Special issues in pediatric deceased organ donation

Weiss, Matthew J.; Blanco, Alicia Pérez; Gelbart, Ben

doi:10.1007/s00134-019-05523-2

Cited by 8 publications

(13 citation statements)

References 11 publications

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“…Studies analyzing the professional perspective show that the most health care professionals have a self-perceived knowledge deficit of the DCD process 28 but while the ethical debate is still ongoing 29 the current broad professional consensus is that pDCD can be ethically practiced in a very similar way of that of adults. 30 We do not have any Italian studies on the healthcare professional perspective on pediatric cDCD, even though we think it would be instead a very interesting topic to investigate.…”

Section: Discussionmentioning

confidence: 99%

“…We need to take into account that the pediatric practice uptake is generally slower and many Hospitals around the world hesitate to implement a pDCD program because of the potentially negative reactions among healthcare providers. Studies analyzing the professional perspective show that the most health care professionals have a self‐perceived knowledge deficit of the DCD process 28 but while the ethical debate is still ongoing 29 the current broad professional consensus is that pDCD can be ethically practiced in a very similar way of that of adults 30 …”

Section: Discussionmentioning

confidence: 99%

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Is donation after circulatory determination of death feasible for pediatric patients in italy?

Giugni

Cecchi

Santucci

et al. 2021

Pediatric Transplantation

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The imbalance between supply and demand of organs affects the pediatric population while size constraints make the organ match more difficult: every year in Europe especially young children die on waiting lists before they receive a transplant. 1 At the time of this writing, in Italy there were around 240 children waiting for a solid organ transplant with a total waiting list mortality that reached 3,3% in 2019. 2 The pediatric waiting list also risks to be lengthened in 2020 due to the new COVID-19 emergency that impacts transplantation and donation side.In addition in Italy the only source of organs for children is still represented only by the pediatric donation after neurologic determination of death (pDND) because there is no experience in pediatric donation after circulatory determination of death (pDCD). There are no legal constraints 3 but the peculiarity of the Italian legislation

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is donation after circulatory determination of death feasible for pediatric patients in italy?

Giugni

Cecchi

Santucci

et al. 2021

Pediatric Transplantation

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“…Bereaved parents stated the importance of honesty and clarity about their child's prognosis, discussed a range of practical steps that can be put in place for support and strongly recommended the practice of follow-up discussions with professionals from PICU. Weiss et al [15] undertook a review of special issues in paediatric organ donation, noting that all children for whom a decision has been made to withdraw life sustaining treatments should be referred to the team responsible for coordinating organ donation, so that the case may be considered. The clinician and parental views on this important step can then be explored, with potential to increase donation rates.…”

Section: Evolution In Pathways Related To End Of Life Carementioning

confidence: 99%

Focus on paediatrics

Brown,

De Luca

2020

Intensive Care Med

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“…Each year, over 250 children die while awaiting life-saving organ transplantation (1–3). Children meeting criteria of brain death (BD) comprise an important group of potential organ donors (1, 4). Two prior studies found that 15% of children who died in U.S. PICUs were children declared BD (5, 6).…”

mentioning

confidence: 99%

Organ Dysfunction Among Children Meeting Brain Death Criteria: Implications for Organ Donation*

Nickerson

Lovett

O’Brien

2022

Pediatric Critical Care Medicine

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Over 70% of pediatric organ donors are declared deceased by brain death (BD) criteria. Patients with these devastating neurologic injuries often have accompanying multiple organ dysfunction. This study was performed to characterize organ dysfunction in children who met BD criteria and were able to donate their organs compared with those deemed medically ineligible. DESIGN: Retrospective cohort study.SETTING: PICU at a quaternary care children's hospital. PATIENTS:Patients with International Classification of Diseases, 9th Edition codes corresponding to BD between 2012 and 2018 were included. MEASUREMENTS AND MAIN RESULTS:Demographics, comorbidities, Pediatric Risk of Mortality (PRISM)-III, and injury mechanisms were derived from the medical record. Organ dysfunction was quantified by evaluating peak daily organ-specific variables. Fifty-eight patients, from newborn to 22 years old, were included with a median PRISM-III of 34 (interquartile range [IQR], 26-36), and all met criteria for multiple organ dysfunction syndrome (MODS). Thirty-four of 58 BD children (59%) donated at least one organ. Of the donors (not mutually exclusive proportions), 10 of 34 donated lungs, with a peak oxygenation index of 11 (IQR,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23); 24 of 34 donated their heart (with peak Vasoactive Inotrope Score 23 [IQR,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]); 31 of 34 donated kidneys, of whom 16 of 31 (52%) had evidence of acute kidney injury; and 28 of 34 patients donated their liver, with peak alanine transferase (ALT) of 104 U/L

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Special issues in pediatric deceased organ donation

Cited by 8 publications

References 11 publications

Is donation after circulatory determination of death feasible for pediatric patients in italy?

Is donation after circulatory determination of death feasible for pediatric patients in italy?

Focus on paediatrics

Organ Dysfunction Among Children Meeting Brain Death Criteria: Implications for Organ Donation*

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