Better preparation for transplants thanks to access to CT scans

“My life as a transplant surgeon is getting better now that I can view CT scans of the donor in advance,” says Mijntje Nijboer. The surgeon at the Leiden University Medical Center works with organ transplants daily. She works in one of the five independent retrieval teams in the Netherlands. If an organ donor passes away in a hospital within her region, this team comes to perform the surgery to retrieve the organs. In addition, she works on the receiving end: as a transplant surgeon, she performs surgeries in which patients receive a donor organ.

Sharp and detailed

Since November 2025, it has been possible to share anonymized CT scans and X-rays of organ donors via the Twiin portal. The 'Implementing Image Sharing' project group of the Dutch Transplant Foundation worked on this for four years. CT scans provide useful information about the size, shape, and quality of a donor organ. “You can see the vascular structures very well, for example,” says organ donation coordinator (ODC) Wim de Jongh from Maastricht UMC+, who was part of the project group. “Anatomically, there is quite a bit of variation in blood vessels. Kidneys, for example, can have multiple supply or drainage vessels instead of one. Such a kidney might be perfect, but still not suitable for the receiving patient.”

Finding the way

Mijntje is therefore happy that, as a transplant surgeon, she can now view CT scans of donor organs in advance. “I find it incredibly helpful to be able to look for myself: will this organ fit this patient? A liver that is too large can lead to many problems. I also know in advance if I need to account for an abnormal number of blood vessels.” Since she has been able to study the CT scans beforehand, she has already rejected donor kidneys. “There were calcifications that extended into the organ. Those kidneys were therefore not retrieved at all. If someone is not donating another organ, it also means you don't have to initiate a procedure with an independent retrieval team. It is also nice for the loved ones if a donor procedure does not have to be started unnecessarily.”

Sharing in advance

A CT scan of the donor is often already made during treatment. Otherwise, this is done before the donor surgery; this has been in the guidelines since 2023. Prior knowledge about the donor's body is of great value to the retrieval surgeon, Mijntje explains. “In living patients, beating arteries are a very important clue for finding your way around someone's body. But in a donor who no longer has blood circulation, there are no beating arteries.” However, until November 2025, there was no technology to share the CT scan in advance from the donor hospital. Mijntje: “As a retrieval surgeon, I only got to see them on-site. The organ donation coordinator could log in in the OR and scroll through the images.”

Portal provides access

The project group first had to find an IT supplier that all hospitals could work with. After countless conversations with IT experts from hospitals, the choice fell on Twiin. That company was already in the process of connecting all hospitals to its portal, a webpage that provides access to information and services.

Anonymizing images

Then came “the hardest part,” says Wim. “We thought: we’ll send the images to Twiin and they’ll send them to the hospitals; easy as pie! But that wasn’t possible just like that, because those images are linked to the donor’s name and date of birth. The question was: how are we going to anonymize those images while still making it clear which donor they belong to?” Not everyone thought anonymization was necessary, Ramona explains. “Doctors said: these patients are deceased anyway, and we have professional confidentiality. But professional confidentiality doesn’t mean that every healthcare provider should be able to look at them.”

Eurotransplant donor number

The project group found a solution: replacing the donors' personal data with their Eurotransplant donor number. The ODCs take care of this. First, the radiologist at the donor hospital sends the images to Twiin. With the push of a button, the ODC can anonymize those images and save them under the Eurotransplant donor number. Via a link in the Eurotransplant Donor Report, anyone who needs the images can view them.

Succeeded quickly

The portal is now in full use. In the beginning, radiologists had to get used to uploading images. “Sending images via Twiin usually happens during the day, by the secretariat. But our procedures are often in the evening and at night and require urgent imaging,” Wim explains. In the launch month of November, they succeeded in sharing the images in half of the cases. The following month, it worked for 32 out of 35 donor procedures. And as of February 2026, it almost always goes well.

Less stress

According to Ramona, the NTS is receiving “super enthusiastic reactions” from doctors. “They also want to start sharing echoes and CAGs. But that’s not possible in this system, because it’s a different type of file. We’ve secretly already looked into that.” Laughing: “So I would say: just enjoy this for now.” Mijntje certainly does. “Both a donor operation and a transplant operation are not the easiest surgeries. They aren’t finished in an hour, either. It saves stress and tension if you go into them well-prepared.”