Organ and tissue donation

Donation after death

The heart, lungs, liver, kidneys and pancreas can be donated after death. We can also donate tissues and cells for treatment purposes, namely corneas, skin, bones, cartilage, ligaments, haematopoietic stem cells, blood cells, heart valves and blood vessels.

The possibility of organ donation is determined by the circumstances of death. According to Slovenian law, organ donation is permitted after confirmed brain or circulatory death. Brain death is defined as the irreversible and definitive loss of the entire brain – both hemispheres and the brain stem. It can be the result of severe brain injuries (due to falls, accidents), sudden, usually spontaneous haemorrhages, strokes, lack of oxygen supply to the brain (due to suffocation, poisoning, cardiac arrest) and cancer formation in the brain area. Despite the best efforts of doctors, a brain-dead person cannot be revived and cured. Circulatory death means an irreversible interruption of blood circulation and respiration. It is usually the result of complete cardiac arrest.

When a person is dead, the organs quickly begin to deteriorate and die. Therefore, in the case of a donation, the artificial maintenance of basic functions such as breathing, blood circulation, body temperature and fluid balance is necessary. Artificial maintenance can only last for a short time (up to a few days) and the organs gradually die despite the help of devices. Donation procedures must therefore be carried out as quickly as possible.

The donation procedure only begins once the deceased’s relatives have given their consent. As soon as consent has been given, the transplant coordinators report the donor’s details to the joint Eurotransplant database. At the same time, the doctors in the Department of Intensive Care check whether the organs are suitable for removal. This means that they use tests to determine whether the organs are still functioning well enough to fulfil their function in another body. They also check whether the donor’s concomitant diseases (e.g. infections, cancer, etc.) do not pose too great a risk for the future recipient.

Organ removal is carried out by an experienced and specially trained team of surgeons and theatre nurses. It is also the surgeons who assess the suitability of an individual organ for transplantation in the final phase and check the match between donor and recipient. At the same time, the logistics of the teams and organs as well as the preparation of the patient/recipient for the surgical procedure – the transplant – take place.

Organ donation is an operation for which the same conditions must be guaranteed as for all other operations. The removal takes place in a specific order, with priority given to organs that can survive for a shorter time outside the body (heart and lungs). The entire donation process is carried out with respect and dignity for the deceased person and their relatives.

After the donation

Donors’ bodies are treated with respect and care. The corpse remains whole, the sutures are visible from the outside, as after an operation. Burial in an open coffin and other traditional or religious funeral rites are possible (depending on the religion of the deceased and their relatives).

The records of the origin and (non-)utilisation of the removed organs and tissues are kept simultaneously by Slovenia-transplant and Eurotransplant. Traceability is guaranteed and verifiable for each organ or tissue.

In accordance with the highest standards for the protection of donors and recipients, all posthumous donation procedures are anonymous. A donation is a selfless act of help for a fellow human being in need, regardless of the patient’s age, origin, nationality, gender or other characteristics. One cannot decide in advance to whom they would like to donate their organs. At the request of the relatives, Slovenia-transplant will inform them of all organs that have been removed and successfully transplanted, as well as the country of the recipient. During the grieving process, relatives have the opportunity to seek professional psychological support.

Living donation

The procedures from donation to transplantation are different in the case of living donation. In Slovenia, it is possible to donate a kidney and regenerating tissues (bone marrow, skin, haematopoietic stem cells, blood cells) during one’s lifetime. The donation of a kidney is only permitted between related or emotionally connected persons. The donor must have both healthy kidneys. Each case is reviewed and authorised by the Ethics Committee for Transplantation. During the interview, it is checked, among other things, that there is no form of coercion or exploitation of the donor. The risk to the donor’s health must be proportionate to the expected benefit for the recipient. Both must be in good psycho-physical condition.

In Slovenia, living donation is rare. In recent years, one or two transplants of this type have been performed per year at UMC Ljubljana.