A study reviewing a restrospective cohort at a children’s hospital, Primary Children’s Hospital, operated by Intermountain Healthcare, concluded that among 224 deaths, the number of pediatric potential candidates for donation after circulatory determination of death was significantly larger than the potential candidates for donation after neurologic determination of death. However, the actual donation rate was significantly lower. Of the 224 deaths, 23 (10%) met neurologic criteria for death with 18 donating organs (conversion rate 78%) and 69% of the 224 deaths had withdrawal of life-sustaining treatments (WLST). Of those who experienced withdrawal, only 24% of the cases were referred to the Organ Procurement Organization (OPO) for evaluation. The study identified that older patients were more likely to be referred than children under the age of 1 year.
The review of the 69% of patients who underwent WLST demonstrated that three quarters of these patients had conditions making them unsuitable to be organ donors. Of those without rule-out criteria, one-fifth did not die within one hour after WLST. Generally, organs will not be recovered if the patient has not died after 60 minutes from time of WLST.
The authors suggest that while pediatrics under the age of one year were more likely to have conditions ruling them out for donation, just under half (46%) of pediatric patients over 1 year of age were suitable for potential donation after circulatory determination of death after WLST. And organ donation after circulatory determination of death increased organs available for transplantation by 32% within this hospital.
Bennett EE, Sweney J, Aguayo C, et al. (2015) Pediatric Organ Donation Potential at a Children’s Hospital. Pediatric Critical Care Medicine, 2015 Jul 30. [Epub ahead of print]. doi: 10.1097/PCC.0000000000000526 – article