The NTS has been licensed by the Dutch Ministry of Health and Welfare as the competent authority for organ allocation in the Netherlands. The institution is an official Arms Length Body of the Department of Health using the legal entity of a Foundation and was established 15 years ago. The NTS employs approximately 60 people and has three divisions: organ center, hospital development, and public education. Main tasks are maintenance of national waiting list for patients awaiting organs or tissues, donor reporting, organ and tissue allocation, development of  organ retrieval programmes in hospitals and public education with regard to donation and transplantation.

The Netherlands has over 16.4 million inhabitants. There are 100 donor hospitals and 8 transplant centers. For logistical reasons the country is subdivided into two retrieval regions (East and West) and has five abdominal organ and three thoracic retrieval teams. At the end of 201 approximately 1311 transplantable patients were on the waiting list. In 2011, 670 transplants were performed with organs derived from deceased donors in The Netherlands.

The Netherlands is one of the seven Member States that collaborates within the organ sharing organisation Eurotransplant (ET). The Eurotransplant region comprises Austria, Belgium, Croatia, Germany, Luxemburg. Netherlands and Slovenia. Eurotransplant yearly allocates more than 7,000 organs. The offices of ET and NTS are both located in Leiden and share the same building.