Who can be a donor?
There are three types of organ donor: those who have died following cardiac arrest or brain death, and living donors. In Switzerland in 2016, there were 96 donors after brain death and 15 donors after circulatory death, as well as 132 living donors (see our 2016 annual report available in German and French).
Donors after brain death (DBD) are deceased persons whose brain is no longer functional due to a lack of blood flow or oxygen supply. The most frequent causes are cerebral haemorrhage, craniocerebral injuries or a lack of oxygen supply to the brain due to illness or injury.
Brain death is determined by two independent specialists.
Brain death is the irreversible cessation of all brain functions (of both the cerebrum and the brain stem). Vital functions such as breathing and the flow of blood can be maintained long enough for organs to be removed through artificial respiration and medication. Brain death is diagnosed in accordance with the guidelines of the Swiss Academy of Medical Sciences (SAMS) by two specialists who do not belong to the transplantation team (compare the guidelines The Determination of Death in the Context of Organ Transplantation, SAMS).
The term Donor after Circulatory Death (DCD) is used for donors who have sustained circulatory death. In the case of Donors after Circulatory Death, too, brain death is determined by two specialists on the basis of clearly defined criteria and death is determined using a strict pattern determined by law (Find out more in the Organspende rettet Leben - Was Sie über herztote Organspender wissen müssen (Organ donations save lives – What you need to know about Donors after Circulatory Death) brochure).
Living donations mostly among family members
Certain organs may also be transplanted from living donors. In Switzerland it is possible to transplant the kidneys and part of the liver. Outside Switzerland, parts of the lungs, the small intestine and, in very rare cases, of the pancreas are also transplanted from living donors. In 2016, 132 living donations were made in Switzerland (see our 2016 annual report).
In the case of living donations, a differentiation is made between directed and non-directed, or altruistic, donations. In directed donations, a donor declares themselves willing to donate a kidney or a part of their liver to a specified recipient. Almost all cases occur among family members (parents, siblings, spouses), although donations are also made among friends. In such instances, the donor knows who their organ is going to benefit. In non-directed donations, the donor decides to donate a kidney to an unknown recipient, on humanitarian or altruistic grounds. In this case, donors and recipients remain anonymous, and organ allocation follows the same rules as for deceased donors. Altruistic liver living donations are not carried out in Switzerland, as donating the smaller left hepatic lobe constitutes a considerable risk for the donor.
Strict checks for living donations
Prior to any living donation, the donor is required to undergo a thorough medical and psychological evaluation. This involves strict testing of the functionality of the kidneys and other organs as well as a thorough blood analysis. The psychological evaluation assesses a person’s motives for donating an organ, and verifies they are doing so of their own free will. A living donation will only be considered if all requirements are met.
The entire living donation procedure will be covered by the recipient’s health insurance provider. It is prohibited to grant or derive financial gain or any other advantage from a donation of human organs, tissues or cells. The compensation for any loss of income or other unavoidable expenses incurred by the donor, and compensation for damage incurred by the donor as a result of the removal of organs, tissues or cells are not regarded as financial gain or other advantage.
Are you interested in becoming a living donor? Please contact your nearest transplantation centre for more information.