Is donation after circulatory determination of death feasible for pediatric patients in italy?

Giugni, Cristina; Cecchi, Costanza; Santucci, Claudia; Scuncia, Glenda

doi:10.1111/petr.13977

Cited by 3 publications

(6 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…DCC requires a brief observation period after cessation of circulatory function (hands off), which is generally accepted as a minimum of 2–5 min. Spanish legislation requires a “hands off” time of 5 min, although legislation in countries such as Italy requires periods of up to 20 min to confirm 2,3,18,19 . This heterogeneity, in our opinion and that of other authors, highlights the need to develop standardized protocols for pediatric and neonatal donation after DCC 3 …”

Section: Discussionmentioning

confidence: 79%

“…Spanish legislation requires a "hands off" time of 5 min, although legislation in countries such as Italy requires periods of up to 20 min to confirm. 2,3,18,19 This heterogeneity, in our opinion and that of other authors, highlights the need to develop standardized protocols for pediatric and neonatal donation after DCC. 3 The informed consent of the legal guardians is required for the donation procedure, but also to perform ante mortem procedures if necessary, such as cannulation of central lines or administration of heparin, aimed at improving the viability of the recovered organs after DCC donation.…”

Section: Donation Procedures and Legal Aspects Of Neonatal Donationmentioning

confidence: 85%

See 1 more Smart Citation

Implementation of a neonatal donation protocol in the neonatal intensive care unit: A single‐center experience

Fernández-Fructuoso

Gil-Sánchez

Sáez-Miravete

et al. 2022

Pediatric Transplantation

View full text Add to dashboard Cite

Background Lack of specific protocols for neonatal donation contributes to the rarity of neonatal donors. In this study, we evaluate the impact of the implementation of a neonatal donation protocol in our NICU. Methods In this single‐center study, we conducted a retrospective chart review of neonatal deaths in our NICU from January 2013 to January 2022. The study was divided into two periods: before and after the implementation of a neonatal donation protocol. The referral rates of potential neonatal donors to the OPO in the two periods were compared using the chi‐square test. A p value < .05 was considered statistically significant. Results Sixty‐four infants were reviewed. Seven (10.9%) met the inclusion criteria for potential neonatal donors after DCC. The referral rate of potential neonatal donors increased from 2.5% to 16.7% after the implementation of this protocol (p = .041), and one infant (4.1%) became an effective heart‐valve donor. Conclusion The implementation of a local neonatal donation protocol could have contributed to increase the referral rate of potential neonatal donors in our NICU. Following the implementation of a local neonatal donation protocol, we were able to perform a heart‐valve donation for the first time in our unit.

show abstract

Section: Discussionmentioning

confidence: 79%

Section: Donation Procedures and Legal Aspects Of Neonatal Donationmentioning

confidence: 85%

Implementation of a neonatal donation protocol in the neonatal intensive care unit: A single‐center experience

Fernández-Fructuoso

Gil-Sánchez

Sáez-Miravete

et al. 2022

Pediatric Transplantation

View full text Add to dashboard Cite

show abstract

“…Different factors such as ethical, cultural, and logistical factors may account for this discrepancy. A retrospective study conducted by our group to evaluate the impact of a potential pDCDD program on a pediatric intensive care unit (PICU) of a tertiary University Hospital found that pDCDD might have increased organ donation by 20% over an 8‐year period [10]. This finding confirms that pDCDD is a viable option for Italy, even if the Italian law requires a 20‐min no‐touch period to declare death based on cardiocirculatory criteria.…”

Section: Introductionmentioning

confidence: 73%

What Italian PICU Healthcare Providers Think About Donation After Cardiocirculatory Determination of Death: A National Survey

