Pediatric death rates and donor yield: a medical examiner's view

Problems relating to organ procurement for transplantation are examined from the medical examiner's perspective. A protocol developed in September 1991 for the County of San Bernardino, California, is described. Procurement statistics and lessons learned during the first 18 months the protocol was used are reviewed. A revised protocol and documentation forms are included. Emphasis is on pediatric donors, especially victims of child abuse. As a result of this program, organ procurement agencies in the area experience fewer denials by the Coroner's Office and organ recoveries have increased by 60%. Internal organs have been recovered from homicide victims, including children, without significant problems occurring during subsequent legal proceedings. There is increasing acceptance of the protocol by all concerned including deputy coroner investigators, homicide detectives, and the District Attorney's Office.