Neonatal donation: are newborns too young to be recognized?

Area of Science:

• Pediatric Medicine
• Transplantation
• Bioethics

Background:

• Neonatal organ and tissue donation is not common in the Netherlands, despite a waiting list for small-sized organs and tissues.
• Low neonatal donation rates may stem from a lack of awareness regarding this donation option.

Purpose of the Study:

• To investigate the prevalence of potential neonatal organ and tissue donors in Dutch neonatal intensive care units (NICUs).
• To assess the number of potential neonatal donors reported to procurement organizations.

Main Methods:

• Retrospective analysis of mortality databases and medical records from two major NICUs in the Netherlands.
• Inclusion criteria: neonates with gestational age >37 weeks and weight >3000g who died between January 1, 2005, and December 31, 2016.
• Exclusion of neonates with general contraindications for donation; assessment of donation suitability for remaining cases.

Main Results:

• Of 259 deceased term-born neonates, 127 records were reviewed for donation suitability after exclusions.
• Five neonates with documented brain death were not identified as potential organ/tissue donors.
• Twenty-seven neonates (21%) were suitable for tissue donation; only one was reported to procurement. Parents initiated donation discussions in three cases.

Conclusions:

• Only 2% of deceased neonates in the study were suitable for organ donation, while 12% were suitable for tissue donation.
• Enhanced awareness of neonatal donation possibilities is crucial for identifying potential donors and supporting families.
• Improved recognition of potential neonatal donors is needed to meet the demand for pediatric transplants.