Research report examines trends in pediatric organ donation and transplantation

Changes in the circumstances of when organs are donated to pediatric patients has resulted in a decreased number of organ transplant wait-list deaths over the past decade, according to research published online this week in the journal Pediatrics.
 
University of Utah pediatric fellow Jennifer K. Workman, M.D., authored the study "Pediatric Organ Donation and Transplantation," which examined trends in pediatric organ donation and transplantation over a 10-year period from 2001 to 2010.  She and her colleagues found that children received more solid organ transplants and fewer children died waiting for a life-saving transplant.
 
Researchers discovered a change in the pattern of organ donation over the time period, Workman said. Traditionally, the main route to donation came after a patient was declared brain dead, and family decided to move forward with organ donation.  That trend has been complemented in recent years by what's called donation after circulatory determination of death (DCDD) as another way for patients and families to choose to donate organs.
 
DCDD donations result when a child is so severely ill or injured that they have no chance of recovery. A family may choose to withdraw them from life support and give the gift of organ donation at that time, after a patient's heart has stopped, Workman said.  The difficult decision to donate organs through DCDD has been embraced with increasing support in recent years, she said.
 
"The bottom line of our research is two things: One, there are just not enough donor organs for all the people waiting on the transplant list. There are upwards of 118,000 people waiting on the transplant list. Thousands of them will die every year waiting for an organ," Workman said.
 
"The second thing is that if a family is interested in donation, we should try to support them in any way we can to make that happen, whether that means donation after brain death or DCDD."
 
Workman's co-authors in the study included Craig W. Myrick, RN, of Intermountain Donor Services; Rebecka L. Meyers, M.D., a Professor of Pediatric Surgery at the University of Utah and a pediatric surgeon at Primary Children's Medical Center; Susan L. Bratton, M.D. M.P.H., a Professor of Pediatrics at the University of Utah and a clinician in the Division of Critical Care Medicine at Primary Children´s Medical Center; and Thomas A. Nakagawa, M.D., M.D., Professor Anesthesiology-Pediatric ICU Anesthesia at Wake Forest Baptist Medical Center.


Workman said there are many approaches to try to decrease the wait list for organ transplants.  Medical communities -including doctors, nurses, OR staff, techs, organ procurement organizations -need to work together to make organ donation a smooth process for families. Workman noted that while organs from pediatric donors are not always transplanted into other pediatric patients, increasing pediatric donation - by whatever method - helps increase the pool of available organs and therefore decreases the strain on the overall organ shortage in the U.S. population.
 
And families, she emphasized, need support to realize that when faced with the terrible tragedy of losing a child, they may provide the gift of life to other children on an organ donation waiting list.
 
"When they are faced with this terrible tragedy, if there's anyway to make this a positive, organ donation could be of help to them, " Workman said.
 
SOURCE University of Utah