The journey from donor to recipient

Who is in charge?

When a potential donor is identified in a hospital, the Organ Center of the Dutch Transplant Foundation (NTS) is called in.

NTS

Commissioned by the Ministry of Health, Welfare and Sport, the Dutch Transplant Foundation (NTS) manages the national coordination and cooperation among all parties involved. The NTS coordinates the organ chain and fulfills statutory duties arising from the Organ Donation Act. These tasks are carried out via the Organ Center, which is accessible to doctors 24 hours a day. The Organ Center consults the Donor Register, registers donor procedures, and organizes logistical components, such as the transport of retrieval teams and donor organs to transplant centers.

Eurotransplant

The NTS has entrusted the allocation of donor organs to Eurotransplant. This international organization manages the joint waiting lists and determines, according to fixed medical rules, which patient receives an available organ. Together, the NTS and Eurotransplant ensure that donor organs reach the patient who needs them most as fairly and efficiently as possible.

The retrieval

In organ donation, everything starts with one fixed point: the time of death communicated to the donor family.

Jeroen de Jonge, transplant surgeon and chairman of the National Consultation of Regional Retrieval Teams (LORUT):
When does the conversation take place, when does the procedure start, and when must the teams be there? Those moments are sacred. Everything that happens afterward—planning, logistics, transport—must adapt to that. The more teams are involved, the more complex the puzzle becomes, but in the Netherlands that is exceptionally well organized. The surgeons on duty do no other clinical work on those days. They are fully available for donation.

And that is what makes our system unique. Sometimes teams know days in advance that a procedure is coming, but often they only have a few hours of preparation time. Behind the scenes, the logistics are impressive: teams, equipment, and organs move across the country via various routes. That combination of precision, speed, and emotion makes this work special and requires immense dedication from everyone in the chain.

Transport by air

When distances are great or time pressure is extreme, the airplane is sometimes the only means to get an organ to the right place on time. This mainly applies to international trajectories.

Marc Buijs, Chief Commercial Officer at Exxaero, NTS partner in organ transport flights:
Within Eurotransplant, the country assigned an organ retrieves it themselves. Dutch teams therefore regularly fly to Germany, Austria, Belgium, or Slovenia. Air transport may also be necessary within the Netherlands, particularly in heart transplantations, where every minute counts. Following a notification from the NTS, a complex logistical operation starts immediately, with coordination between the ODC, pilots, doctors, NTS, Eurotransplant, and ground transport. Donor flights are given priority in air traffic; that time saved can be crucial for the success of a transplantation.

Transport by road

For the road carrier, organ logistics starts with a single phone call, but it only ends when every organ has safely arrived at the right place.

Lammert de Wind, coordinating driver at Kijlstra Zorgvervoer:
My role is to oversee that entire process: not just the driving itself, but also the transport of ODC's, retrieval teams, and blood samples. During a donation procedure, easily seven or eight drivers can be on the road at the same time, each with their own assignment and time pressure. Organs never travel together; each organ follows its own route because risks must be spread and destinations can change until the very last moment. That makes our work intense, but also precise. We work with specially trained drivers who know very well what they are transporting and why every minute counts.

Tissue donation: a different route

A donor can also donate tissue. This involves eye tissue, skin, heart valves, and bone and tendon tissue. Tissue retrieval takes place within 24 hours of death in a mortuary, funeral home, or hospital and is carried out by retrieval staff from the Tissue Retrieval Organization Netherlands (WUON). After retrieval, the tissue goes to a tissue bank for quality measurements, processing, and storage. After retrieval, WUON organizes the transport to tissue banks before distribution follows. Tissues are transported without urgency, but with strict protocols for packaging, cooling, and storage. That logistical precision makes the longer chain safe and effective. As soon as a recipient is found, the tissue bank releases the tissue for transplantation. Waiting times vary per tissue type.

This article is from Transparant magazine (no. 97).
Curious about more stories and background? Read the full magazine here.