Successful extracorporeal membrane oxygenation transport of a 4‐month‐old brain‐dead infant for organ donation: A case report

Abstract

A 4‐month‐old infant was declared brain‐dead 2 days after being initiated on venoarterial ECMO for a refractory septic shock. All brain death diagnostic criteria were fulfilled according to French law, and parental consent was given for organ donation. The hospital where ECMO was initiated had no authorization for organ procurement, and the donor was then transferred to the local referral center for child organ recovery with our mobile ECMO team to maintain organ perfusion. The kidneys were recovered and successfully transplanted to a child who is now well and alive. Although the transport elements of this case report are of limited relevance to an international audience as no other country, to our knowledge, has this particular organization, it does show excellent collaboration between teams to realize the goal of organ donation for this family. This is the first case describing a successful inter‐hospital transport for organ procurement of a brain‐dead infant on ECMO. Brain‐dead pediatric patients undergoing ECMO can be considered as potential organ donors to expand the donor pool.

Is deceased organ donation using extracorporeal membrane oxygenation transport ethical and feasible?

“…Dr Leblanc and colleagues report interesting and technically challenging experience in the “Successful extracorporeal membrane oxygenation transport of a 4‐month‐old brain‐dead infant for organ donation: a case report.” The ethics and feasibility around this case likely make it unique to France. One of the most significant features of this case is its representation of the shift in attitude of pediatric intensive care units (PICUs) and teams toward organ donation .…”