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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Bone Marrow Sampling and Transplants01:22

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Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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[National recommendations on pediatric donation].

Antonio Rodríguez Núñez1, Alicia Pérez Blanco2,

  • 1Sección de Pediatría Crítica, Cuidados Intermedios y Paliativos Pediátricos, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, España.

Anales De Pediatria
|July 5, 2020
PubMed
Summary

Spain aims to enhance pediatric organ donation, including donation after circulatory death, by streamlining procedures and addressing ethical considerations for newborns and children. This initiative seeks to improve organ availability and family-centered care during critical times.

Keywords:
Adecuación de medidas terapéuticasAsistolia controladaBrain deathChildrenConsentimiento informadoCuidados centrados en la familiaCuidados paliativosDonación de órganosDonation after the circulatory determination of deathEthicsFamily-centered careMuerte encefálicaNeonatosNewbornsNiñosOrgan donationPalliative careSurrogate consentTransplantationTrasplanteWithholding and withdrawal of life sustaining measuresÉtica

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Area of Science:

  • Pediatrics
  • Transplantation Medicine
  • Bioethics

Background:

  • Spain is a leader in organ donation and transplantation.
  • There is a need to improve pediatric donation rates, including donation after circulatory determination of death (DCDD).

Purpose of the Study:

  • To facilitate donation procedures for newborns and children.
  • To analyze ethical dilemmas associated with pediatric donation.
  • To establish ethical standards for organ and tissue donation in children.

Main Methods:

  • Summary of a consensus report by the Organización Nacional de Trasplantes and the Spanish Pediatrics Association.
  • Discussion of ethical principles, clinical assessment, death determination criteria, and intensive care management for pediatric donors.
  • Analysis of DCDD and donation procedures for specific pediatric populations (e.g., newborns with severe malformations, children receiving palliative care).

Main Results:

  • The report provides a framework for improving pediatric donation processes.
  • Ethical considerations and practical guidelines for pediatric organ and tissue donation are detailed.
  • Emphasis on DCDD and donation in specialized pediatric cases.

Conclusions:

  • Systematically considering organ and tissue donation when a child dies is an ethical imperative.
  • Improving pediatric donation is crucial for meeting transplantation needs.
  • Ensuring family-centered care is a key ethical standard in pediatric donation.