Management of paediatric organ donor

Abstract

Paediatric transplantation suffers from a real shortage of compatible organs which is not compensated by attribution priorities, particularly in the case of small children. Paediatric organ recovery should be given more importance by optimizing the intensive care of potential organ donors and family counselling. Brain death is a clinical diagnosis made in the presence of complete and irreversible cessation of all brain functions, after identification of a compatible aetiology. The irreversible status of brain death can be confirmed by two isoelectric and non-reactive electroencephalograms, performed in strict conditions or based on cerebral angiography. Once brain death is confirmed, intensive care aims maintaining haemodynamic parameters, to protect organs instead of brain function. Procedures leading to the diagnosis of brain death in children as well as systemic intensive management of small donors should be well-known and accepted by each member of the caring team. This strategy aims at allowing the participation of the whole caring team and obtaining parents’ confidence and consent for donation.