The current status of neonatal organ donation in the UK

Wright, Joanna; Barlow, Adam D.

doi:10.1136/archdischild-2014-307053

Cited by 6 publications

(5 citation statements)

References 24 publications

(19 reference statements)

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“…In the USA, neonatal organ donation is more established, while in the UK it is gaining momentum. 95 In one US cohort, profound central nervous system injury and/or encephalopathy was the most common cause of death for potentially eligible neonatal donation after cardiac death donors. 96 Importantly, despite the global hypoxia ischaemia suffered in HIE, organs such as the kidney usually recover once transplanted.…”

Section: Redirection Of Care and Organ Donationmentioning

confidence: 99%

Management and investigation of neonatal encephalopathy: 2017 update

Martinello

Hart

Yap

et al. 2017

Arch Dis Child Fetal Neonatal Ed

152

122

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This review discusses an approach to determining the cause of neonatal encephalopathy, as well as current evidence on resuscitation and subsequent management of hypoxic-ischaemic encephalopathy (HIE). Encephalopathy in neonates can be due to varied aetiologies in addition to hypoxic-ischaemia. A combination of careful history, examination and the judicious use of investigations can help determine the cause. Over the last 7 years, infants with moderate to severe HIE have benefited from the introduction of routine therapeutic hypothermia; the number needed to treat for an additional beneficial outcome is 7 (95% CI 5 to 10). More recent research has focused on optimal resuscitation practices for babies with cardiorespiratory depression, such as delayed cord clamping after establishment of ventilation and resuscitation in air. Around a quarter of infants with asystole at 10 min after birth who are subsequently cooled have normal outcomes, suggesting that individualised decision making on stopping resuscitation is needed, based on access to intensive treatment unit and early cooling. The full benefit of cooling appears to have been exploited in our current treatment protocols of 72 hours at 33.5°C; deeper and longer cooling showed adverse outcome. The challenge over the next 5–10 years will be to assess which adjunct therapies are safe and optimise hypothermic brain protection in phase I and phase II trials. Optimal care may require tailoring treatments according to gender, genetic risk, injury severity and inflammatory status.

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Section: Redirection Of Care and Organ Donationmentioning

confidence: 99%

Management and investigation of neonatal encephalopathy: 2017 update

Martinello

Hart

Yap

et al. 2017

Arch Dis Child Fetal Neonatal Ed

152

122

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“…The 2015 guidance by the Royal College of Paediatrics and Child Health allows for the diagnosis of DNC, raising the possibility of increased donation in this age group . Recent audits from the neonatal centers in the UK have highlighted that the potential of donation from neonates is significantly higher if these organs can be utilized for transplantation . We have previously reported on the feasibility of EKT from infant and neonatal donors .…”

Section: Discussionmentioning

confidence: 99%

“…The UK have highlighted that the potential of donation from neonates is significantly higher if these organs can be utilized for transplantation. 10,11 We have previously reported on the feasibility of EKT from infant and neonatal donors. 12,13 We have seen a steady expansion of our experience of kidney transplant from infant and neonatal donors in recent years.…”

mentioning

confidence: 99%

Bilateral adrenal hemorrhage in a neonatal kidney donor

Martinez-Lopez

Wijetunga

Ecuyer

et al. 2018

Pediatric Transplantation

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EKT from neonatal donors remains rare despite successful outcome being reported. The surgical aspects of neonatal abdominal organ recovery remain unfamiliar to the vast majority of abdominal organ recovery teams and renal transplant surgeons. BAH is not uncommon in newborn babies suffering distress in the perinatal period. BAH is often also associated with RVT and will impact on utilization of kidneys for transplantation. We present a case of a neonatal kidney donor with massive BAHs discovered at the time of organ recovery. This made the procurement challenging. Both kidneys were recovered en bloc with pancreas and the liver with aorta and inferior vena cave as vascular conduits. The kidneys were successfully implanted into an adult recipient with good function at 1-year follow-up. Association between adrenal hemorrhage and RVT needs to be considered before utilizing such kidneys. This case exemplifies successful outcome after careful assessment and transplantation of such kidneys.

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“…Whilst the benefits of decellularised tissues and organs are undisputed, these scaffolds are dependent on donors; as in adult allotransplantation, the supply of neonatal and pediatricsized tissues and organs are also severely limited [32]. Despite those limitations, decellularised tissue has lead to clinical translation of tissue engineered airways with worse outcome associated to the use of synthetic materials, particularly in pediatrics [33].…”

Section: Organ Scaffoldsmentioning

confidence: 99%