TISSUE
DONATION

Everything youneed to know

EDQM
2022

This guide has been drawn up by the Councilof Europe European Committee
on Organ Transplantation (CD-P-TO).
For more information, please visit
https://go.edqm.eu/transplantation.
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that they are not used out of context and do notprovide incomplete information or mislead thereader. The source must be duly acknowledged.
Editorial director: Dr P. Doerr
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FranceInternet: www.edqm.eu© Council of Europe, 2022

INTRODUCTION
Every year, thousands of patients benefit
from human tissue grafts that improve theirquality of life (e.g. corneas), or even savetheir lives (e.g. heart valves). In most cases,tissues can only be donated after your death.
However, some tissues can be removed
during certain planned medical interventions (e.g. hip replacement), and you candecide to donate them as a living donor.
Each country has its own regulations and
Did you know?
legislation governing tissue donation. ForFor every patient who receives an example, there may be a national list whereorgan transplant, more than 50 you can register your decision to donate (or­patients receive a tissue transplant. not to donate) organs and/or tissues after
your death. You can also choose which
tissues you want and do not want to donate.
In some countries, the legislation assumes
that if you did not make your wishes clear
before your death, your organs and tissues
may automatically be used to help others.
This is known as ‘opting out’ as opposed to‘opting in’. However, whatever your feelings3and thoughts about donation, it is important that you discuss them with your family
and friends to ensure that your wishes anddecisions are respected after your death.
Every country has an organisation or authority that co-ordinates donation andtransplantation. This may be at the local, regional or national level, and the authorities
can provide you with information about
the system in your country and answer anyquestions you might have.
This booklet provides some basic information about tissue donation. It is intended
to provide readers with clear, accurate andbalanced information that will help themmake informed decisions according to theirvalues.
This guide has been prepared by the Councilof Europe European Committee on Organ
Transplantation (CD-P-TO), composed ofinternationally recognised experts, in collaboration with the European Associationof Tissue Banks (EATCB) and the European Eye Bank Association (EEBA).

4WHAT IS TISSUE DONATION?
Tissue donation is like organ donation inthat you can donate parts of your body – forexample heart valves, blood vessels, corneas
or musculoskeletal tissues – to help others.
Donation is governed by a very strict set of
ethical principles and the donor’s consent
is always obtained beforehand. Like giving
blood, tissue donation is an altruistic act;
no payment is made for donated tissues.

Did you know?
All tissue donations have to comply
with all ethical and legal requirements according to national legislation, whether during life or after
death.

Donated tissues can be used for transplants
but also for research purposes or for the development of new treatments. In hospitals,
tissue transplants and tissue-based medicines are used to repair or to replace tissues
that have been damaged as the result of abirth defect or accident, or through disease.
Wherever possible, doctors prefer to use
donated tissue to repair such damage as theoutcomes for patients are better.

WHICH TISSUES CAN BE DONATED
AND HOW CAN THEY BE USED?
After death, the most commonly donatedtissues are:
✓ Skin: can be used to treat serious burninjuries. It is normally removed from thelegs or back of the torso. Skin is never removed from areas of the body that might
be visible during a funeral.
✓ Bones: can be used to replace bones thatneed to be removed because of cancer, orreplace bone that has been damaged by5

