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Explanation of donation form

Why is it important to fill out this form? By filling out the donation form, the medical professional becomes more aware of the possibility of donation for every deceased person. In addition, this gives the NTS more insight into the donor potential.

How do you fill out the donation form?

  • Identification/patient sticker: serves as identification of the deceased and potential donor. Are the requested details not on it? Use a punch card or patient sticker.
  • Donor recognition by the physician.
  1. The cause of death can be a contraindication for donation. If the cause of death is unknown, consult the NTS organ center (071 5 795 795).
  2. In your opinion, is the deceased medically suitable for organ donation? Only the pre-printed options are absolute contraindications for organ donation. If there are no absolute contraindications and circulation is still intact, consult the NTS organ center (071 5 795 795) or the on-duty organ donation coordinator.
  3. In your opinion, is the deceased medically suitable for tissue donation? The pre-printed options are the most common absolute contraindications for tissue donation. In case of doubt, consult the NTS organ center (071 579 57 95).

Will of the deceased

  1. The Organ Donation Act requires the medical professional in the hospital to always consult the Donor Register in the event of a poor prognosis or after death, if the patient is potentially suitable as a donor.
  2. If a 'personal declaration' such as a donor codicil or other will is present, the declarations must be compared. Under the new Organ Donation Act (Art. 20 paragraphs 3 and 4), it follows that: • if the Donor Register result is 'consent or no objection', the personal declaration always takes precedence (instead of the registration in the Donor Register). • for other results from the Donor Register, the most recent declaration applies. For this, we ask you to note the date of the other declaration.

Donation conversation

The will of the potential donor is always leading. Depending on the will in the Donor Register, follow-up steps must be taken. If the Donor Register result for a competent patient is:

  • Consent or no objection → inform next of kin that donation will take place. Note: in the case of a 'consent' or 'no objection' registration, surviving relatives1 have the opportunity to make it plausible that the registration or donation was against the patient's wishes.
  • Partner or family decides or designated person decides → ask for consent from the partner, family (surviving relatives up to the 2nd degree), or designated person.
  • No → inform next of kin that no donation will take place. If the patient's will is deviated from, note the reason for this. NB: one cannot deviate from a 'no consent' registration. If the patient is incompetent, go to www.donatiegesprek.nl for more information about the meaning of the will and with whom you should conduct the donation conversation.

Donor registration with NTS

If the deceased has not been registered as a donor with the NTS Organ Center (071 5 795 795), state the reason for this. In the case of an unnatural death, the body must first be released before the retrieval can take place. You can coordinate this with the NTS organ center (071 5 795 795).

Signature

Sign the form and send it with the deceased to the mortuary so that it reaches the donation coordinator. Completing the donation form is mandatory for every deceased person in a hospital and is required based on the WOD (Organ Donation Act) article 20, 5th paragraph.