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Updated: Feb 7, 2026
Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
Organ Donation Following Neurologic and Circulatory Determination of Death
Thomas A Nakagawa1,2,3, Sam D Shemie4,5,6, Karen Dryden-Palmer7
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Insights
Caring for critically ill children requires supporting families through end-of-of-life care and pediatric organ donation. Coordinated multidisciplinary teams are essential for successful organ recovery and honoring family wishes.
Area of Science:
- Pediatric critical care medicine
- Organ donation and transplantation
- Bioethics and end-of-life care
Background:
- Pediatric organ donation is a critical aspect of end-of-life care for critically ill children.
- Supporting families through the process of pediatric organ donation is crucial for their healing.
- Effective pediatric organ donation requires collaboration among healthcare teams.
Purpose of the Study:
- To outline key considerations in caring for critically ill children who are potential organ donors.
- To describe best practices for supporting families during a child's end-of-life process and organ donation.
- To emphasize the multidisciplinary approach needed for successful pediatric organ donation.
Main Methods:
- Comprehensive literature review on pediatric donation practices.
- Analysis of expert commentary on donor management.
- Inclusion of pediatric data from the U.S. Organ Procurement and Transplantation Network.
Main Results:
- Successful pediatric organ donation relies on coordinated efforts between critical care, organ donation, and transplant teams.
- Effective donor management ensures optimal organ recovery for transplantation.
- Collaboration reduces waiting list morbidity and honors family decisions.
Conclusions:
- Pediatric organ donation is integral to end-of-life care, aiding family and staff healing.
- Healthcare providers must proactively preserve donation options and secure family consent.
- Managing pediatric organ donors necessitates specialized multidisciplinary expertise for both neurological and circulatory determination of death.
Objectives:
To describe important considerations during the process of caring for critically ill children who may be potential organ donors and supporting the family during the death of their child.
Design:
Literature review and expert commentary.
Measurement And Main Results:
Medical literature focusing on pediatric donation, best pediatric donation practices, donor management, and factors influencing donation were reviewed. Additional pediatric data were obtained and reviewed from the U.S. Organ Procurement and Transplantation Network. Achieving successful organ donation requires the coordinated efforts of the critical care team, organ donation organization, and transplant team to effectively manage a potential donor and recover suitable organs for transplantation. Collaboration between these teams is essential to ensure that all potential organs are recovered in optimal condition, to reduce death and morbidity in children on transplantation waiting lists as well as fulfilling the family's wishes for their dying child to become a donor.
Conclusions:
Organ donation is an important component of end-of-life care and can help the healing process for families and medical staff following the death of a child. The process of pediatric organ donation requires healthcare providers to actively work to preserve the option of donation before the death of the child and ensure donation occurs after consent/authorization has been obtained from the family. Medical management of the pediatric organ donor requires the expertise of a multidisciplinary medical team skilled in the unique needs of caring for children after neurologic determination of death and those who become donors following circulatory death after withdrawal of life-sustaining medical therapies.
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