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Updated: Apr 15, 2026
Large-Animal Model of Donation after Circulatory Death and Normothermic Regional Perfusion for Cardiac Assessment
Published on: May 10, 2022
Cardiac dysfunction following brain death in children: prevalence, normalization, and transplantation
Vijay Krishnamoorthy1, Xenia Borbely, Ali Rowhani-Rahbar
11Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA. 2Harborview Injury Prevention and Research Center, Seattle, WA. 3Department of Epidemiology, University of Washington, Seattle, WA. 4Department of Cardiology, University of Washington, Seattle, WA.
Cardiac dysfunction is common in pediatric brain death (38%), but often improves over time. Initial echocardiograms should not solely determine organ procurement decisions for pediatric cardiac donors.
Area of Science:
- Cardiology
- Pediatric Critical Care
- Organ Donation
Background:
- Cardiac dysfunction affects up to 42% of adult brain death cases, potentially limiting organ donation.
- Limited data exists on the prevalence and course of cardiac dysfunction in pediatric brain death.
- Understanding these factors is crucial for improving pediatric cardiac donor screening and transplant practices.
Purpose of the Study:
- To determine the prevalence of cardiac dysfunction in pediatric patients following brain death.
- To describe the natural course of cardiac dysfunction in this population.
- To inform organ procurement and transplant strategies for pediatric cardiac donors.
Main Methods:
- A cross-sectional study analyzing data from an organ procurement organization (Life Center Northwest).
- Reviewed transthoracic echocardiograms of pediatric potential cardiac donors (age ≤ 18 years) diagnosed with brain death (January 2011 - November 2013).
- Cardiac dysfunction defined as ejection fraction <50% or regional wall motion abnormalities; longitudinal data analyzed in a subgroup.
Main Results:
- Identified 60 pediatric potential cardiac donors with post-brain death echocardiograms.
- Cardiac dysfunction was present in 38% (23/60) of patients.
- Patients with dysfunction had lower ejection fractions and lower procurement rates; however, 73% of those with serial data showed functional improvement.
Conclusions:
- Cardiac dysfunction is highly prevalent in pediatric brain death.
- Improvement in cardiac function over time is common, suggesting initial echocardiogram findings may not preclude organ procurement.
- Serial echocardiography can provide valuable information for organ procurement decisions in pediatric cardiac donors.
