Pediatric organ donation: retrospective study in five centers in Argentina

Introduction. Advances in medicine have made organ and tissue transplantation a feasible therapeutic option. However, the shortage of pediatric donors leads to deaths among children on the organ waiting list in Argentina. The objective of this study was to identify variables related to the donation process that may offer opportunities to improve the pediatric donation rate. Population and methods. This was a retrospective observational study conducted in five institutions. Data were obtained from the medical records of patients aged 0 to 18 years who met the clinical criteria for death based on neurological criteria (DNC) in pediatric intensive care units (PICUs), emergency departments, and cardiovascular intensive care units between January 1, 2018, and December 31, 2022. Results. Among the participating centers, three were pediatric and two were general hospitals. A total of 124 patients with clinical DNC were included (1.3% of PICU admissions, 23% of deaths). Of these, 21 (17%) were donors. An 83% rate of missed donation opportunities was identified; the main areas for improvement were detection, diagnosis, and evaluation. Conclusion. DNC is an uncommon condition in pediatrics. This study identifies key areas for action to optimize the evaluation, detection, and management of potential donors-necessary steps to reduce deaths among children on transplant waiting lists.