The Dutch Organ Donation Act (Wet op Orgaandonatie) stipulates how the donation of human tissue must be carried out. Organisations that carry out the duties described in the WOD are appointed by the Ministry of Health, Welfare and Sport (VWS).
If a patient dies in hospital, the treating physician will consult the Donor Register The Netherlands Transplantation Foundation (NTS) will process this consultation, which can be performed 24/7. If the deceased is a registered donor and/or their next of kin give permission, the NTS will register the potential donor.
The Netherlands Transplantation Foundation (NTS) will check whether a donor fulfils the acceptance criteria. If the deceased is medically eligible for donation (i.e. fulfils the acceptance criteria), the retrieval teams will be informed of this.
Following retrieval, during the storage phase, the donor will once again undergo an extensive medical screening by the NTS. To that end, additional medical information, for instance autopsy results or information about the donor’s medical history from their GP, will be obtained and reviewed against the requirements in the applicable EU Guidelines. In addition, the donor’s blood will be tested for the presence of communicable diseases. For that purpose, officially recognized and accepted blood tests will be conducted by Sanquin Diagnostic Services, a qualified and certified laboratory.
If, following the extensive medical screening, the donor is found suitable for donation, the tissue bank will assess the tissues to determine their suitability for transplantation.
Femoral head donation
The above procedures do not apply to the medical screening of donors undergoing hip surgery who want to donate their worn femoral head. In that case, the screening will be conducted by ETB‑BISLIFE’s medical staff in collaboration with the treating orthopaedic surgeon.
Retrieved bone tissue and tendon tissue is retained and stored under controlled conditions. A number of special freezers have been installed for this purpose in the facilities of ETB-BISLIFE at the Leiden Bio Science Park. These freezers are supervised 24/7.
Following a donor’s death, corneas, skin, bone tissue and heart valves will be retrieved by the teams of WUON retrieval organization as soon as possible. Corneas, skin and heart valves are retrieved in hospital morgues. To ensure sterility, bone tissue is retrieved in operating rooms.
STORAGE AND PROCESSING
Following retrieval, the tissues are taken to the respective tissue banks, where they will be assessed, processed and stored until they can be released and shipped for transplantation.
The assessment of tissues for their suitability for transplantation will include results of any microbiological screenings and additional testing of the tissues. Following that, the tissue bank will release the tissues for transplantation, allowing them to be processed into grafts. This involves the tissues being cleaned and customized into various grafts that surgeons can use in a wide range of surgeries.
Tissues that are available in fair numbers, i.e. that are not scarce, are supplied directly by ETB-BISLIFE. In the Netherlands, a legal obligation applies under which tissues that are in short supply, i.e. are scarce, such as typed corneas and some types and sizes of heart valves, must be allocated by the NTS subject to allocation regulations. These regulations are established by the NTS, for which it may engage in consultations to obtain external input.