Solid organ transplantation (Tx) and Haematopoietic stem cell transplantation (HSCT) are complex procedures required to treat terminal organ dysfunction. These programs require multidisciplinary teams and represent highly demanding challenges to patients, families, health professionals, hospitals, organ procurement organizations and national health systems. Tx Patients share numerous common issues both pre-transplantation and in the long term follow up.  We want to report the whole transplant activity in one of the few paediatric hospitals where any organ may be transplanted. Every solid organ program has its own Tx team but additionally some complicated patients are treated by a common multidisciplinary team that might include any kind of paediatric subspecialist  which helps significantly patient care.  We highlight the year each organ Tx began, types of procedures performed and long term patient survival.
Since the start of these programs, 1.799 patients have received either a solid organ or HSCT at our hospital up to December 31st 2016. Kidney Tx started in 1985 and includes 443 procedures (134 living donor) with graft survival for living donors of 97.8% and 90.4% at 1 and 5 years respectively.  Graft survival after cadaveric kidney Tx was 92.4% and 82.1% at 1 and 5 years.  Global patient survival was 97% at 5 years. Liver Tx started in 1986, 675 patients have been transplanted (cadaveric or living donor and split procedures) with a 92.5%, 85.3 and 83% patient survival at 1, 5 and 10 years. Retransplantation was required in 17% of the cases from 1990 to 2010 and in 6% from 2011 to 2015. Living donor procedures account for 27% of total procedures and 2/3 nowadays. Heart transplantation began in 1994, 60 procedures have been performed with a global survival of 75%, 60% and 55% at 1, 5 and 10 years after Tx.  After 2005 survival increased to 80% at 12 months and a 75% at 100 months. Intestinal and multivisceral Tx have been performed for 99 patients since 1999 with a graft survival of 67.5%, 47.5% and 41.1% and a patient survival of 78%, 68% and 66% at 1, 5 and 10 years. Lung Tx began in 2012 with 2 procedures performed with no deaths.
Autologous (54%) and Allogenic (55%) HSCT h as been undertaken since 1991 for 520 patients from HLA identical familiar donor with 71% survival at 10 years, HLA non identical donor with a 58% survival, haploidentical with 40% survival an umbilical cord Tx with a 57% survival.
Transplantation programs at our hospital have good long-term results. Concentration of different transplantation programs and professionals may lead to an improvement in patient care and in the quality of life of our patients.