Department of Pediatric Cardiology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee;
Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania.
Pediatrics. 2021 Jun;147(6). doi: 10.1542/peds.2020-009506. Epub 2021 May 7.
A shortage of donor organs represents the major barrier to the success of solid organ transplantation. This is especially true in the pediatric population for which the number of organ donors has decreased over time. With this study, we aimed to assess the factors associated with deceased organ donor consent in the pediatric population and determine the variability in consent rates across organ procurement organizations (OPOs).
All eligible pediatric deaths were identified from the Scientific Registry of Transplant Recipients (2008-2019). The rate of organ donor consent was determined, and multivariable logistic regression was used to assess the factors independently associated with successful donor recruitment. The probability of donor consent was determined for each OPO after adjusting for patient demographics.
A total of 11 829 eligible pediatric deaths were approached to request consent for organ donation. Consent was successful in 8816 (74.5%) subjects. Consent rates are lower in the pediatric population compared with young adults and are directly related to patient age such that eligible infant deaths have the lowest rate of successful donor consent. There is significant variability in donor consent rates across OPOs, independent of population demographic differences.
OPO is predictive of pediatric deceased organ donor consent independent of demographic differences, with some regions having consistently higher consent rates than others. Sharing best practices for pediatric deceased donor recruitment may be a strategy to increase organ availability in the pediatric population.
供体器官短缺是实体器官移植成功的主要障碍。对于儿童来说，这一点尤其如此，因为随着时间的推移，器官捐献者的数量一直在减少。本研究旨在评估与儿科人群中已故器官捐献者同意相关的因素，并确定各器官获取组织（OPO）之间同意率的差异。
从移植受者科学登记处（2008-2019 年）确定所有符合条件的儿科死亡病例。确定器官捐献者同意的比率，并使用多变量逻辑回归评估与成功招募供体者相关的独立因素。在调整患者人口统计学因素后，确定每个 OPO 的供体同意概率。
共对 11829 名符合条件的儿科死亡病例进行了接触，以请求器官捐献同意。8816 名（74.5%）患者同意。与年轻成年人相比，儿科人群的同意率较低，并且与患者年龄直接相关，即符合条件的婴儿死亡者的成功供体同意率最低。OPO 独立于人口统计学差异预测儿科已故器官捐献者同意，不同 OPO 之间的同意率存在显著差异。
OPO 是儿科已故器官捐献者同意的预测指标，独立于人口统计学差异，某些地区的同意率始终高于其他地区。分享儿科已故供体招募的最佳实践可能是增加儿科人群器官可用性的策略。
