Tissue donation and transplantation medicine are complex topics. Only those who are comprehensively informed can make an independent and stable decision. We provide many information materials on tissue donation in compact form as brochures and for download (most in German only)!
These tissues can be donated
Ocular tissue (Cornea)
The cornea is the clear window of the eye – the window to the world around us. Neither age nor visual impairment affect the quality of the cornea. When the cornea is donated, the whole eyeball is removed by a trained DGFG coordinator. A glass prosthesis in the colour of the deceased’s eyes ensures that the donor’s appearance is respectfully restored. A removal is possible up to 72 hours after death.
Why cornea donation helps: Corneal transplantation may be the last treatment option to save the eyesight of patients. The success rate is very high and many patients regain full vision.
Heart valves and blood vessels (cardiovascular tissues)
Heart valves and blood vessels are donated either after cardiac death or within the framework of organ donations. A doctor may only remove valves if the heart is not suitable for organ transplantation due to a pre-existing condition – a possible heart transplantion always comes first.
Why donation of cardiovascular tissue helps: A typical application for cardiovascular grafts is the replacement of infected artificial prostheses. Transplantation is often an emergency operation that saves lives. In addition, heart valves are used to treat childhood heart valve defects. The need for about 500 transplants in Germany per year will continue to increase due to demographic changes.
Bones, cartilage, tendons, ligaments and skin (musculoskeletal tissue)
Bones and cartilage come both from living donors (e.g. femoral head after hip prosthesis) and from deceased persons. Specially trained staff remove the tubular bones of the extremities, the iliac crest, rib cartilage, but also entire joints. A high age does not exclude donation. Precisely fitting prostheses replace the removed tissue. Tendons, ligaments and skin can also be removed as part of postmortem tissue donation.
Why donation of musculoskeletal tissue helps: In orthopaedics and trauma surgery, severe bone defects caused by illness or accident can often only be cured by the precise use of bone grafts.
Amniotic membrane (Placenta)
The amniotic membrane is the thin, inner egg membrane of the maternal amniotic sac that surrounds the embryo. A Caesarean section birth and the consent of the mother after a comprehensive explanation are preconditions for the donation.
Why donation of amniotic membrane helps: The amniotic membrane is characterised by its special wound-healing and pain-reducing properties. Amnion transplants are mainly used for the treatment of superficial injuries of the conjunctiva and cornea of the eye, but also for the treatment of skin burns or the treatment of chronic wounds, such as diabetic foot.
In the pancreatic islets of Langerhans, beta cells produce the hormone insulin. Only if the pancreas cannot be transplanted as an organ, a tissue donation is allowed. The donations purpose then needs to be rededicated to tissue for the production and transplantation of islet cells.
Why donation of islet cells helps: If the function of the islets of Langerhans are disturbed, as in patients with diabetes mellitus type 1, life-threatening derailments of the blood sugar level may occur. In addition to transplantation of the entire pancreas, islet transplantation is the only available beta cell replacement therapy.
People donated tissue to the DGFG network between 2007 and 2022.
Frequently Asked Questions (FAQ)
Different from organ donation, tissue donation is not linked to the diagnosis of brain death. More than 90 percent of tissue donors have died a normal death, e.g. from heart failure or cancer. Depending on the tissue, tissue donations can be collected up to 72 hours after cardiac arrest.
Living tissue donation is only possible in a few cases: Mothers can opt for placental donation in the context of planned Caesarean sections. Patients who receive an artificial hip joint can donate the removed femoral heads. If a patient receives a donor heart transplant, the diseased heart can be donated. Despite the severe heart disease, the aortic or pulmonary valve is often still intact and can help other patients.
There are no rigid age limits for tissue donation. If, for example, an eye cornea has fulfilled its function well until death, it has proved its worth and will also give the transplant recipient a clear view. DGFG does not exclude potential donors on the basis of age alone. Even though there are empirical studies for cardiovascular and musculoskeletal tissue that show decreasing tissue quality with increasing age. Still, there is always a comprehensive assessment of donor suitability that takes many other factors into account. For more information, click requirements for a tissue donation.
In Germany there is currently no register for tissue and organ donors. Nevertheless, it is possible to document the personal decision for or against a donation: Wearing an organ and tissue donor card as well as document one’s decision in a living will are important. Besides documenting one’s will, talking to relatives and next of kin about personal opinions and decision regarding tissue and organ donation are key.
In addition to a written declaration by the deceased (e.g. organ and tissue donation card, living will), the following persons are entitled to make a decision in favor or against tissue donation:
- the person to whom the decision was transferred, e.g. noted on the organ and tissue donor card,
- the relatives on behalf of the deceased’s orally declared or presumed will,
- the relatives according to their own values, if the presumed will of the deceased can not be determined.
Each tissue removal is a surgical procedure performed by experienced and trained staff under the responsibility of a physician. Without exception, every tissue donation ends with the reverent restoration of the body. Relatives have the opportunity to say goodbye. A laying-in-state is just as possible as religious rituals.
No. A tissue donation is a voluntary and altruistic act. It is a gift to life – a selfless and unpaid donation. This is also stated in the transplantation law with the trade prohibition for organs and tissue preparations.
In principle, anyone can donate tissue. Every tissue donation is preceded by a comprehensive examination of the donor regarding contraindications:
Did the donor suffer from any infectious diseases? Is the donor himself the recipient of a corneal or dura mater transplant?
In addition to absolute, medical contraindications, there are also tissue-specific reasons that can speak against the suitability of a donor. The optimal benefit for the recipient and the unconditional protection against communicable diseases require a strict risk assessment. The medical service of the DGFG clarifies together with doctors and relatives whether a tissue donation is possible.
Recipients of corneal transplants and dura mater are not allowed to donate tissue due to a risk of prion transmission (Creutzfeldt-Jakob disease) according to the transplantation law and EU guidelines.