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Organ donation after euthanasia
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Practical implementation

The practical organisation of organ donation after euthanasia: who does what, what preparation is needed and what happens on the day itself — including the differences with the Belgian procedure.

All topics for professionals

Division of roles: performing physician and ODC

  • The performing physician is responsible for the euthanasia, its assessment and communication with the patient; the donation pathway adds no extra tasks.
  • The organ donation coordinator (ODC) takes the donation logistics out of their hands: the screening, the scheduling of the operating theatre, the coordination with Eurotransplant and the support of patient and relatives around the donation.
  • This allows the performing physician to focus on their own role in the euthanasia, knowing that the donation is medically and logistically managed by the ODC and the donation team.
  • For consultation and registration: the NTS can be reached on working days from 9 a.m. to 5 p.m. via +31 71 579 57 77; physicians can reach the Organ Centre 24/7 via +31 71 579 57 95.

Screening and logistics

  • As the performing physician, contact the organ donation coordinator in your region via the Dutch Transplant Foundation once the SCEN procedure is completed.
  • Schedule blood sampling, virology, HLA typing and imaging well before the planned date.
  • Reserve operating capacity, retrieval teams and a separate, quiet room for patient and relatives.
  • Draw up a written step-by-step plan with a timeline and share it with everyone involved.

On the day itself

  • The tasks described below are carried out by the organ donation coordinator (ODC), in close consultation with the performing physician.
  • Offer relatives guidance and a fixed contact person.
  • Preferably place an arterial line, so continuous blood pressure measurement is directly available and the isolation and perfusion technique of the organs can be optimally prepared.
  • Observe the no-touch period of five minutes after circulatory arrest.
  • Aim for a short warm ischaemia time while safeguarding the dignity of the farewell.
  • The performing physician is supported at every step by the organ donation coordinator and/or the donation intensivist, who together take care of the logistics and medical support around the procedure.
  • Agree in advance who determines death and who communicates.

Care for the team

  • Plan a debriefing with operating staff, nurses and physicians.
  • Respect conscientious objections; participation is voluntary.
  • Arrange aftercare and a follow-up conversation with relatives, including anonymised outcomes.

Differences with Belgium

  • In Belgium organ donation after euthanasia has been performed since 2005; the Netherlands followed in 2012. Belgium therefore has more experience with the procedure.
  • In the Netherlands the euthanasia is reported as a non-natural death to the forensic physician; retrieval only starts after release by the public prosecutor. In Belgium the euthanasia is reported to the Federal Control and Evaluation Committee and this release step is absent, which simplifies the logistics around the retrieval.
  • Different age limits apply to minors: in the Netherlands euthanasia is possible from the age of 12 (with parental involvement under 16); in Belgium, since 2014, also for younger minors with decision-making capacity.
  • In both countries the initiative and the explicit wish must come from the patient themselves; a physician may not initiate organ donation after euthanasia.
  • The medical and logistical principles (arterial line, short warm ischaemia time, no-touch period) are comparable in both countries. For the Belgian procedure, always consult the protocols of your own institution and the local donation team.