What are the criteria for being a donor?

In addition to the principle of presumed consent, several medical and legal criteria determine whether a person can become an organ donor. The main considerations include:

1. Health Status
   A potential donor should be in good overall health. Certain medical conditions may prevent organ donation, including active infectious diseases (such as COVID-19) or certain types of cancer. Each potential donor is assessed individually by the medical team.
2. Type of Death
   Organ donation is possible after brain death or circulatory (cardiac) death. Because organs must be retrieved quickly to remain viable, potential donors are generally cared for in a critical care environment such as an intensive care unit, emergency department, or operating theatre.
3. Age and Physical Characteristics
   There is no strict upper age limit for organ donation. The condition and function of the organs are more important than the donor’s age. Organs from older donors can often be successfully transplanted if they remain healthy. Factors such as height and weight are also considered, particularly for organs such as the heart, lungs, and liver, to ensure an appropriate match between donor and recipient.
4. Family Consultation
   After a person’s death, the national donor registry is checked to determine whether they recorded a decision regarding organ and human body material donation. If no decision has been registered, the medical team consults the family to determine whether they know the deceased person’s wishes. Although Belgian law is based on presumed consent, discussing one’s wishes with family members in advance can help avoid uncertainty during an emotional time.
5. Living Donation
   In addition to deceased donation, living individuals may donate certain organs or parts of organs, such as one kidney or part of the liver. Belgian law requires that living donors:
   • Be at least 18 years of age.
   • Give free and informed consent.
   • Receive comprehensive information about the physical, psychological, social, and family implications of donation.
   • Sign their consent in writing in the presence of an adult witness.
   • Donate for an altruistic purpose.
   A living donor may withdraw their consent at any time before the procedure. The physician responsible for the donation must ensure that all legal requirements have been met, including proof of informed consent and compliance with all eligibility criteria. Under Belgian law, living donors who donate a kidney or part of their liver are entitled to ten years of free medical follow-up.
6. Compatibility
   Compatibility between the donor and recipient is essential for a successful transplant. Matching is based on factors such as blood group, tissue compatibility, organ size when relevant, and other medical criteria to minimize the risk of rejection and maximize the likelihood of long-term transplant success.