Organ procurement and abusive head trauma in infants: current practices in France

Abstract

INTRODUCTION

Infant deaths from abusive head trauma are part of a medico-legal procedure that may interfere with organ donation processes. The objective of this study is to describe the current practices of organ procurement in these brain-dead infants in France.

METHODS

A national survey was conducted between April and December 2018 among the 33 pediatric organ procurement organizations and the 28 forensic institutes. Data from 2013 to 2017 were collected. 

RESULTS

Sixteen cases were reported and reviewed. The management of abusive head trauma eligible for organ procurement is very heterogeneous depending on the center. The organ procurement organizations consider that the judicialization of the cases represents the main obstacle to the organ donation. Only 6 of forensic institutes systematically approve the removal of organs in abusive head injuries, with nearly 11 of them believing that it could prevent the detection of thoracoabdominal lesions, compromise the interpretation of certain lesions or the determination of causes of death.

CONCLUSION

A standardization of the organ procurement practices including a close collaboration between resuscitators, organ procurement teams, forensic doctors and magistrates are essential to facilitate the pediatric organ procurement and therefore improve the organs disposable for infants awaiting transplantation in France.