Current Topics in TransplantationOrgan procurement/allocationPotential Pediatric Organ Donors After Cardiac Death

- Data are still too scarce data to promote donation after cardiac death in children.
- We retrospectively analyzed the deaths in our pediatric intensive care unit.
- Twenty-nine percent of the deaths occurred after withdrawal of care.
- One-third of those patients could have become organ donors.
- Donation after withdrawal of care could quadruple the number of pediatric donors.

BackgroundMore than 50 people die each year on the Swiss transplant waiting list. To increase their organ donors pool, some centers have developed a post-cardiac death organ donation program. Information about its impact in the pediatric population is still scarce. The aim of this work was to determine the potential impact of a program of organ donation after cardiac in a pediatric population.MethodsThis was a retrospective study of all children deceased from 2005 to 2014 in a tertiary pediatric and neonatal intensive care unit. The deceased were categorized as brain dead, deceased despite maximal resuscitation, deceased after withholding of care, and deceased after withdrawal of care. Potential organ donors were identified by the absence of medical contraindication and agonal time <120 minutes.ResultsA total of 189 nonpremature children died during the 10-year period. Of the 36 (19%) brain-dead children, only 5 became organ donors. A further 67 (35%) died despite maximal resuscitation, 31 (16%) after withholding of care, and 55 (29%) after withdrawal of care. Regarding the latter category, median agonal time was 16 minutes. Eighteen children could potentially have given ≥1 organ each.ConclusionsDevelopment of organ donation after cardiac death in children could generate a 4-fold increase of the donor population.