Improving organ donation in pediatrics

Adult organ donation has risen over the past years, but declined in pediatrics. A study examined consent for pediatric organ donation.

Death is a devastating experience for loved ones, especially so when a child has died. Death can also mean a chance at a longer life for those who receive solid organ transplants from a deceased person. However, a shortage of donor organs is a major issue with solid organ transplantation, particularly in pediatrics, as the number of donors has decreased over time. An investigation in Pediatrics examines the factors linked to deceased organ donor consent.1

The investigators identified all eligible pediatric deaths from the Scientific Registry of Transplant Recipients (2008–2019). They determined the rate of organ donor consent and used multivariable logistic regression to assess the factors independently linked to successful donor recruitment. Following adjustment for patient demographics, the probability of donor consent was found for each organ procurement organization.

There were 11,829 eligible pediatric deaths included in the study. The parents or guardian for each child was approached to request consent for organ donation. The consent request was successful for 8816 children. Overall, the consent rates were lower in the pediatric population than in the young adult population and appeared to be directly linked to the patient age. This relationship led to eligible infant deaths having the lowest rate of successful donor consent. Significant variability in donor consent rates across organ procurement organizations was noted and was independent of population demographic differences.

The investigators concluded that there was high variability across organ procurement organization. Some regions in the United States have higher overall consent rates than others, which suggests that some organ procurement organizations have better programs to attain consent. The sharing of best practices for pediatric deceased donor recruitment across organ procurement organizations could be one important way to increase the available donor organs in pediatrics.

Reference

1. Godown J, Butler A, Lebovitz D, Chapman G. Predictors of deceased organ donation in the pediatric population. Pediatrics. May 7, 2021. Epub ahead of print. doi:10.1542/peds.2020-009506