Tissue donation: explanation for loved ones
Did the doctor speak with you about tissue donation? On this page you can read how this works and what you can expect.
Which tissues are involved?
With tissue donation, a deceased person donates tissue. This can involve:
- Eye tissue
- Skin
- Heart valves
- Bone, cartilage and tendon tissue
After removal, this tissue ends up in a tissue bank. Doctors use these tissues to help patients. This can improve their quality of life.
Before tissue removal
The doctor first wants to know what the deceased's status is in the Donor Register. They discuss the registration with the loved ones and explain tissue donation.
What should you pay attention to as a surviving relative?
Mention your wishes in the conversation with the doctor regarding:
- TattoosSometimes a doctor has to cut through a tattoo. Do you have any objections to this? Indicate this.
- Light embalming
It is possible that a light embalming is desired. This is called thanatopraxy. This ensures that the body remains viewable for longer. This form of embalming is possible, except in the case of skin donation. Discuss with the doctor what takes priority: the deceased's wish for skin donation or thanatopraxy. - Ritual washing
During a ritual washing, water is used to purify the body and mind. Tissue donation is no longer possible after this. Before the washing, it may still be possible. Do you want a ritual washing for the deceased? Then discuss the possibilities available after tissue donation with the doctor.
Consent for research
Sometimes it turns out after removal that the tissue is not suitable for transplantation. It can then be used for research. However, this is only permitted if the deceased has given consent for this in the Donor Register or if the relatives give consent.
If there is no consent, the unsuitable tissue is destroyed. The recovery team never removes tissue solely to conduct research.
Registering the donor with the NTS
Before tissue donation can start, a lot of information is still needed to assess whether the deceased can donate tissues.
To this end, the doctor looks up medical information about the health of the deceased and sometimes also asks the relatives a few questions.
Then they call the Dutch Transplantation Foundation (NTS) to register the donor.
Course of the removal
A special team recovers the tissues and draws blood for testing. The deceased must be refrigerated within 6 hours of death.
Tissue donation always takes place in a funeral home or hospital:
- Recovery of ocular tissue, skin, and heart valves usually takes place in the mortuary of a funeral home or in a hospital.
- In the case of bone, cartilage, and tendon tissue, the recovery always takes place in an operating room.
The recovery can start up to 24 hours after death.
How much time does the tissue removal take?
The recovery of tissues is done carefully and therefore takes time. As a result, it can up to 30 hours after death it can take before the body of the deceased is available to the surviving relatives.
Sometimes, in the event of an unnatural or unexpected death, an investigation into the cause is necessary. This is called an autopsy. Tissue donation always takes place before the autopsy. The doctor will inform you about this.
Why does tissue removal sometimes take so long?
There is not always an immediate space available for the removal at the funeral home or hospital. It is also possible that all the special teams that remove the tissues are already out on a call. Because of this, it can take a while before a team arrives at the removal location.
After the removal
After the tissue removal, the deceased goes to the location chosen by the relatives. For example, home or to a funeral home. Laying in state is always possible. The team ensures that the deceased looks neat and tidy after the donation.
Read here per tissue what is removed and what you need to take into consideration regarding care.
Eye tissue
In eye tissue donation, the removal team removes the eyeballs and places eye prostheses back. They then close the eyes. This makes the face look normal again.
Care
Sometimes a hematoma occurs: a blue discoloration around the eye. A funeral director uses makeup to ensure this is not visible.
Heart valves
The tissue bank needs the entire heart to examine whether the heart valves are in good condition. During the donation of heart valves, the removal team therefore removes the entire heart. Sometimes a piece of the large blood vessels around the heart is also removed at the same time. The removal team makes a Y-shaped incision in the chest to remove the heart. They then stitch the wound and cover it with plasters.
Care
We advise choosing clothing with a neckline that is not too low when laying in state. That way, the plasters will not be visible.
Bone tissue, cartilage, and tendons
During the donation of bone tissue, cartilage, and tendon tissue, the removal team removes these from the upper arms, legs, and/or pelvis. Only if heart valve donation is also taking place does the removal team also remove the cartilage from the ribs.
The removal team makes incisions to remove the tissues. The team replaces the bones with biodegradable prostheses. This keeps the shape of the body as much the same as possible. After the removal, the removal team stitches the wounds and covers them with plasters.
