'The NTS holds a unique position in a complex and fascinating field'

Naomi Nathan is the director of the NTS. Joyce Deggens is the policy manager. What is their take: how is the Netherlands doing in the field of donation and transplantation? What challenges do they see for the future? Read their conversation about opportunities, areas for improvement, and future prospects.

Where does the Netherlands stand in the field of donation and transplantation?

Naomi:

‘The Netherlands is very progressive, for example when it comes to living donation. Take cross-over kidney donation. This is a system used when a donor kidney is not suitable for the person to whom the donor intended to give the kidney. In that case, a kidney can be ‘exchanged’ between couples. In this way, donation and transplantation are still made possible. In that area, we are European champions.’

Joyce:

‘We have developed that specific knowledge in the Netherlands, something to be truly proud of. I think other countries can learn a lot from us, but it is also extremely interesting for our further development to look beyond our national borders.’

Naomi:

‘The Netherlands has a liberal mindset, an Italian colleague once said. We are willing to explore new possibilities, such as donation after euthanasia. This also applies to organ donation after circulatory arrest (DCD, or Donation after Circulatory Death). That is not possible in all countries. We have the perfusion equipment to ensure that the organ is of high quality.’

Read also: success of DCD heart donation in the Netherlands

What challenges do you see for the NTS?

Naomi:

‘We are a true network organization, a chain coordinator. This means we are responsible for a fair distribution of tissues and organs and that we facilitate developments that lead to better patient care. To increase knowledge about donation and transplantation, we want to unlock and make data available at a European level. That will be a challenge for the NTS in the coming years. There is a great national and international need for decision-support software. However, we must be able to facilitate the development and provision of this within the rules of the law.’

Joyce:

‘I think we need to clearly put the obstacles in the areas of organization and legislation on the agenda. Together with stakeholders, we are working on an ever-improving organization of donation care. Fortunately, we are already receiving help from the ministry and stakeholders in finding solutions. And we have a good legal department at the NTS, which actively thinks along with us and the Ministry of Health, Welfare and Sport (VWS). Fortunately, we are not facing an unwilling government, but are really looking at the possibilities together.’

What are your ambitions?

Naomi:

‘In the coming year, we want to create software that can even better predict whether a living donor and recipient are compatible. We are doing this based on new models developed by immunologists at the LUMC together with neurologists at the Erasmus MC. The NTS does not develop that software itself, but it is validated based on our data. There is also still a lot to learn and develop in the field of machine perfusion of organs. The NTS supports the transplant centers in the introduction of new applications.’

Joyce:

‘The NTS is willing to change. That doesn't mean changes happen quickly, because we have to deal with many stakeholders. But the drive to innovate and learn is truly there. We must hold onto that.’

What do you hope to have achieved with the NTS in 5 years?

Joyce:

‘I hope that by then we will have at least removed the most important barriers in the field of data accessibility. We have incredibly rich data sources that we can effectively use for decision support and assistance. It would be wonderful to link all those sources together. And of course, I hope that in 5 years we will have significantly increased the number of donors. That is, after all, why we are here on earth.’

Naomi Nathanhas been the director-general of the NTS since February 2023. In her work, she values clear analyses and humor. ‘A question I always ask: do we understand the problem we are solving? You have to have that very clearly in mind, otherwise you quickly end up just treating symptoms.’

Naomi's motivation for doing this work:

‘This field is special because with organ donation you save lives, and with tissue donation you can truly improve the quality of life for transplant patients. Furthermore, I find it rewarding to play a role at the intersection of tertiary care, innovation, and science. I am proud to do so at a great organization like the NTS, where many motivated people work.’

Joyce Deggenshas been the policy manager at the NTS since July 2023. She likes to take action and thinks in terms of possibilities. ‘If I have to name something that characterizes my way of working, it’s that I don’t like “yes-buts.” For me, the word “but” does not exist.’

Joyce's motivation for doing this work:

‘The NTS has a special position in a complex and fascinating field. With our knowledge, expertise, and role as a network hub, the NTS is of great value when knots need to be untangled or issues need to be investigated, while naturally keeping stakeholders well-involved. I am proud of how persistent and committed the people at the NTS and in the field are to continuously raising the bar together.’