Published online January 2, 2007
PEDIATRICS Vol. 119 No. 1 January 2007, pp. e219-e224 (doi:10.1542/peds.2006-0375)

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Durall, A. L. Articles by Randolph, A. G. Search for Related Content PubMed PubMed Citation Articles by Durall, A. L. Articles by Randolph, A. G. Related Collections Heart & Blood Vessels Related AAP Red Book topics: Human Immunodeficiency Virus... Social Bookmarking                         What's this?

ARTICLE

Potential for Donation After Cardiac Death in a Children's Hospital

Amy L. Durall, MD^a,b, Peter C. Laussen, MBBS^b,c and Adrienne G. Randolph, MD, MSc^a,b

^a Division of Critical Care, Department of Anesthesia, Perioperative and Pain Medicine
^c Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
^b Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts

OBJECTIVES. A task force was convened to decide whether a donation after cardiac death policy should be implemented at Children's Hospital Boston. As part of this process, we sought to determine the number of potential kidney donation after cardiac death donors in our PICUs.

METHODS. We examined all 254 deaths in the Medical/Surgical ICU and the Cardiac ICU from 2002 to 2004 and identified potential donation after cardiac death donors. Inclusion criteria were age 3 months, mechanical ventilation, and creatinine 1.5 mg/dL. Exclusion criteria were HIV infection, malignancy other than primary brain tumor or nonmelanoma skin cancer, evidence of ongoing infection, death despite resuscitation attempts, and brain death.

RESULTS. Twenty-one of the 254 deaths met criteria for brain death, and 233 patients did not. Of the 116 patients >3 months of age for whom life support was withdrawn, 92 were not suitable for kidney donation after cardiac death. Of the 24 children identified as potentially eligible for donation after cardiac death, 14 died within 1 hour of withdrawal of support and could have proceeded with donation after cardiac death. In the other 10 children, donation would have been aborted because of prolonged time to death.

CONCLUSIONS. Of all patients who died in our ICUs, 5.5% would have been potential candidates for donation after cardiac death. Assuming the rates of parental consent are similar to that of our heart-beating organ donors (47%), a donation after cardiac death protocol could have potentially yielded 7 additional organ donors and 14 additional kidneys over this 3-year period.

---

Key Words: donation after cardiac death • pediatric

Abbreviations: DCD—donation after cardiac death • CICU—cardiac ICU • OPO—organ procurement organization • CHOP—Children's Hospital of Philadelphia • MAP—mean arterial pressure • ARDS—acute respiratory distress syndrome • BMT—bone marrow transplant • CNS—central nervous system • HIE—hypoxic ischemic encephalopathy

---

Accepted Jul 19, 2006.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J. DuBose and A. Salim Aggressive Organ Donor Management Protocol J Intensive Care Med, November 1, 2008; 23(6): 367 - 375. [Abstract] [PDF]