Pediatric Donation and Transplantation

Camlien Chau

NU 497 Directed Study

Assignment # 4

Assignment # 4 (E): Search Alabama Organ Center (AOC)

        Out of each of the boxes I found the most interesting information to me was the Pediatric Donation. Pediatric donation is a difficult subject. The loss of a child or infant is always tragic, and the option of organ, eye and tissue donation is especially hard on parents, who are the decision makers in such an event. Pediatric donors become eligible for organ procurement after the determination of neurologic death has been made. Although most pediatric donors will meet standard criteria for declaration of brain death, donation after cardiac death (DCD) or non–heart-beating organ donation has the potential to increase organ donation. Pediatric donation is different from adult donation.

        When a potential donor is under the age of 18, the parent or legal guardian always must authorize the donation. In many states if the child dies before the age 18, the parents must make the donation decision. Currently, near 2,000 children under the age of 18 are on the national transplant waiting list. 1, 898 children received transplants in 2015. There were 929 pediatric organ donors in 2015. Although they ranged from newborns to age 17, most were age 1 to 11. 150 pediatric organ donors in 2015 were babies under the age of 12 months.

        The organs that children tend to need most varies by the age. Most children under the age of 1 year are waiting for a liver or heart. Children age 1 to 10 are waiting for a kidney or liver, followed by heart. Many children age 11 to 17 are primarily waiting for a kidney, followed by a liver. The size of the body and the organ are considered when matching donors to recipients. That is why very small children most often receive donations from other young people although older children and adults can often match. Sometimes, children can receive donations of partial organs such as a piece of liver or lung.

        Just like adult donations there are some considerations for the medical team caring for the pediatric organ recipient include support (emotional and spiritual) for the recipient, other siblings (eg, social aspects relating to their care), and parents or guardians (eg, maintaining employment status) and the availability of pediatric subspecialty support (critical care, dialysis, anesthesia, interventional radiology, etc.) Children are much harder to relocate to a transplant center for care, because their families must accompany them and siblings must be cared for at the same time. Involvement of the child's primary care physician and local subspecialist can be beneficial in providing follow-up visits and laboratory monitoring where these capabilities exist. This decrease transportation costs and improves patient access to medical intervention. Keeping the family unit intact reduces stress on the family and improves the outcome for the child.