Giugni,

Cecchi,

Giometto

et al. 2024

Pediatric Transplantation

Self Cite

View full text Add to dashboard Cite

BackgroundItaly presently does not have a pediatric organ donation program after cardiocirculatory determination of death (pDCDD). Before implementing a pDCDD program, many centers globally have conducted studies on the attitudes of pediatric intensive care unit (PICU) staff. This research aims to minimize potential adverse reactions and evaluate the acceptance of the novel donation practice.MethodsWe conducted an electronic and anonymous survey on attitudes toward pDCDD among healthcare professionals (HCPs) working at eight Italian PICUs. The survey had three parts: (I) questions about general demographic data; (II) 18 statements about personal wishes to donate, experience of discussing donation, and knowledge about donation; (III) attitudinal statements regarding two pediatric Maastricht III scenarios of organ donation.ResultsThe response rate was 54.4%, and the majority of respondents were nurses. Of those who responded, 45.3% worked in the Center, 40.8% in the North, and 12.8% in the South of Italy. In total, 93.9% supported pediatric organ and tissue donation, 90.3% supported donation after neurological determination of death (DNDD), 78.2% supported pDCDD, and 69.7% felt comfortable about the idea of participating in pDCDD on Type III patients, with a higher percentage of supportive responses in the Center (77.2%) than in the North (65.1%) and South (54.5%) of Italy (p‐value < 0.004). Concerning scenarios, 79.3% of participants believed that organ retrieval took place in a patient who was already deceased. Overall, 27.3% considered their knowledge about DCDD to be adequate.ConclusionsOur study provides insight into the attitudes and knowledge of PICU staff members regarding pDCDD in Italy. Despite a general lack of knowledge on the subject, respondents showed positive attitudes toward pDCDD and a strong consensus that the Italian legislation protocol for determining death based on cardiocirculatory criteria respects the “dead donor rule.” There were several distinctions among the northern, central, and southern regions of Italy, and in our view, these disparities can be attributed to the varying practices of commemorating the deceased. In order to assess how practice and training influence the attitude of PICU staff members, it would be interesting to repeat the survey after the implementation of a program.

show abstract

“…12 In addition, a recent study estimated an active paediatric DCD programme could increase potential donations by 20%. 14 Therefore, there are recurrent missed opportunities for donation for both donors and recipients in Canadian PICUs.…”

Section: Introductionmentioning

confidence: 99%

“…Although most paediatric deaths occur in the PICU,3 13 a 2019 survey showed that several Canadian PICUs did not offer DCD 12. In addition, a recent study estimated an active paediatric DCD programme could increase potential donations by 20% 14. Therefore, there are recurrent missed opportunities for donation for both donors and recipients in Canadian PICUs.…”

Section: Introductionmentioning

confidence: 99%

Paediatric death after withdrawal of life-sustaining therapies: a scoping review protocol

et al. 2022

View full text Add to dashboard Cite

IntroductionThe physiology of dying after withdrawal of life-sustaining measures (WLSM) is not well described in children. This lack of knowledge makes predicting the duration of the dying process difficult. For families, not knowing this process’s duration interferes with planning of rituals related to dying, travel for distant relatives and emotional strain during the wait for death. Time-to-death also impacts end-of-life care and determines whether a child will be eligible for donation after circulatory determination of death. This scoping review will summarise the current literature about what is known about the dying process in children after WLSM in paediatric intensive care units (PICUs).Methods and analysisThis review will use Joanna Briggs Institute methodology for scoping reviews. Databases searched will include Ovid MEDLINE, Ovid Embase, Cochrane Central Register of Controlled Trials via EBM Reviews Ovid, Ovid PsycINFO, CINAHL and Web of Science. Literature reporting on the physiology of dying process after WLSM, or tools that predict time of death in children after WLSM among children aged 0–18 years in PICUs worldwide will be considered. Literature describing the impact of prediction or timing of death after WLSM on families, healthcare workers and the organ donation process will also be included. Quantitative and qualitative studies will be evaluated. Two independent reviewers will screen references by title and abstract, and then by full text, and complete data extraction and analysis.Ethics and disseminationThe review uses published data and does not require ethics review. Review results will be published in a peer-reviewed scientific journal.

show abstract

Is donation after circulatory determination of death feasible for pediatric patients in italy?

Cited by 3 publications

References 19 publications

Implementation of a neonatal donation protocol in the neonatal intensive care unit: A single‐center experience

Implementation of a neonatal donation protocol in the neonatal intensive care unit: A single‐center experience

What Italian PICU Healthcare Providers Think About Donation After Cardiocirculatory Determination of Death: A National Survey

Paediatric death after withdrawal of life-sustaining therapies: a scoping review protocol

Contact Info

Product

Resources

About