Mazor Robert, Baden Harris P
Children's Hospital and Regional Medical Center, Division of Critical Care Medicine, W-9824, 4800 Sandpoint Way NE, Seattle, WA 98105, USA.
Pediatrics. 2007 Oct;120(4):e960-6. doi: 10.1542/peds.2006-3550.
Organ donation after cardiac death is viewed as one way of partially closing the current gap between organ supply and demand. There are no published guidelines for organ donation after cardiac death specific to the pediatric population. The objective of this study was to examine the cumulative pediatric donation-after-cardiac-death experience to set the context for the development and sharing of best-practice guidelines.
This was a retrospective, descriptive study that used data from the Organ Procurement and Transplantation Network/United Network for Organ Sharing database from 1993 to 2005. Organ data from all donors after cardiac death who were < 18 years of age were analyzed. The list of donor medical centers was then cross-referenced with the member list from the National Association of Children's Hospitals and Related Institutions.
There were 683 organs from donation-after-cardiac-death donors < 18 years of age. Of those, < 5% were used for pediatric recipients. In comparison, approximately 20% of non-donation-after-cardiac-death organs from pediatric donors were used for pediatric recipients. The vast majority of donation-after-cardiac-death organs donated were kidneys and livers. More than 50% of medical centers that had a pediatric organ-donation-after-cardiac-death donor had just 1. The medical center with the largest pediatric organ-donation-after-cardiac-death donation experience had 14 donors. Forty-three percent of medical centers that had > or = 1 pediatric donation-after-cardiac-death donor were members of the National Association of Children's Hospitals and Related Institutions. Fifty-six percent of all of the pediatric donation-after-cardiac-death organs were donated from the National Association of Children's Hospitals and Related Institution member centers.
Data regarding the use of pediatric donation-after-cardiac-death organs for pediatric recipients remain sparse. Few medical centers have had enough donation-after-cardiac-death donor experience to report a tried-and-true approach. We advocate for comprehensive collection and reporting of outcome data for all-aged recipients of pediatric donation-after-cardiac-death organs to help facilitate the generation of evidence-based best-practice guidelines for pediatric donation after cardiac death.
心源性死亡后的器官捐献被视为部分弥合当前器官供需差距的一种方式。目前尚无专门针对儿科人群的心源性死亡后器官捐献指南。本研究的目的是审视心源性死亡后儿科器官捐献的累积经验，为制定和分享最佳实践指南奠定基础。
这是一项回顾性描述性研究，使用了器官获取与移植网络/器官共享联合网络数据库1993年至2005年的数据。对所有18岁以下心源性死亡后捐献者的器官数据进行了分析。然后将捐献者医疗中心名单与全国儿童医院及相关机构协会的成员名单进行交叉对照。
有683个器官来自18岁以下的心源性死亡后捐献者。其中，不到5%的器官用于儿科受者。相比之下，儿科捐献者的心源性死亡后未捐献器官中约20%用于儿科受者。心源性死亡后捐献的器官绝大多数是肾脏和肝脏。有儿科心源性死亡后器官捐献者的医疗中心中，超过50%仅有1例捐献者。儿科心源性死亡后器官捐献经验最丰富的医疗中心有14例捐献者。有1例或更多儿科心源性死亡后捐献者的医疗中心中，43%是全国儿童医院及相关机构协会的成员。所有儿科心源性死亡后器官中，56%是由全国儿童医院及相关机构协会成员中心捐献的。
关于儿科心源性死亡后器官用于儿科受者的数据仍然稀少。很少有医疗中心有足够的心源性死亡后捐献者经验来报告一种经过验证的方法。我们主张全面收集和报告儿科心源性死亡后器官所有年龄段受者的结局数据，以帮助促进制定基于证据的儿科心源性死亡后器官捐献最佳实践指南。
