Methods
As mediator between donor and recipient, Eurotransplant plays a key role in the acquisition and distribution of donor organs for transplantations. The data of all potential recipients, such as blood group, tissue characteristics (HLA groups), cause of the disease, clinical urgency and the hospital where the patient is to be transplanted, are passed on to Eurotransplant. This information is stored in a central computer database. Subsequently, the patient is put on the (inter)national waiting list. At that point, the waiting time starts. The waiting time for kidney patients starts on the date of the first dialysis. As soon as a donor becomes available somewhere within the Eurotransplant area, the regional tissue-typing laboratory determines the donor's blood group and tissue characteristics. All relevant (medical) information about the donor is then transferred on to Eurotransplant's database. Subsequently, the Eurotransplant staff enters the donor information into a computer program especially developed for this purpose. After the data entry, the program selects the patient most suitable to receive the organ of this donor. It is crucial that the donor organ matches as good as possible with the patient. The selection criteria for the most suitable patient vary for different donor organs (see table).
| Organ | Selection criteria |
|---|---|
| Kidney | Bloodgroup, tissue characteristics, clinical urgency and waiting time |
| Pancreas | Bloodgroup, (tissue characteristics), clinical urgency and waiting time |
| Heart + Lung | Bloodgroup, height and weight of the donor, clinical urgency and waiting time |
| Liver | Bloodgroup, height and weight of the donor, clinical urgency and waiting time |
After completing the computer selection procedure (see match presentation), the Eurotransplant staff immediately contacts the physicians in the patient's transplant center to send all information about the donor. These physicians are then responsible for the decision whether or not to accept the organ. If the organ is accepted, the physician immediately contacts the patient.
As soon as the donor organ has been accepted, Eurotransplant, in consultation with the regional coordinator of the donor hospital, arranges for the organs to be removed. At the same time, the (international) transportation of the organs from the donor hospital to the recipients in the transplant hospitals is organized. If there are no suitable recipients within the Eurotransplant area, Eurotransplant gets in touch with one of its sister organizations, such as UK Transplant or Scandiatransplant.
The whole process from the removal of the donor organ(s) to the implantation into the recipient must not take longer than a few hours, depending on the organ concerned. An impeccably smooth-running organization is thus literally of life-saving importance. Hence the Eurotransplant central office is manned 24 hours a day, 7 days a week, by specially trained staff. In addition to the support from the physicians, assistance from the police, ambulance services and airline companies is also indispensable to Eurotransplant.
