American Academy of Pediatrics’ guidance for organ donation and transplantation


Updated guidance for pediatricians that interact with children and their families, who need a potentially life-saving organ donation or transplantation, has been released by the American Academy of Pediatrics (AAP).

American Academy of Pediatrics’ guidance for organ donation and transplantation | Image Credit: © vchalup - © vchalup -

American Academy of Pediatrics’ guidance for organ donation and transplantation | Image Credit: © vchalup - © vchalup -

The American Academy of Pediatrics (AAP) has released guidance on pediatric organ donations and transplantations for pediatricians who work directly with families of children waiting for a potentially life-saving organ transplant, according to a recent press release from the organization.

Approximately half of children that wait for an organ transplant are waiting for more than a year, and some children and teenagers die amid the waiting period. Though some 1,700 children and teenagers receive organ transplants each year, hundreds stay on the waiting list.

The AAP offers guidance in the updated policy statement, “Pediatric Organ Donation and Transplantation: Across the Care Continuum.” The statement addresses several aspects of organ donation and transplant indications. Further, guidance is listed for structure of transplant teams, important ethical issues regarding organ donation and transplantation, and the medical and psychosocial support needed for organ transplant recipients and their families.

“These are important conversations, and it’s best that pediatricians are prepared and comfortable in providing anticipatory guidance about organ donation,” said Benson Hsu, MD, MBA, FAAP, statement author, (written by the Committee on Hospital Care, Section on Critical Care, Section on Surgery, and Committee on Bioethics) in the press release. “This may come up during a regular office visit with a teenager who is asked about organ donation when registering for a first driver’s license. In other cases, a pediatrician may be helping support a family facing end-of-life care.”

According to the statement, few families of adults, children, or adolescents “appear to suffer psychological harm by having the option of donation presented to them.” A statement to keep in mind if a clinician is hesitant to initiate a conversation regarding organ donation or transplantation.

The following is recommended by the AAP:

  • Basic and current knowledge of donation and transplant medicine, policies, and ethics by the pediatric health care provider is needed.
  • To the extent a medical condition allows, teenagers and older children should be involved in discussions about organ donations and transplantations.
  • Those with developmental and intellectual disabilities are not “categorically excluded from organ donation or as transplant recipients.”
  • While acknowledging the parents’ important role, discussions should respect the child’s “emerging autonomy.”
  • Recipients and their respective families will need a multidisciplinary care team of support. This can include a mix of primary and specialist care providers, a critical care team, surgeons, child life specialists, among others.

For more on the updated guidance from the AAP, click here.


American Academy of Pediatrics issues guidance on pediatric organ donation and transplantation. American Academy of Pediatrics. Press release. July 24, 2023. Accessed August 1, 2023.

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