Organ Transplant Waiting Times Longer for Patients with Migrant Backgrounds in the Netherlands

• Yvonne Roerdink

  a journalist

Patients with a migrant background can wait longer for an organ transplant than people with a Dutch background. The Dutch Transplant Foundation, responsible for coordinating and facilitating organ donations and transplants, wants research into waiting times.

People with a migrant background do not so often give permission to donate an organ in the donation register. The fear is that patients from these groups will have to wait longer for a transplant.

“A suitable organ, which is not rejected by the body, is found based on blood group and tissue characteristics. As an intensivist at the Radboud university medical center, he regularly consults with family members of dying patients who are eligible for organ donation.

Although there are medications to prevent rejection, these medications also have risks. So it is better for patients to get the most suitable organ. Abdo fears there could be a shortage of organs for people with a history of migration.

The donation law was introduced in the Netherlands four years ago. Since then, every Dutch person has to make an active choice whether he or she wants to donate organs in the event of death. If you do not do this, you will automatically be registered with ‘no objection’ to the grant.

Since get up the number of transplants is slowing, but there is still a shortage of donor organs. In 2023, 123 people died while on the transplant waiting list. 119 patients had to leave the waiting list because their condition was too serious.

Of Dutch people with a Moroccan background, 79 percent have actively registered and 96 percent of these say they do not want to donate. Of Dutch people with Surinamese background, 76 percent do not give consent.

This is much lower among the Dutch whose both parents were born in the Netherlands: one in three indicates that they do not want to donate organs after their death.

It is not known exactly what effect the differences will have on minority waiting lists and mortality rates. This has been studied in the United Kingdom: non-Western patients there wait longer for a transplant. Ethnicity plays an important role, especially in the kidneys. Patients are doubly disadvantaged because kidney failure occurs more often in people of non-Western backgrounds.

“Now that we know this from other countries, it would be interesting to look at this as well,” said Naomi Nathan, director of the Dutch Transplant Foundation. “It is now forbidden by law to register ethnicity, but we have to work with the ministry and doctors to see how we can explore this in a feasible and meaningful way.”

Outgoing Minister Pia Dijkstra (Public Health), who at the time pioneered the grant law as Member of Parliament for D66, says News hour that she does not think it is desirable to record ethnicity. She sees no legal basis for it. The ministry has provided funding for further research into ethnicity and organ donation.

In the United Kingdom, the government has launched targeted campaigns to increase the number of donors among non-Western Britons. Imams, among others, are used to encourage patients to register as organ donors in videos.

“Within the religions of the world, including Islam, there are different opinions about organ donation. One of the opinions is that it is allowed,” said Mustafa Bulut, spiritual advisor at Elisabeth-TweeSteden Hospital .

Bulut is regularly in intensive care during discussions between doctor and family about donation. He sees that religion is not the main reason for not giving.

“For example, religious people believe that their bodies are God’s property so they don’t often say ‘yes’. The question of organ donation is often asked too soon after death, which means that the family does not agree. There was no place to handle the bad news cultures.”

The Dutch Transplant Foundation has started dialogue training for doctors with attention to different religions. The foundation also organizes donor discussions aimed at people with a migrant background outside the West.