Donation after cardiac death in pediatric critical care*

Identifying potential heart donors among newborns undergoing circulatory determination of death

“…25 Although our study has identified potential for DCDD donation in the NICU population, we recognize that DCDD implementation would face several barriers. First, as our data show, NICU personnel do not encounter (brain-dead) donors and have had little interaction with the OPO.…”

“…13,14 Many PICUs across the United States have already defined policies and procedures and implemented DCDD programs. 24,25 Indeed, implementation of a DCDD program in a children's hospital has been shown to markedly increase the number of organ donors, with 37% of all donors being the DCDD type in a recent study. 26 If DCDD infant heart transplantation becomes established, some of the wait-listed patients could potentially benefit from wider implementation of NICU DCDD programs.…”

Pediatric Donation After Circulatory Determination of Death

“…Flexibility regarding the complex logistics around pDCDD (e.g., WLST in or near the operating room [OR]) (23) should be determined by local factors to permit effective procurement while sustaining family support (24,87,88). Implementing WLST protocols (87) may assist consistency of practice.…”

“…No medication can be given with the intent to hasten death (53,88). Families should be given the option to be present at the time of WLST and the determination of death (24,53,88). A joint British recommendation stated that WLST should proceed only under the supervision of senior medical staff (87).…”

Understanding the antecedents of the acceptance of donation after cardiac death by healthcare professionals*

“…These professionals have the unique ability to impede or assist DCD through their actions in three separate areas: their willingness to identify potential donors and to provide referrals to the appropriate procurement agency, whether they themselves actually decide to approach bereaved families with the option to donate, and the strength of their support for DCD during the request process (21). Despite the importance of healthcare professionals in the DCD process, there is a paucity of empirical research investigating the antecedents for increasing support for DCD within this important target population (22,23).…”