Traumatic Brain Death and Organ Donation in Pediatrics. How to Optimize Organ Procurement in Case of Forensic Reservations?

Abstract

Pediatric organ donors are rare and mainly due to unnatural brain death. These traumatic circumstances issued from accidental or nonaccidental events can lead to forensic reservations, which complicate the donation process. In the aim to recruit these young potential donors, health care professionals have to prove a close collaboration with the judiciary team, by not interfering in the research of the exact cause of death. They must make available any medical and radiological date before and during operative period. In response, prosecutors will be more attentive to these intensive care doctors and the Organ Donation Service Teams (ODST) who solicit them for an authorization of a Multiple Organ Procurement. If the judiciary investigation permits it, the prosecutors can initially give an agreement in principle. Later, if the donation process develops favorably with a parental agreement, an official judiciary authorization can be given to the ODST who claim it. This close collaboration and mutual respect between the health care workers and the judiciary team has contributed to facilitate recruitment of potential donors with an increased organ procurement in this cohort of 22 brain dead children under 3 years old, identified by the ODST.