A retrospective review of the characteristics of patients deemed unsuitable for organ donation in a paediatric intensive care unit over a 5-year period

Introduction

Children on organ transplant lists are more likely than adult patients to develop complications or die whilst waiting for a transplant. This reflects children's frequent need for size-matched organs, which are rarely available.

Objectives

The aim of this study was to review characteristics of patients deemed unsuitable for organ donation in a paediatric intensive care unit over a 5-year period to identify opportunities for practice improvement.

Methods

This was a quantitative, retrospective, observational study, using a descriptive design. Data were extracted from the clinical intensive care database STATIC into Microsoft Excel for children who died between the 1st of January 2018 and the 31st of December 2022. Data were analysed descriptively.

Results

Across the 5 years, 226 children died; 94 (41%) were referred to the state organ donation service DonateLife, and 26 (11.5%) became organ donors. Most children died from a cardiac cause. Of the total children who died, 152 (66%) were deemed to be unsuitable for organ donation. The most common reasons for children being deemed unsuitable for organ donation were as follows: poor organ function (46%), pre-existing systemic disease (34%), sepsis (15%), too young (10.5%), and due to legislation (9.8%).

Conclusion

This study identified cohorts of patients who were deemed unsuitable for organ donation. Based on published evidence, some of these patients may have been suitable or could have been considered for organ donation. Identifying these cohorts may optimise knowledge translation regarding donor suitability, with the outcome of increasing organ donation opportunities.