If you donate organs and tissues after death, you can help persons who are very sick. They can keep living if they receive a donor kidney or liver. And thanks to the eye tissue of a donor, they can see again. In the Netherlands, more than 1,000 persons are on an organ waiting list. About 150 individuals die every year while waiting for an organ. A deceased donor donates three organs on average, so that every year these organ donors save the lives of about 800 persons. One would think that this takes care of everyone on the waiting list, but that is not the case. The waiting list just keeps getting longer.
No, not everyone can donate their organs or tissues after death. A doctor will assess upon your death whether your organs or tissues are suitable for donation.
But what everyone can do is specify their choice in the Donor registry – even if you are sick, sometimes even if you have (or have had) cancer, have received a blood transfusion or are taking medications. It is always a good thing to specify your choice. An organ or tissue that is damaged by disease or medication can sometimes become ineligible for transplantation, but other organs or tissues may still be suitable.
Things can also change in the future, as medical science is able to solve more issues. While today you may not able to donate because of a disease, in a few years that same disease may no longer constitute a problem.
Yes, you can. You can donate if you are sick or taking medications. Upon your death, the doctor will assess which organs or tissues can still be used for a patient. Sometimes organs or tissues are no longer suitable for transplantation, for instance due to damage or disease, but other organs or tissues may still be suitable for transplantation.
No, you yourself cannot decide who gets your organs or tissues after your death. That is stipulated by law. One reason for it is that in the Netherlands, everyone must be able to get the same level of healthcare. This is why you cannot be the one determining who you will or will not donate to. An organ goes to the patient on the waiting list who needs it most urgently, and who is the best fit for the organ.
Everyone can specify their choice in the Donor registry. Whether you are homosexual or heterosexual makes no difference, so you may be eligible to donate organs.
Yes, even if you have an unhealthy lifestyle, it can be helpful to give a ‘yes’ in the Donor registry. A person on the waiting list for a new organ can die if the organ does not arrive on time. Lungs of a smoker may be better than the person’s own lungs, and the liver of a drinker can sometimes help a liver patient. So if you smoke or drink, it doesn’t necessarily mean you cannot donate your organs. What is important is that the organ still be suitable for transplantation. A doctor will properly assess this in advance.
Organ and tissue donation can be done from birth to old age. A doctor will assess the suitability of every organ or tissue. Skin donation is only possible from age 20. The heart of an 80-year-old is generally no longer suitable for donation, but that person may still be able to donate kidneys.
Yes, all the organs and tissues that you can donate are listed on the Donor form. You may want to donate some organs and tissues but not others. You can specify this on the form.
Organ donation can only be done when people die at the hospital, for example because of a severe stroke or an accident. In this way, a person may be able to donate organs after their death. Authorisation is always needed from the donor or from their family. Only when it is certain that a patient is going to die, does a doctor take a look in the Donor registry to see the choices that were made.
Did you give a ‘yes’ in the Donor registry? Or has your family said ‘yes’? Only then can the hospital start the testing. The physicians may take an ECG or blood tests, and ensure that the body stays at the right temperature. Organ donation can take between 10 and 24 hours, sometimes even longer. Did you give a ‘no’ in the Donor registry? Then there will be no donation and no testing.
Donation of tissues works out more often than donation of organs. In such cases it doesn’t matter whether you die at home or at the hospital. Special teams harvest the tissues at a hospital or another suitable space, following strict rules.
After a patient dies, a doctor takes a look in the Donor registry to see the choices that were made. Have you not specified a choice? In that case, your family will decide about donation. Has permission been given for donation? In that case, the doctor will report the donor to the Dutch Transplant Foundation, and the donation process will get started. Altogether, tissue donation takes between 8 and 28 hours.
After your death, you can donate the following organs and tissues:
Organs: liver, heart, lungs, pancreas, small intestines, kidneys
Tissues: eye tissue, heart valves, large vessels, skin, bone, cartilage and tendons
The chances are not that large. Organ donation is quite exceptional and does not happen often. How come? An organ donor must always die at the intensive care unit (ICU) of a hospital and be receiving artificial respiration, and the organs must still be suitable for transplantation.
In 2018, 273 persons gave organs after their death. Every year, about 153,000 people die. This means that the chances of becoming an organ donor are 1 in 560.
