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

Naomi Nathan is director of the NTS. Joyce Deggens is policy manager. What are their views: how is the Netherlands performing in the field of donation and transplantation? What challenges do they foresee for the future? Read their conversation about opportunities, areas for improvement, and distant horizons.

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 the donor intended to give it to. In that case, kidneys can be 'exchanged' between couples. This makes donation and transplantation possible after all. In that respect, we are European champions.'

Joyce:

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

Naomi:

'The Netherlands has a liberal mindset, an Italian colleague said. We are willing to explore new possibilities, such as donation after euthanasia. The same applies to organ donation after circulatory death (DCD). That is not possible in all countries. We have the perfusion equipment to ensure that the organ is of high quality.'

Also read: 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 the fair allocation 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 the 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 its development and provision within the rules of the legislation.'

Joyce:

'I think we need to clearly place on the agenda any barriers that exist in terms of organization and legislation. Together with stakeholders, we are working on an increasingly better organization of donation care. Fortunately, we already receive assistance 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. Fortunately, we are not facing an unwilling government, but are genuinely looking at the possibilities together.'

What are your ambitions?

Naomi:

'Next 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 from the LUMC together with neurologists from Erasmus MC. The NTS does not develop this 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 transplantation centers in introducing new applications.'

Joyce:

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

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

Joyce:

"I hope that by then we will have at least removed the most important barriers in the field of data access. We have enormously rich data sources that we can deploy well for decision support. It would be fantastic to link all those sources together. And of course, I hope that in 5 years we have significantly increased the number of donors. That is what we are here for after all."

Naomi Nathan has been the managing director 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 need to have that very clear in your mind, otherwise you're just treating symptoms."

Naomi's motivation for doing this work:

"This field of work is special, because with organ donation you save lives and with tissue donation you can truly improve the quality of life for transplant patients. In addition, I enjoy being able to play a role at the intersection of tertiary care, innovation, and science. I am proud to do this at a wonderful organization like the NTS, where many motivated people work."

Joyce Deggens has been policy manager at the NTS since July 2023. She likes to take action and thinks in possibilities. "If I have to name something that characterizes my way of working, it's that I don't like 'yes-buts'. The word 'but' doesn't exist for me."

Joyce's motivation for doing this work:

"The NTS has a special position in a complex and fascinating field. With our knowledge, expertise, and networking role, the NTS is of great value when knots need to be untied and issues need to be investigated, while naturally keeping stakeholders closely involved. I am proud of how persistent and dedicated the people at the NTS and in the field are in continuously raising the bar together."