What happens when someone becomes an organ donor?

Organ donation is only possible if someone passes away in hospital. A patient in intensive care, for instance, who is being ventilated. It almost always involves a situation that arises suddenly. Someone who has suffered a heart attack, a brain haemorrhage or an accident, for example.

People who die at home can only donate body tissues, such as skin, bone, cartilage or tendons.

Naturally, the doctors in the hospital will do all that they can to ensure that the patient recovers. The doctor is only permitted to look at the patient’s choice in the Donor Register if it becomes clear, over time, that the patient will not recover and is dying. The wishes of the patient are recorded in the Donor Register.

Meanwhile, a machine will ensure that the patient continues to receive oxygen. That oxygen keeps the patient’s heart pumping and the blood circulating around their body. If the patient has not given his or her permission for organ donation, the machine will be switched off. It no longer makes sense to continue treating the patient. The best time to do this will be discussed with the patient’s family. When the machine is stopped, the heart will stop beating due to the lack of oxygen and the patient will pass away.

Determining when the patient is dead

If the patient has stated that they wish to be an organ donor, the doctor will need to do some additional checks. After the doctor has performed the examination, the deceased can become an organ donor. Now, the doctor knows for sure that the patient is dead.

The point of death is defined as when the brain dies or when the heart has stopped beating forever:

  • Brain death. If the doctor thinks that the patient is brain dead, he or she will examine the patient to check whether that is indeed the case. If brain death has occurred, the patient’s brain is no longer active. The brain has stopped working forever. Several doctors now need to check the patient to make sure that brain death has occurred, following the brain death protocol. During and after these examinations, the patient continues to receive oxygen from the machine and the heart can continue beating. Because the heart and organs are still receiving oxygen, organ donation remains possible.
    The chest continues to rise and fall, the heart is still beating and the patient is still warm. But medically, and legally, the patient is dead. This can sometimes be difficult for the family to understand.

  • Heart and blood circulation. If the doctor is certain that it no longer makes sense to continue treating the patient and that the patient is dying, the doctor is obliged to stop the treatment. The machine that supplies oxygen is switched off. Organ donation is only possible within two hours of the blood ceasing to circulate. When the blood stops circulating, the doctor will wait another five minutes. This is to be certain the heart has not started beating again, and the patient is dead. The death forms are completed.

The donation process

If the deceased patient is an organ donor, the family will receive support from a nurse who knows all about organ donation. Family members can be with the patient both before and after the operation. There is time to say goodbye until the operation starts. This is often a very sad and sometimes distressing time for the family.

After the operation, the body of the deceased is returned to the family. The doctors will always ensure that the body looks neat and tidy. The family can choose when the funeral or cremation will take place.

About six weeks after the operation, the family will be informed whether the transplants have been successful. The family is then also told whether the recipient is a man or a woman and which age category the recipient is in.

More information about organ and tissue donation

You can read more about the donation process on the website of the Dutch Transplant Foundation (Nederlandse Transplantatie Stichting, NTS):

  • How does organ donation work?
  • How does tissue donation work?

The NTS can help you if you have any questions about organ and tissue donation. On www.transplantatiestichting.nl, you can find the answers to all your questions, such as:

  • When is organ donation possible and when is it not?
  • How will the discussion with my family about donation be handled?
  • Can my family still say their farewells to me if I am a donor?

You can also phone us on 0900-821-2166.