Article Text

  1. K Patel1,
  2. R Hodge2,
  3. R J Mildner1
  1. 1PICU, Birmingham Children’s Hospital, Birmingham, UK
  2. 2Regional Donor Transplant Coordinators, Queen Elizabeth Hospital, Birmingham, UK


Objective The United Kingdom has a shortage of solid organs for transplantation. However, national data on available tissue for transplantation are limited. Recent data from our local tissue bank show a significant shortfall. We aimed to determine potential number of tissue donors among children who die in PICU.

Method A retrospective audit in a 20 bed multidisciplinary PICU over 1 year. We identified potential non-heart beating (NHB) and heart-beating (HB) donors and determined eligibility based on national and local criteria. We also determined whether donor transplant coordinator referral occurred, whether next-of-kin (NOK) were approached and whether tissue donation actually happened.

Results Of 74 deaths (68 NHB and 6 HB), 52 (70%) were potential tissue donors based on national criteria, and 24 (32%) by local criteria. Of these 19 were NHB and 5 HB donors. The approach rate in potential HB donors was 40%, but 0% in NHB donors. One HB donor donated tissue (consent rate 50% in HB donors), while no potential NHB donor did.

Conclusions This audit shows that in the majority of potential tissue donors, NOK were not approached for consent. Also, in potential HB donors put forward for solid organ donation, tissue donation is often not considered.

There is a need to raise awareness amongst PICU healthcare professionals and to improve systems for identifying potential tissue donors and approaching NOK. Also, development of a process whereby potential NHB donors can donate solid organs should be explored. The implications for PICU workload of these developments should be assessed.

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