How does organ donation work?
Organ donation is carried out with great care for the donor and their loved ones, and according to a fixed step-by-step plan. Read here how organ donation works.
Organ donation in 8 steps
If someone is in the intensive care unit and can no longer recover, doctors investigate whether this patient can become an organ donor. The doctor follows a step-by-step plan before any organs are potentially donated. Do you want to know exactly how that works? Watch the video or read the step-by-step plan below.
Step 1: The Donor Register is consulted
When it becomes clear that someone can no longer recover and treatment is futile, the doctor discusses this with the loved ones. Only after it has been decided to stop treatment and it is clear that the patient will pass away, does the doctor call the Donor Register. This states whether or not someone wants to donate organs and tissues.
Only a doctor may request the patient's choice. This is only allowed when it is clear that the patient will pass away within a few hours. The Donor Register is accessible to doctors day and night.
Step 2: Doctor talks to the loved ones
The doctor then tells the partner and the patient's family the choice in the Donor Register. We call this the donation conversation. If the patient has indicated they do not want to be an organ donor, they will not become a donor. If the patient is in the Donor Register with consent, the doctor informs the loved ones. If the patient has chosen for the family and partner to decide, they are given time to make this decision. During the conversation, the doctor also has time to answer the questions of the loved ones.
In preparation for organ donation, the treatment team performs a number of tests. For example, they examine the blood and urine and keep the body at temperature.
Step 3. The organ donation coordinator comes to the hospital
To ensure that the donation process runs as smoothly as possible, an organ donation coordinator (ODC) comes to the hospital.
These are the tasks of an organ donation coordinator:
- Have tests carried out on the suitability of the organs
- Collect all data of the donor
- Report organs suitable for transplantation to Eurotransplant (the organization that allocates organs for transplantation)
- Maintain contact with next of kin and answer questions
- Call in specialists for the donor surgery
Step 4. The organs are examined
A doctor always examines whether the organs are suitable for transplantation. They do this using a CT scan. The organ donation coordinator, a nurse, or a doctor asks the donor's next of kin questions. These questions are about how the patient lived. For example, whether someone smoked and what illnesses the patient may have had. This information is important for determining whether someone can be a donor.
Step 5. The doctor determines death
The doctor can determine that someone is dead in two ways.
Method 1: Determining brain death
Someone is brain dead when all brain functions have ceased and will not recover. To determine this, doctors use a special step-by-step plan called the Brain Death Protocol. This is the same in every hospital in the Netherlands. This protocol is enshrined in law. By following the steps in the Brain Death Protocol, doctors are certain that someone is brain dead. The time at which brain death is determined is the official time of death.
Method 2: Determining that the heart and circulation have stopped
Organ donation can also take place after the heart and circulation have stopped. Determining this involves several steps. First, the doctors, together with the family, decide to stop treatment because recovery is no longer possible. This also means that the ventilator is turned off. After that, the heart stops and the patient dies. As soon as the heart stops, doctors always wait five minutes. Only then can they officially determine that the patient has died.
Step 6: The surgery is prepared
Method 1: After brain death
The next of kin are given time to say goodbye to their loved one. Meanwhile, the medical team begins preparing for the donor surgery. They ensure that the organs remain in good condition. They do this, for example, by keeping the body at the right temperature and artificially maintaining circulation. This keeps the organs suitable for transplantation.
Method 2: After the heart and circulation have stopped
Once the heart has stopped, the doctors wait five minutes. Then they officially determine that the donor has died. Because no blood or oxygen is reaching the organs, they quickly become damaged. Therefore, the donor is taken to the operating room immediately. For the next of kin, there is only a short time to say goodbye at that moment. After the surgery, they can say goodbye in peace. The organ donation coordinator (ODC) arranges for a retrieval team of specialists to come to the hospital for the donor surgery.
Step 7. The donor surgery
The team of specialists begins by removing the organs at the hospital where the donor is located. The surgery to remove the organs usually takes about six hours. If someone also donates tissues, the surgery may take longer.
Read more about donor surgery here
Step 8. After the organ removal
After the surgery, the body of the deceased is returned to the next of kin. They can then say their final goodbyes. The doctors always ensure that the donor's body looks presentable.
Six to eight weeks later, the organ donation coordinator contacts the next of kin to share which organs were successfully transplanted. This only happens if the next of kin wishes. The next of kin are informed of the age category and gender of the recipient. This is always done anonymously. The donor's next of kin do not know who the organs go to. The organ recipients also do not know who they received the organ from. In the Netherlands, this islaid down by law.
Frequently asked questions
Am I really dead if I am a donor?
Yes. Organs and tissues are only removed once doctors are 100 percent certain that a person has died. The determination of death is carried out according to strict rules and by multiple doctors.
Do the donor's next of kin receive support during the donation process?
Yes. The organ donation coordinator is in contact with the donor's next of kin throughout the entire process. This coordinator answers all questions and explains what is happening.
Can my family and loved ones say goodbye if I am a donor?
Yes, there is always time to say goodbye.Family and loved ones can be with the donor before and after the donor surgery. After the donation procedure, the family decides for themselves what happens next, such as where the person is laid out and when the funeral takes place.
Do doctors still do their best for me if I am a donor?
Yes!A doctor always does everything possible to save a patient's life.They never let someone die to keep someone else alive. Only when it is certain that someone cannot recover and death is expected does the doctor discuss organ donation with the next of kin. In the Netherlands, the doctor who determines death is not involved in any potential transplantation at all.
Why is organ donation only possible if someone dies in the hospital?
Organ donation is only possible if someone is in the hospital in the intensive care unit on a ventilator and passes away.This is because the organs need oxygenated blood to remain suitable for transplantation.In the hospital, someone who has passed away can be kept on a ventilator. This ensures that enough oxygen-rich blood continues to reach the organs.
With donation after the heart and circulation have stopped (DCD donation), organ donation is only possible if the donor is taken to the operating room immediately after death. If someone passes away outside the hospital, this is not possible and the organs are no longer suitable for transplantation.