Project

CT scan pilot for better donor screening

This NTS pilot investigates the added value of CT scans in the screening of organ donors.

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With this pilot, we are investigating the use of CT scans in the screening of organ donors. This helps doctors better assess the quality of organs. The pilot has been running since 2023.

Reason

Until now, an ultrasound of the abdomen and an X-ray of the chest were performed during the screening of organ donors. Retrieval surgeons indicated that a CT scan provides more and more detailed information about the quality and potential abnormalities of organs.

The average age of donors is increasing, which means that undiscovered conditions or tumors are found more often. A CT scan can help detect these before the surgery, so that unnecessary retrieval surgeries are prevented.

What is the goal?

We are looking at the benefits, but we are also looking at potential drawbacks.

Benefits

Does the CT scan provide a better view of abnormalities and the quality of organs?
Does the CT scan reduce the risk of damage to organs during retrieval?
Does the CT scan prevent unnecessary surgeries by identifying unsuitable organs in advance?
Does the CT scan help doctors be better prepared for the retrieval procedure?

Drawbacks

A donor must be transported to the radiology department. This has an impact on the donor but also takes up time from intensive care healthcare providers.
We are also looking at the risk of organs being wrongly rejected due to incidental findings on the scan.
A CT scan is more expensive than the current method – an abdominal ultrasound and a chest X-ray. Therefore, we are carefully examining the added value of the CT scan in relation to the costs.

Collaboration

The NTS pilot was carried out in close collaboration between involved professionals such as retrieval surgeons, ICU teams, and organ donation coordinators. Physician-researcher Kinita Chotkan is evaluating the pilot as part of her doctoral research.

Approach and planning

In the pilot hospitals, the CT scan replaces the ultrasound and X-ray in the screening process. After each donation procedure, the organ donation coordinator and surgeon complete a questionnaire about the influence of the CT scan on acceptance decisions, logistics, and the execution of the retrieval.

At the end of the pilot, all data were analyzed: acceptance rates, surgery duration, and any logistical bottlenecks.

The pilot has now been successfully completed. Formal implementation in the screening process will follow.

Where is the pilot running?

The pilot started small and is now running nationwide:

Start January 2023: Groningen donation region.
Expansion July 2023: North Holland, South Holland, Flevoland, Zeeland, and part of Utrecht.
Nationwide: January 2024

Interview with researcher

The evaluation is part of the doctoral research of physician-researcher Kinita Chotkan. In an interview in early 2024, she talks about the initial positive experiences with the new approach.

Read the article