Care
In the case of bone tissue, cartilage, and tendon donation, it is not recommended for surviving relatives to care for the deceased themselves. This is because arms and legs are less stable than before.
The funeral director or relative can no longer wash the body of the deceased after skin donation. We advise choosing clothing with long sleeves and long trousers or a skirt when laying in state. Cremation and burial remain possible, even in a natural burial ground.
Skin
During skin donation, the removal team takes skin from the back, legs, buttocks, and flanks of the deceased. These are very thin layers of skin. From the back, they can sometimes also take a thicker layer of skin tissue. They take this layer from the shoulder blades down to the lower back.
After the skin is removed, the deceased is put into a special suit. The suit is necessary because the body can lose fluid after the removal. Regular clothing can be worn over this special suit.
Care
In the case of skin donation, it is not recommended for surviving relatives to care for the deceased themselves. The funeral director or relative can no longer wash the body of the deceased after skin donation.
We advise choosing long-sleeved clothing and long trousers or a skirt when laying the deceased in repose. Burial at a natural burial ground is no longer possible.
What happens to the tissues after retrieval?
After retrieval, the donated tissues go to a tissue bank. This is an organization that examines the tissues and assesses their quality.
Once approved, the tissues are processed and stored. The storage period for donated tissue ranges from 4 weeks to 5 years.
How does donated tissue help a patient?
Donor tissue can help many patients. As soon as a patient needs tissue, the doctor submits a request to the tissue bank for their patient.
Sometimes there is more tissue in stock than is needed for Dutch patients. In that case, the tissue bank looks for a recipient abroad. This prevents the tissue banks from having to discard tissue. The Netherlands also receives tissue from foreign tissue banks in order to help people in the Netherlands.
Eye tissue: cornea and sclera
We use two parts of the eye: the cornea and the sclera.
- A cornea can become cloudy due to disease or a condition. Donated cornea can restore someone's sight.
- The sclera is the outer white layer of the eye. The sclera can be used to preserve a damaged eye.
Heart valves
A heart valve can help patients lead a normal life again. The patients are newborn babies with a congenital heart defect, adults with a malfunctioning heart valve, and patients with an acute infection of the heart valve.
They urgently need a new heart valve. It is also examined whether certain parts of the heart's major blood vessels (patches) can be used for transplantation. These patches are used to repair a patient's blood vessels.
Bone, cartilage and tendon tissue
- Bone
With bone from a donor, doctors can replace bone that has been damaged, for example by cancer or during hip surgeries. - Cartilage
Doctors use donor cartilage to repair damaged joints. Think of knee tissue, for instance. This can help patients move better and can reduce pain. - Tendons
With tendons, doctors can repair damaged joints. For example in patients with rheumatism. Tendon tissue is also used to repair torn tendons in, for example, knees or shoulders.
Skin
Donor skin is needed for people with burns and other skin injuries. Doctors use donor skin as a kind of bandage. Donor skin results in less pain, fewer infections, and fewer scars.
Eventually, the donor skin falls off the healed wound on its own. If a thick piece of skin is used, it does grow onto the recipient.
Would you like to know the results of the tissue donation?
If you want to know the results of the donation, you can tell the doctor.
After about one week, you will then receive a letter from the NTS stating which tissues were donated, along with a brochure containing information about the use of donated tissue.
You will not be told who received the tissues. That remains anonymous. That is stipulated by law.
No need for information?
You can also indicate to the doctor that you do not wish to receive information about the donation. In that case, you will not receive a letter from the NTS.
You will also not receive information if the retrieval did not proceed. Sometimes a retrieval does not go ahead because the donor's blood is unsuitable or the retrieval team discovers something that poses a problem for donation.
If you would still like more information at a later time, you can always send an email to the NTS: nabestaanden@transplantatiestichting.nl. Clearly state the details of the deceased.
No extra costs for the surviving relatives
Of course, you do not have to pay anything extra for the tissue donation procedure. You only pay for the costs that are always associated with a death.
Thank-you letter from the recipient
Very occasionally, people who have received tissues send a thank-you letter. At that time, the NTS will ask you if you would like to receive the letter. The letter is anonymous and you will receive it via the NTS.
Questions about donation?
Do you have specific questions about the tissue donation of the deceased? Ask the doctor involved in the donation.