Objective To define the demographic characteristics, clinical features and outcome of patients with brain death and to emphasise the importance of organ donation in children.
Setting Centre I: 14-bed, tertiary care Paediatric Intensive Care Unit (PICU).
Centre II: Tertiary care Intensive Care Unit (ICU), Trauma centre.
Methods Data were collected from September 2009 to October 2012 retrospectively. Twenty children who were diagnosed as brain death were included. Data including demographics, disease leading to brain death, duration of brain death evaluation, ancillary tests to confirm the brain death, complications and outcome, duration of hospitalisation, status of survival and organ donation were collected for statistical evaluation.
Results The mean age were 6.2 ± 5.3 (median:3.8) years. Male/female ratio was 1.85. Disease leading to brain death was traumatic brain injury in 11(55%) patients. The mean duration of brain death evaluation was 6.7 ± 6.4 (median:4) and 1.7 ± 1(median:1) days in Centres I and II respectively. The duration of hospitalisation was 12.5 ± 10.7 (median:7.5) days. Electroensefalography (EEG) was applied in 18(90%) patients. Complications included diabetes incipitus in 9(45%) cases. Duration of survival was 9.8 ± 9.4 (median:6) days. One of the patients’ parents give consent to organ donation in Centre I while 4 parents accepted organ donation in Centre II. The study demonstrated that duration of brain death evaluation in Centre I was longer when compared to Centre II (p < 0.05). There was no difference between centres in obtaining concepts of organ donation, survival after the diagnosis of brain death and length of stay in PICU (p > 0.05).
Conclusion The early diagnosis of brain death and prompt evaluation of the patients by the ICU physicians once the diagnosis is considered will probably yield better organs and reduce costs. Training of the PICU physicians, nurses and organ donation coordinators and increasing the awareness of the children via public means may increase the families’ acceptance rate for organ donation in future.