International organ exchange

International organ exchange guarantees the optimal distribution of scarce organs by offering them to a suitable recipient in another country, when there is no matching recipient on the national waiting list in the donor’s country.

In 2010 European Union legislation was passed that encourages the exchange of organs between EU member states. This was an important step to increase the number of available organs within the Union. Member states are also encouraged to establish written agreements with European organ exchange organizations, on condition that EU quality and safety requirements are met.

Most EU member states are already involved in cross-border organ exchange, either through bilateral agreements and/or broader alliances such as Eurotransplant. These agreements provide a guarantee that the EU framework is adhered to, and that specific tasks are assigned in relation to cross-border exchanges also beyond EU borders.

Over the years, Eurotransplant has signed agreements with 17 other organ exchange organizations. These agreements ensure that so called surplus organs for which no suitable recipient could be found within the own country can be offered to a suitable recipient in another country:

Agreements made between Eurotransplant and other European Organ Exchange Organizations
Scandiatransplant (Denmark, Finland, Iceland, Norway, Sweden and
Poltransplant – Poland2000
Slovak Transplant – Slovakia2001
Etablissement Français des Greffes – France2001
Swisstransplant – Switzerland2001
Hungarotransplant – Hungary2002
Centro Nazionale Trapianti – Italy2003
Stradiņa Klīniskā universitātes slimnīca – Latvia2008
Transplant Coordinating Center, Prague – Czech Republic2008
Hellenic Transplant Organization – Greece2008
Nationalinis Transplantacijos Biuras – Lithuania2010
National Transplant Center – Israel2011
Organización Nacional de Trasplantes – Spain2011
Bulgarian Executive Agency for Transplantation – Bulgary2013
Romanian National Transplant Agency – Romania2017
Ministry of Health of the Republic of Montenegro – Montenegro2018
NHS Blood and Transplant – United Kingdom 2019

Although international organ exchange increases the chance of an optimal donor-recipient match, a major limiting factor in international organ exchange is the cold ischemia time (this is the time the organ is cold-stored – during transportation – and remains outside the human body). Organs with short cold ischemia times are less suitable for long-distance transports. Improvements in machine perfusion techniques might provide a solution to this problem in the near future.

Eurotransplant aims to cooperate with as many partners in Europe as possible so that even more organs can be exchanged internationally in future and more patients can benefit from life-saving organ transplantation.