar, may spend hours listening to the relatives and asking them to consider organ donation in a private room away from the hospital wards.

Only about 15 percent of families approached in Spain refused consent for organ donation, a huge drop from the 40 percent who refused in the 1980s before the system was set up.

At a handful of hospitals the refusal rate is nearly zero percent.

A single decision to donate can help four patients who need a kidney, lung, liver or heart.

Spain is working in the European Union to help introduce a similar system across the bloc.

"We want to extend to all 27 nations of the European Union the same conditions of quality and security which Spanish citizens enjoy and at the same time the same levels of organ donation," said Jimenez.

Spain's health ministry estimates that if the organ donation rate across the EU were at the same level which it is in Spain, the number of donors in the bloc could double to 18,000 from just under 9,000 in 2008.

This could save or improve the lives of at least 20,000 more people each year, the ministry said.

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