Definitely. Organs and tissues are only harvested when doctors are 100% sure that a person has died. Death is diagnosed according to strict rules, and this is done by several physicians.
Donation and family
No. Family cannot change your choice just like that. The doctor will almost always honour the choice you made in the Donor registry. That is what you wanted. If there is a very good reason, a doctor may decide differently.
An organ or tissue donation must be done with the utmost care, so it takes time. Altogether, organ donation can take between 10 and 24 hours, sometimes even longer.
The time between diagnosing brain death and harvesting organs is between 4 and 12 hours. If the heart and blood circulation have stopped, there is less time. As soon as blood is no longer circulating through the body, organs quickly become less suitable for transplantation. This is why harvesting of organs begins quickly after death is diagnosed.
If the body of a tissue donor is refrigerated within six hours, tissues can still be harvested for transplantation up to 24 hours after death. The tissue donation procedure can thus last between 8 and 28 hours.
Certainly. There is always someone for the family at the hospital. During the entire duration of the donation process, a hospital staff member (such as the transplant coordinator) will be in touch with the family.
Yes. Removing organs and tissues is always done with great care. Doctors consider it very important for a donor to look presentable after the operation. They do not remove anything from places that are visible when a body is viewed. Stitches with bandages are applied on operated areas.
Yes, there is always time to say goodbye. Family can be with the donor before and after the donation. After the donation procedure, the family itself determines what happens with their loved one. The family can also choose the viewing location, at a funeral centre or at home.
Yes, you can. A funeral or cremation can take place on the day chosen by the family and does not need to be postponed because of the organ or tissue donation.
No, there are no costs involved. The family of the donor doesn’t pay anything for donation.
Donation and religion
Donation and religion can be compatible. Most faiths approve of organ donation. If you have any doubts about this, it is important that you discuss it with someone – perhaps a pastor, an imam or someone else knowledgeable about your religion – so that you can arrive at a joint perspective about organ and tissue donation.
You can only be included in the Donor registry if you yourself specified your choice in the Donor registry. Anyone from the age of 12 can specify their choice in the Donor registry. There are four choices:
Choice 1: Yes, I grant permission
You want to become a donor. You can donate the following organs: pancreas, intestines, heart, liver, lungs and kidneys;
and the following tissues: blood vessels, bone, heart valves, cartilage, tendons, skin and eye tissue.
You may want to donate some organs and tissues but not others. You can specify this on the form.
Choice 2: No, I do not grant permission
You do not want to become a donor.
Choice 3: My partner or family will decide
Upon your death, your partner or family are allowed to make the choice.
Choice 4: The person I have appointed will decide
You want someone else to decide for you after your death.
Everyone in the Netherlands will receive information from the government about the new law.
If after 1 July 2020, you still haven’t specified a choice in the Donor registry, you will receive a letter asking whether you want to specify your choice.
If you do not specify anything after the first letter, you will receive a reminder after six weeks.
If again you do not specify anything, ‘No objection against organ donation’ will be listed under your name. You will get another letter to confirm this. ‘No objection against organ donation’ means that your organs can go to a patient after your death.
It remains important that you yourself specify a choice about organ donation. If you have already done so, your choice will remain valid.
The choices are the same as in the current law. Something will change only if you haven’t made a choice yet. Nothing changes even after you receive a letter after 1 July 2020 in which you are asked to specify a choice.
If you do not specify a choice in the Donor registry, ‘No objection against organ and tissue donation’ will appear under your name. This means that your organs can go to a patient after your death. The doctor at the hospital will discuss this with your family. If your family is very sure and can explain to the doctor that you really did not want to be a donor, then you will not be a donor. It is therefore very important for your partner and family to know what your choice is, and especially for you yourself to specify it.
It is important for you to specify in the Donor registry whether you do or do not want to become a donor. You can specify this choice in three different ways:
When it comes to organ and tissue donation, a person must be able to understand what it is about. The person must also be able to understand the consequences of the choice they make. If the person cannot do that, then they are legally incapable for organ donation.
At present, a legally incapable person cannot be a donor. That will change when the new donor law goes into effect on 1 July 2020.
When an organ or tissue is harvested, a doctor can discover that it is not suitable for transplantation after all, for instance because the quality of the organ or tissue is not good enough or because an unexpected damage or disease is found. In such cases, the organ can be used for scientific research. Through this research, physicians learn more about transplantation. This is different than donating your entire body to science.