Background: In 2021 an improvement plan was established to achieve national publicity and uniformity. It implied that anonymous contact between family and recipients could be established via the organ donation coordinator (ODC). The impetus for the improvement plan came from various media. Those media covered situations in which the relatives of post-mortem donors were surprised, disappointed and sometimes even agitated that they had received little or no notice from the recipients of the deceased donor's organs5. The experience of ODC’s in the Netherlands shows that receiving a letter from organ recipients is perceived positively by the relatives. This usually appears to provide comfort during a period of mourning and to be helpful in processing grief and loss. The improvement plan can prevent negative publicity about organ donation and thus indirectly have a positive effect on registrations in the Dutch Donor Register.
Methods: A pilot project at Radboud University Medical Center in 2020 showed a doubling of letters by kidney recipients; by properly informing the recipient, discussing the possibility of writing a letter, and offering support in writing.
Results: This above led to an interactive presentation at the Dutch Congress of the NTV in March 2021, where “the importance of anonymous contact” was discussed. That kicked off the improvement plan to implement above mentioned actions as starting points in every Dutch transplant hospital.
After the launch in 2021, a number of UMCs have seen an increase in the number of gratitude letters received. Nationwide, you see a total number of letters in 2022 of 121, in 2023 of 156 and 2024 of 176 gratitude letters.
Conclusions: The increase in letters in most of the transplant hospitals varies per donated organ and per hospital. However, the absolute numbers are not a goal; it is about the contribution of writing or receiving a letter in the mourning process.
Receiving an organ from a deceased donor and losing a loved one are both profound life events.
Both writing and receiving a gratitude letter contribute to coping with this.

References:
1 Organ Donation Coordination, Transplant center, Leiden University Medical Center, Leiden, the Netherlands.
2 Organ Donation Coordinator, Nephrology Department, Radboud University Medical Center, Nijmegen, The Netherlands.
3 Medical social work, Nephrology Department, Radboud University Medical Center, Nijmegen, The Netherlands.
4 Organ Donation coordinator, Transplant center, Maastricht University Medical Center, Maastricht, the Netherlands
5 Volkskrant 26-4 2019, RTL nieuws 11-12 2017, AD 2-2-2019.