Eurotransplant Foundation: the original framework of organ exchange

Abstract Eurotransplant is an international organ exchange organization which co-ordinates the allocation of donor organs to patients waiting for a transplantation. All transplant programmes in Austria, Belgium, Germany, Luxembourg and The Netherlands collaborate with Eurotransplant. Since its establishment in 1967, circa 70 000 transplantations have been performed through this organization. Currently, more than 15 000 patients are registered on the central waiting list for a kidney, heart, lung, liver or pancreas transplantation. The greatest problem Eurotransplant is facing is the increasing shortage of donor organs. Because of improved transplant results, more patients become transplantable while on the other hand the donor availability has not increased. To deal with this persistent shortage of donor organs, allocation systems have been established with the aim to achieve optimal use of available organs in a transparent and objective way. In Eurotransplant different location systems are being used for the specific organs, mainly based on the current available scientific data in immunology and transplant medicine. Because the success of transplantation is seriously restricted by the shortage of donor organs, a lot of initiatives such as public campaigns, donor cards and donor registries, appointment of transplant co-ordinators and further development of extended hospital donation programmes have been introduced. Although these factors all help, they are so far insufficient to increase the donor supply and insufficient to help all the patients waiting for a transplantation. Alternatives for the usual donor pool should be considered, such as extended donor criteria, non-heart-beating donors and living donation.