Literature overview highlights lack of paediatric donation protocols but identifies common themes that could guide their development

Vileito, Alicija; Siebelink, Marion J.; Verhagen, Eduard

doi:10.1111/apa.14288

Cited by 13 publications

(28 citation statements)

References 22 publications

(120 reference statements)

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“…20 While some such guidelines have been published since, 6 there remains a dearth of evidence-based guidance for how to best identify and manage patients who are potential organ donors. As identified in recent literature reviews, 21,22 this is due to a variety of factors, including the lack of research in this vulnerable population. A standard, international registry will allow stakeholders to identify areas of system performance variability.…”

Section: Discussionmentioning

confidence: 99%

Development of a multinational registry of pediatric deceased organ donation activity

Weiss¹,

Domínguez‐Gil

Lahaie

et al. 2019

Pediatric Transplantation

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Background There are no currently agreed upon international standards for reporting of pediatric deceased organ donation activity. This leads to difficulty in comparisons between jurisdictions for both researchers and policy stakeholders. The goal of this project was to develop and test a standardized registry for pediatric deceased donation activity. Methods Four countries (Canada, Spain, USA, and the UK) with geographical and practice diversity were approached to participate. Iterative exchanges were used to create data fields and definitions that were acceptable to all participants. Data from 2011 to 2015 (inclusive) were requested from national health databases and analyzed on a secure, web‐based survey platform. Results Data were obtained from three of the four countries (Canada unable to provide). Total pediatric donation rates were stable over the 5‐year period, but with variation between countries. pDCD rates were the most variable, representing 32.2% of total pediatric donation in the UK, 14.4% in the United States, and 2.6% in Spain during the studied period. Most organs from pediatric donors were allocated to adult recipients, though the rates of allocation of pediatric kidneys to pediatric recipients ranged from 7% in the United States to 40% in Spain. Discussion In this limited cohort of three countries, we demonstrated substantial variation in pediatric donation rates and practice. These data highlight opportunities for practice improvement such as the development of rigorous clinical practice guidelines. Future development of this registry will seek to engage more countries, and address barriers that prevented full participation of approached jurisdictions.

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Section: Discussionmentioning

confidence: 99%

Development of a multinational registry of pediatric deceased organ donation activity

Weiss¹,

Domínguez‐Gil

Lahaie

et al. 2019

Pediatric Transplantation

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“…We thank Dr. Weiss et al for their interest in our paper (1) and would like to thank him for the constructive and encouraging and highly relevant response (2) on our paper.…”

Section: Dear Editormentioning

confidence: 99%

Response to the letter to the editor: Literature review on Paediatric Deceased Donation Guidelines

2018

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“…In current practice, neonatal donation is usually not considered, and less than 10% are actually referred to organ procurement organizations before withdrawal of life-sustaining treatment in a NICU [8]. This situation could be attributed, at least in part, to insufficient knowledge about the rules for donation and the corresponding legislation, a lack of institutional donation protocols, and the relative rarity of donation in neonates [7,[9][10][11]. In addition, neonatal donation is frequently judged as contra-indicated, based on perceived multi-organ injury, as it is likely to occur after profound perinatal asphyxia.…”

Section: Introductionmentioning

confidence: 99%

Neonatal donation: are newborns too young to be recognized?

et al. 2021

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Neonatal organ and tissue donation is not common practice in the Netherlands. At the same time, there is a transplant waiting list for small size-matched organs and tissues. Multiple factors may contribute to low neonatal donation rates, including a lack of awareness of this option. This study provides insight into potential neonatal organ and tissue donors and reports on how many donors were actually reported to the procurement organization. We performed a retrospective analysis of the mortality database and medical records of two largest neonatal intensive care units (NICUs) in the Netherlands. This study reviewed records of neonates with a gestational age >37 weeks and weight >3000g who died in the period from January 1, 2005 through December 31, 2016. During the study period, 259 term-born neonates died in the two NICUs. In total, 132 neonates with general contra-indications for donation were excluded. The medical records of 127 neonates were examined for donation suitability. We identified five neonates with documented brain death who were not recognized as potential organ and/or tissue donors. Of the remaining neonates, 27 were found suitable for tissue donation. One potential tissue donor had been reported to the procurement organization. In three cases, the possibility of donation was brought up by parents.Conclusion: A low proportion (2%) of neonates who died in the NICUs were found suitable for organ donation, and a higher proportion (12%) were found suitable for tissue donation. We suggest that increased awareness concerning the possibility of neonatal donation would likely increase the identification of potential neonatal donors. What is Known:• There is an urgent need for very small organs and tissues from neonatal donorsWhat is New:• A number of neonates who died in the NICU were suitable organ or/and tissue donors but were not recognized as donors.• Knowledge on neonatal donation possibilities is also important for proper counseling of parents who sometimes inquire for the possibility of organ and tissue donation.

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Literature overview highlights lack of paediatric donation protocols but identifies common themes that could guide their development

Cited by 13 publications

References 22 publications

Development of a multinational registry of pediatric deceased organ donation activity

Development of a multinational registry of pediatric deceased organ donation activity

Response to the letter to the editor: Literature review on Paediatric Deceased Donation Guidelines

Neonatal donation: are newborns too young to be recognized?

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