Study: Scarcity of organs a major limiting factor in paediatric transplantation

The low numbers of organ donation from deceased children is impacting on paediatric transplantation programmes, research shows.

Over an 11-year-period from 2007 to last year in Ireland, there were organ donations or tissue heart valves from 36 deceased children. The age range was from a one-day-old baby to 15 years.

This represents a donation rate of 2.9 per million population of children, compared with a US donation rate of 1.2 per million children, which is even lower.

The most recent UK data reports that there were 57 deceased paediatric organ donors aged zero to 17 years. Yet the total number of deceased donors across all age groups was 1,574.

However, the Irish data found that the survival of donor grafts was 80% for kidneys, liver, lung, and heart.

In the Irish Medical Journal, author Dr John F Murphy points out that studies by HM Marshall and JK Lechner respectfully, highlight that paediatricians’ ability to understand and apply the criteria of brain death in young infants leaves substantial room for improvement.

“Therefore it is not surprising that cases of neonatal organ donation are rare. More often than not the request comes from the parents rather than from the caregivers.

There is an increasing awareness in society about the need for organ donation and transplantation. In children, the scarcity of available organs is a major limiting factor in the paediatric transplantation programme.

Mr Murphy, points to there being both a lack of unawareness and a reluctance to raise the subject of organ donation with the parents of a terminally ill infant.

In JK Lechner’s research it was found that more experienced, senior staff are needed when dealing with paediatric organ donations. He also believes there must be a strong emphasis on the training of caregivers who approach families about organ donation as It is a complex process.

Dr Murphy added that Mr Lechner’s analyses, “raises awareness about organ donation in young infants. The number of potential donors is small but there is room for improvement.The better understanding and acceptance of brain death criteria in young infants is a step forwards.”

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