Allocation of organs

Eurotransplant plays a key role in the allocation and distribution of donor organs for transplantation. The allocation system is objective, transparent, reproducible and valid. It is designed to make the best match possible given the circumstances.

After removal a donor organ is to be transplanted as soon as possible. The time frame in which the transplantation must take place varies per organ. An impeccable and smoothly running organization is of life saving importance. Therefore, the Eurotransplant office is manned by specially trained staff, 24 hours a day, 7 days a week.

One waiting list

All transplant centers within the member states of Eurotransplant have access to the central computer database. The transplant centers enter general and medical information of their patients into this database. The requested donor profile is also entered. These profiles contain the characteristics of patients and donors and form the basic principle of making the best match possible given the circumstances.

At time the information is entered into the central database, the patient is put on the international waiting list. At that point, the waiting time starts. The waiting time for kidney patients starts on the date of the first dialysis.

Making the match

As soon as a donor becomes available within the Eurotransplant area, the regional tissue typing laboratory determines the donor’s blood group and tissue characteristics. All relevant information about the donor and the specific organs are transferred to the Eurotransplant database.

Eurotransplant generates a so-called match list for each available donor organ. The match list is generated by a complicated computer algorithm that takes all medical and ethical criteria into account.

The allocation system is

  • objective: the match list is the same no matter which duty officer arranges the allocation
  • reproducible: the same question will lead to the same answer
  • transparent: every step in the process can be accounted for
  • valid: the system is based upon valid medical and ethical criteria that are supported by consensus within the transplant community

The match is based upon two general principles

  1. expected outcome
  2. urgency (as determined by experts in an objective and transparent way)

Furthermore, the following is considered

  • national organ balance – for Eurotransplant pursuits a reasonable balance in the exchange of organs between countries
  • waiting time

Offering donor organ(s)

The donor organs are offered to patients according to their ranking on the match list. The duty officers of Eurotransplant inform the transplant coordinators and physicians in the patient’s transplant center. They also inform the transplant center of the second patient on the match list. The donor information is made available to both transplant centers. The treating physicians decide whether to accept the organ or not.

As soon as the organ is accepted the physician contacts the patient. Eurotransplant establishes contact between the donor hospital and the transplant center. The exact time of the procurement operation is determined. This takes place in consultation with the transplant coordinator of the donor hospital. At the same time the (cross border) transportation of the organs from the donor hospital to the patient(s) in the transplant hospitals is arranged.

If there are no suitable patients within the Eurotransplant area, Eurotransplant contacts a sister organization.

Limited time

The whole process from the removal of the donor organ(s) to the implantation in the patient must take place as soon as possible. There is a time window in which organs stay viable outside the body (the cold ischemic period). The time frame in which the transplantation must take place varies per organ. An efficient and reliable organization is vital.