Introduction: Transplantation is an established medical procedure with six decades of experience and is a routine clinical in more than 80 countries worldwide. Several advances have been performed to increases a successfully results in a short and long-term. However, its degree of implementation is unequal between countries, and Pan American region is not the exception.

Method: With the aim to promote equitable access to transplantation through voluntary donation the Strategy and Plan of Action on Donation and Equitable Access to Organ, Tissue, and Cell Transplants from Pan American Health Organization emerged in 2019 (resolution CD57/11. Proposal was agreed by the Ministers of Health of the region. Regional main challenges were defined (e.g. lack of national programs, financing, and competent human resources) following WHO principles, and the guidelines for other actors, as the Ibero-American Network/Council of Donation and Transplantation. Implementation frame is 2019-30, and it is expected to be gradual and progressive, according country’s needs, vulnerabilities and priorities. It is based on 4-Strategic Lines of Action:

1. Strengthen health authority governance and stewardship
2. Increase the availability of organs, tissues, and cells through voluntary non-remunerated donation
3. Increase equitable access to transplants in health systems
4. Improve information management, monitoring, surveillance, risk evaluation, and risk management activities.

Each of them, with objectives and indicators to follow their advances.

Results: Implementation continues, preliminary results are:

• Baseline: Member States defined an indicators´ baseline. This overview give a regional panorama regarding and barriers/weaker points in where is mandatory to focus efforts.  Lowest scoring indicators are: absence of an adequate budget to finance a national plan, lack of a quality management system, scarcity of trained transplant coordinator or transplant service in high-complexity hospitals, the need to improve the supervision, control, and monitoring the activity, and lack of biovigilance systems.
• Current situation: In Pan American region, donation and transplantation rates were significantly reduced, and in some countries it stopped due pandemic of Coronavirus disease-19. To stimulate their reactivation a technical guideline was defined.
• Follow-up evaluation: Countries has started the process to fulfil the information regarding the first two-years of implementation. After their reception a new panorama will be stablished through the data analysis.

Conclusion: Regional indicators revels the main barriers for the gradual expansion of transplantation; between them, lack of financing and adequate financial protection, absence of quality system, scarcity of human resources with the necessary competencies and training, and poor development of supervision, control and biovigilance systems.