Child Post-Mortem Organ Donation Procedures Vary

Study finds inconsistencies in pronouncing death, life support, and other organ donation issues
By Jeff Muise
HealthDay Reporter

TUESDAY, May 12 (HealthDay News) -- While most children's hospitals have policies for post-mortem organ donation, they vary on key points, such as the processes for pronouncing death and withdrawing life support, according to a study reported in the May 13 issue of the Journal of the American Medical Association.

Armand H. Matheny Antommaria, M.D., of University of Utah School of Medicine in Salt Lake City, and colleagues collected and reviewed the guidelines for organ donation after cardiac death from children's hospitals in the United States, Canada, and Puerto Rico in late 2007 and early 2008.

Of the 105 respondents, the researchers found that 76 hospitals (72 percent) had organ donation policies, 20 (19 percent) were in the process of developing them, and seven (7 percent) did not have polices and were not developing any. Among 73 polices reviewed, the authors note that 61 (84 percent) specify the criteria for a death pronouncement, 64 (88 percent) prohibit transplant personnel from pronouncing death, and 37 (51 percent) prohibit transplant personnel from involvement in management of the body after death. Thirty-seven polices (54 percent) said withdrawal of life support should take place in the operating room while three polices require that it occur in the intensive care unit.

"The policies exhibit notable variation both within those we studied and compared with authoritative reports and statements. Further research will be required to determine the importance of variation in the tests for declaring death or the processes for withdrawing life-sustaining treatment," the authors conclude.

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