Lee Laurie A, Okpere Augustina, Martin Dori-Ann, Mahoney Meagan, James Lee, Avitzur Yaron, Piggott Bailey, Tomlinson Christopher, Urschel Simon, Hamiwka Lorraine
Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
Department of Pediatrics, Cuming School of Medicine, University of Calgary, Calgary, AB, Canada.
Front Transplant. 2024 Sep 27;3:1458563. doi: 10.3389/frtra.2024.1458563. eCollection 2024.
Solid organ transplantation in children is a lifesaving therapy, however, pediatric organ donation rates remain suboptimal.
We conducted a cross-sectional survey of Canadian organ donation organizations (ODOs) and pediatric transplant programs (TPs), aiming to describe policies and practices for pediatric organ allocation, acceptance, and utilization in Canada.
Response rates were 82% and 83% respectively for ODOs and transplant programs comprising 7 kidney, 3 heart, 2 lung, 2 liver and 1 intestine programs. All 9 ODOs reported offering pediatric organs following death by neurological criteria (DNC), while 8 reported offering organs following death by circulatory criteria (DCC) for some organs. Variability was found across ODOs and TPs. There was little agreement on both absolute and organ-specific donor exclusion criteria between ODOs. There was further disagreement in organ specific acceptance criteria between ODOs and TPs and between TPs themselves. Notably, despite the development of pediatric donation after DCC guidelines, organs from DCC donors are excluded by many ODOs and TPs.
Further variability in pediatric specific training, policies, and allocation guidelines are also documented. Significant areas for improvement in standardization in organ acceptance, offering, and allocation in pediatric donation and transplantation across Canada were identified.
儿童实体器官移植是一种挽救生命的治疗方法，然而，儿科器官捐赠率仍不理想。
我们对加拿大器官捐赠组织（ODO）和儿科移植项目（TP）进行了横断面调查，旨在描述加拿大儿科器官分配、接受和利用的政策与实践。
ODO和移植项目的回复率分别为82%和83%，包括7个肾脏、3个心脏、2个肺、2个肝脏和1个肠道项目。所有9个ODO均报告按照神经学标准判定死亡（DNC）后提供儿科器官，而8个ODO报告对某些器官按照循环标准判定死亡（DCC）后提供器官。ODO和TP之间存在差异。ODO之间在绝对和器官特异性供体排除标准方面几乎没有共识。ODO与TP之间以及TP自身之间在器官特异性接受标准方面存在进一步分歧。值得注意的是，尽管制定了DCC后儿科捐赠指南，但许多ODO和TP排除了DCC供体的器官。
还记录了儿科特定培训、政策和分配指南方面的进一步差异。确定了加拿大全国儿科捐赠和移植中器官接受、提供和分配标准化方面的重大改进领域。
