May 13, 2009

Differences in Organ Donor Policies at Children’s Hospitals

Many children's hospitals are developing policies for organ donation after cardiac death, although some hospitals do not house a policy and others are unwilling to release such policies, new research shows.

Donation after cardiac death (DCD) enables patients who may not meet criteria for death to potentially donate their organs.

"Controlled DCD occurs following planned withdrawal of life-sustaining treatment," study authors said. This may include circumstances such as patients with catastrophic brain injury or end-stage neuromuscular diseases.

Researchers found of 124 hospitals, 72 percent currently held DCD policies, 19 percent were developing policies, and 7 percent neither had nor were developing a policy. Eighty-four percent of the approved policies contained specific criteria or tests for declaring death, 88 percent prevented the transplant staff from declaring death, and 51 percent prohibited them from being involved prior to death.

Policies also differed on topics such as the importance of palliative care and the location of the withdrawal of life-sustaining treatment.

SOURCE: JAMA, May 13, 2009