The journey from donor to recipient
Every organ transplant is the result of a tightly orchestrated chain in which people, resources, and timelines come together. Who is involved, and what requirements and challenges are involved before an organ reaches the recipient?
30 maart 2026
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
The Dutch Transplant Foundation (NTS), commissioned by the Ministry of Health, Welfare and Sport, manages the coordination and cooperation between all involved parties nationwide. The NTS coordinates the organ chain and fulfills legal tasks arising from the Organ Donation Act. These tasks are carried out via the Organ Center, which is available to doctors 24 hours a day. The Organ Center consults the Donor Register, registers donor procedures, and organizes parts of the logistics, such as the transport of retrieval teams and donor organs to transplant centers.
Eurotransplant
The NTS has delegated 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. In this way, the NTS and Eurotransplant work together to ensure that donor organs reach the patients who need them most as fairly and efficiently as possible.
“Teams, equipment, and organs move across the country via various routes”
The retrieval
In organ donation, everything starts with one fixed point: the time of death for 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. As more teams become involved, the puzzle becomes more complex, 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 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 enormous commitment from everyone in the chain.
Air transport
If distances are great or time pressure is extreme, the plane is sometimes the only means to get an organ to the right place on time. This is especially the case with international trajectories.
Marc Buijs, Chief Commercial Officer at Exxaero, NTS partner for organ transport flights:
Within Eurotransplant, the country that is allocated an organ retrieves it itself. Dutch teams therefore regularly fly to Germany, Austria, Belgium, or Slovenia. Air transport can also be necessary within the Netherlands, particularly for heart transplants, where every minute counts. After a notification from the NTS, a complex logistical operation starts immediately, with coordination between the ODC, pilots, doctors, NTS, Eurotransplant, and ground transport. Air transport is given priority in air traffic; that time gain can be crucial for the success of a transplant.
Approximately 75 charter flights take place per year for heart, lung, and liver transplants.
These flights cover a distance of at least 500 kilometers or have a travel time of more than 2 hours.
Road transport
For the road carrier, organ logistics begins 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 ODCs, retrieval teams, and blood samples. During a donation procedure, there can easily be seven or eight drivers on the road at once, 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 exactly what they are transporting and why every minute counts.
Tissue donors in 2025
There have never been as many tissue donations as in 2025. This is mainly due to the broadening of criteria for eye tissue donation. Eye tissue can now also be donated at an advanced age: 13% of these donors were 86 years or older.View more figures about tissues here.
Tissue donation: a different route
A donor can also donate tissue. This concerns eye tissue, skin, heart valves, and bone and tendon tissue. Tissue retrieval takes place within 24 hours after death in a mortuary, funeral home, or hospital and is performed 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 by tissue type.
This article is from Transparant magazine (no. 97).
Curious about more stories and background? Read the full magazine here.
