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Organ donation after cardiac death in children: acceptance of a protocol by multidisciplinary staff
Allison S Cowl1, Brian M Cummings, Phoebe H Yager
1Connecticut Children's Medical Center, Hartford, CT, USA.
Insights
Multidisciplinary staff in a pediatric intensive care unit accepted organ donation after cardiac death (DCD). Staff understanding and support for DCD were high, similar to donation after brain death (DBD).
Area of Science:
- Organ transplantation research
- Medical ethics in critical care
- Healthcare provider attitudes
Background:
- Organ donation after cardiac death (DCD) offers outcomes comparable to donation after brain death (DBD).
- Hospitals often delay DCD protocol implementation due to potential negative reactions from healthcare providers.
Purpose of the Study:
- To assess the acceptance of a DCD protocol among multidisciplinary staff in a pediatric intensive care unit (PICU).
Main Methods:
- An anonymous 15-question Likert-scale survey was administered to PICU staff.
- Opinions on DBD and DCD were collected using a 5-point scale.
Main Results:
- Survey response rate was 67% (n=60).
- High staff understanding (82-100%) and support (85% for DCD, 90% for DBD) were reported.
- Staff perception of DCD and DBD was similar (P < .001).
- Staff directly involved with DCD donors found it worthwhile, but 60% suggested protocol improvements.
Conclusions:
- Multidisciplinary staff have accepted DCD.
- DCD has been integrated without differences in acceptance compared to DBD.
- Staff are open to DCD, with suggestions for protocol enhancement.
Background:
Organ donation after cardiac death is increasingly implemented, with outcomes similar to those of organ donation after brain death. Many hospitals hesitate to implement a protocol for donation after cardiac death because of the potential negative reactions among health care providers.
Objectives:
To determine the acceptance of a protocol for donation after cardiac death among multidisciplinary staff in a pediatric intensive care unit.
Methods:
An anonymous, 15-question, Likert-scale questionnaire (scores 1-5) was used to determine the opinions of staff about donation after brain death and after cardiac death in a pediatric intensive care unit of a tertiary-care university hospital.
Results:
Survey response rate was 67% (n = 60). All physicians, 89% of nurses, and 82% of the remaining staff members stated that they understood the difference between donation after brain death and donation after cardiac death; staff supported both types of donation, at rates of 90% and 85%, respectively. Staff perception was the same for each type of donation (ρ = 0.82; r = 0.92; P < .001). The 20 staff members who provided care directly to patients who were donors after cardiac death considered such donation worthwhile. However, 60% of those providers offered suggestions to improve the established protocol for donation.
Conclusions:
The multidisciplinary staff has accepted organ donation after cardiac death and has fully integrated this kind of donation without reported differences from their acceptance of donation after brain death.
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