[Report of Sata Clinical Fellowship; brain death and organ donation in hospital for sick children, Toronto, Canada].

I have experienced two cases of pediatric organ donation from the brain dead patients in Hospital for Sick Children in three months. First case was a 9-year-old boy after a traffic accident. Second case was an 11-year-old boy with intracranial hemorrhage. Brain death is diagnosed by clinical criteria alone in Canada, as in many of developed countries. EEG or brain flow studies are not mandatory. In the first case, brain death was confirmed after additional brain flow study, EEG, and SSEP because of cervical spinal injury. Second case was diagnosed as brain death by clinical criteria alone, and cardiopulmonary resuscitation was performed after brain death diagnosis. MORE (multiple organ receival and exchange program of Ontario), Organ Donation Team (critical care physicians, nurses, organ donation coordinators, social workers and chaplains) in HSC, and volunteers play the important role to help the family and to make the organ transplantation successful. In Canada, pediatric brain death and organ donation are widely accepted, but there remains an imbalance between the demand for transplantation and the number of organs available.