Objectives: Since August 2010, there has been more than 120 pediatric brain-dead organ donations in Japan. Unlike other countries, most deceased pediatric organ donations are performed in non-pediatric intensive care units (PICU) facilities (EDs). Although our hospital does not have PICU, we have attached great importance to family-centered grief care especially for pediatric patients.
Methods: Retrospective, single-center, descriptive study. All death patients under 18 years of age who were admitted to our hospital between 2014 and 2024, and who were medically eligible for organ donation and were included.
Results: During the study period, 14 children (<18 years) died in our hospital. From those, 6 patients were identified potential braindead organ donors. All 6 patient families were asked for their consent for organ donation by the in-hospital coordinator or the chief of emergency department. The mean age of the patients at the time of death was 9.5 years. Four patients were male. The cause of death was hypoxic brain injury in 3, Influenza-associated encephalopathy in 2 and traumatic subarachnoid hemorrhage in 1. Three families agreed to organ donations. One family rejected organ donation because maternal grandparents disagreed while the parents agreed. One family disagreed because they wished to keep aggressive treatment. One patient whose family agreed to organ donation died of severe hemodynamic instability before organ donation. Three patients donated 2 hearts, 3 bilateral lungs, 3 livers, 2 pancreases, 6 kidneys and one intestine. The mean number of organs donated per patient was 5.7.
Conclusions: All families of patients who were medically eligible for organ donation were asked for their consent for organ donation. Out of 6 patients whose family agreed to donate, 3 patients donated 17 organs. Establishment of children’s family care as well as approach for families to obtain consent for organ donation is important to make pediatric deceased organ donation feasible even in hospital without PICUs.