Examples of tissues that can be donated
CORNEAS

SKIN

HEART
VALVESPLACENTA/AMNIOTICMEMBRANECARTILAGEVEINS AND
ARTERIESFEMORALHEADS

LIGAMENTS
AND TENDONS

BONES

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accidents or disease. The grafts are usually taken from the limbs.
✓ Tendons: can be used to replace torn orbroken tendons and help to restore mobility. The grafts are taken from the joints,
mainly the knee and ankle.
✓ Blood vessels: may be used to replacediseased and blocked blood vessels. Thegrafts are usually obtained from the chest,
abdomen or legs.
✓ Heart valves: can be transplanted to treat
children born with heart defects and toreplace damaged heart valves in adults.
✓ Cornea: this is the transparent front partof the eye that covers the iris and pupil.
Cornea grafts can be used to restore sightto blind or partially sighted people.
Tissues that can be donated by living donors
include:✓Amniotic membrane: this is the innermost layer of the sac in which the baby develops. Women giving birth by Caesarean
section may donate their placenta, so thatthe amniotic membrane can be removed
and banked. It is generally used to treat
wounds on the surface of the eye but also
for skin replacement.
✓ Femoral heads: they are removed duringjoint replacement surgery and may be
used in other joint replacement surgeries
or procedures to repair damaged spines.
In some cases, bone grafts are also usedin maxillofacial surgery as bone fillingmaterial.
✓ Heart valves: these can be taken fromhearts removed from some patients

7

under­going heart transplant. The heart
valves are processed and used to replacedamaged heart valves in other patients.

Did you know?
During your lifetime you candonate various tissues, such as amniotic membrane, and other tissues
that are discarded during certain
surgeries.

Unlike donated organs, which must beused immediately, donated tissues can be
stored in tissue establishments for longer
periods of time, from days to years depending on the tissue, providing more flexibility for transplants. Tissues are processed
and tested according to set requirements toensure that the transplanted tissues are safefor the recipient. Tissue establishments areauthorised and inspected by their national
competent authority.

WHO CAN BE A TISSUE DONOR?
In most cases, human tissues can only bedonated after your death. However, there
are some situations where tissue is removed
during an operation, for example in hip
replacement or after a Caesarean section(to obtain the amniotic membrane). These
tissues can be donated to help others while
you are alive.
The identity of donors and their relatives isprotected and recipients of donated tissues
will not be able to contact them directly.
However, in some countries recipients
may be allowed to send letters of thanks todonors or their relatives.
Tissue donation also differs from organ
donation in that potential deceased tissue
donors may be found in places other thanhospital intensive care and emergency units.
In general, almost anyone can be consid-8ered as a tissue donor for at least one kindof tissue. Depending on the tissue andother factors, donation may take place up
to 72 hours after death. Specific quality
and safety criteria are used to determine
whether a person is eligible as a donor. A
medical team makes sure that all donors
comply with these criteria.
To reduce the risk of disease transmission, areview of the donor’s medical and lifestylehistory (including a possible interview withthe relatives about these topics) as well asa physical examination will take place andrelevant tests (including blood samples) areperformed. Based on the results, a healthcare professional will determine which
tissues may be donated and used.

Tissue donation can save or improve the quality of life of patients. However, due to their humanorigin, they also carry some risks and it is important to prevent the transmission of any disease
coming from the donor. For this reason, the medical history of potential donors and other potential personal and behavioural risks are thoroughly checked and tests carried out to minimise
health threats to recipients.

9WILL TISSUE
DONATION
AFFECT FUNERALARRANGEMENTS?
The donation and procurement procedures are scheduled in such a way as to allow
the funeral arrangements toproceed as planned.
Donated tissues are always removed withthe greatest care and respect. Procurement
is performed by trained professionals andthe donor is treated with the utmost respect
Did you know?
and dignity. After donation, the body is reTissue donation is carried out like stored to normal appearance using special
any other surgical procedure, with prostheses or materials to replace thethe utmost respect for the donor, donated tissue. This means that families
and is never an impediment to car- can spend time with their relatives after
the procurement procedure and that anrying out funeral arrangements.
open-casket funeral is still possible.

10TAKE HOME MESSAGES
Donated tissues can dramatically improve
the quality of life for recipients, and help
save lives.
Tissues from one deceased donor may betransplanted into as many as 100 individuals. Some other tissues can be provided only
by living donors, as long as the donation
procedure does not carry risk to the donor.
If you want to make a real difference by becoming a tissue donor, check what steps you
may need to take in your country and, mostimportantly, tell your family and friends
that you want to be a donor so they can
support your decision.

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ENG

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