Better preparation for transplants thanks to access to CT scans

"My life as a transplant surgeon is improving now that I can view CT scans of the donor in advance," says Mijntje Nijboer. The surgeon at the Leiden University Medical Center is daily involved in organ transplantations. 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 operations in which patients receive a donor organ.

Sharp and detailed

Since November 2025, it has been possible to share CT scans and X-rays of organ donors anonymously via the Twiin portal. The project group 'Implement Image Sharing' 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. "For example, you can clearly see the vascular structures," says organ donation coordinator (ODC) Wim de Jongh from Maastricht UMC+, who was on the project group. "Anatomically, there is quite a bit of variation in blood vessels. For instance, kidneys can have multiple incoming or outgoing blood vessels instead of one. Such a kidney can be perfect, yet still not suitable for the receiving patient."

Finding the way

Mijntje is therefore glad that as a transplant surgeon she can now view CT scans of donor organs in advance. "I find it immensely helpful to be able to check myself: does this organ fit into this patient? A liver that is too large can lead to many problems. I also know beforehand whether I need to account for an abnormal number of blood vessels." Since she has been able to study the CT scans in advance, she has already rejected donor kidneys on occasion. "There were calcifications that extended into the organ. Those kidneys were therefore not retrieved at all. If someone is also not donating any other organ, it means you do not have to initiate a procedure with an independent retrieval team either. 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 has often already been made during treatment. Otherwise, this is still done before the donor operation; that has been in the guidelines since 2023. Prior knowledge about the body of the donor is namely of great value to the retrieval surgeon, Mijntje explains. "In living patients, beating arteries are a very important clue to find 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 the spot. The organ donation coordinator could log in in the OR and scroll through the images."

Portal provides access

First of all, the project group had to find an ICT supplier that all hospitals could work with. After countless conversations with ICT 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.

Anonymising images

Then came "the hardest part," says Wim. "We thought: we'll send the image material to Twiin and they'll send it to the hospitals; piece of cake! But it wasn't that simple, because those images are linked to the donor's name and date of birth. The question was: how are we going to anonymise these images, and still make it clear which donor they belong to?" Not everyone thought anonymisation was necessary, Ramona explains. "Doctors said: these patients have passed away anyway, and we are bound by medical confidentiality. But medical confidentiality doesn't mean that every healthcare provider should be able to view them."

Eurotransplant donor number

The project group found a solution: replacing the personal data of donors with their donor number within Eurotransplant. The ODCs take care of this. First, the radiologist of the donor hospital sends the images to Twiin. With the push of a button, the ODC can anonymise 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.

Quickly successful

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, handled by the secretariat. But our procedures often take place in the evening and at night, and imaging is urgent," Wim explains. In the launch month of November, they managed to share the images in half of the cases. The following month, it already succeeded in 32 out of 35 donor procedures. And as of February 2026, it almost always goes right.

Less stress

According to Ramona, the NTS receives "super enthusiastic reactions" from doctors. "They also want to start sharing ultrasounds and CAGs. But that's not possible in this system, because it's a different kind of file. We've secretly already looked into that." Laughing: "So I would say: enjoy this first." Mijntje certainly does. "Both a donor operation and a transplant operation are not the easiest surgeries. They also don't finish in an hour. It reduces stress and tension if you go into them well-prepared."