Paediatric Organ and Tissue Donation: Developing a Comprehensive Protocol for Effective Donation Procedures in the Netherlands
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Abstract
The waiting list for children needing organ and tissue transplantation increases yearly; some die while waiting for a suitable transplant. Most of them need small organs or tissues from paediatric donors. Paediatric donation is a unique and extremely sensitive process that requires specific knowledge and competencies. Because paediatric donation is relatively rare and complex, gaining knowledge and experience in this field is difficult.
This article describes essential facts about donation and transplantation concerning children in the Netherlands and summarises studies reporting on the various factors influencing paediatric donation.
The methodology used combines various research methods, including literature review, online survey, face-to-face interviews, and retrospective study, to evaluate the organ and tissue donation protocols for the paediatric population in Dutch Paediatric Intensive Care Units and Neonatal Intensive Care Units. The studies provide insights into the current process and limitations of paediatric donation and offer recommendations for the development of a paediatric donation protocol.
Recurrent themes that emphasise the importance of a robust paediatric donation process were identified and later used to form the groundwork for a paediatric donation protocol.
Healthcare professionals lack knowledge and experience with donation procedures. Work experience at the Paediatric Intensive Care Unit or Neonatal Intensive Care Unit is not related to the gained experience in the organ or tissue donation procedure. Paediatric Intensive Care nurses had significantly less experience than Paediatric Intensivists.
The survey respondents confirmed needing more guidance on the paediatric donation process. They further agreed there was a need for an easily accessible and clear guidelines document for paediatrics known as “the children's protocol” to cover all types of paediatric donation procedures (Donation after Brain Death, Donation after Circulatory Death and tissue donation). Neonatal Intensive Care Unit donation potential is limited.
A new donation protocol for paediatrics was designed using the results of all the above studies. The comprehensive protocol for paediatric organ donation in the Netherlands aims to assist healthcare professionals in identifying potential donors and referring them to an Organ Procurement Organization in a timely manner. Additionally, the protocol will support healthcare professionals in conducting sensitive yet necessary discussions with the family regarding the possibility of organ and tissue donation. Finally, while using the protocol, healthcare professionals provide the appropriate state-of-the-art support to the parents during a challenging and emotional time.
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References
2. Eurotransplant - statistics report library, waiting list. https://statistics.eurotransplant.org/index.php?search_type=waiting+list&search_organ=&search_region=by+country&search_period=2021&search_characteristic=&search. Accessed 04/04/, 2022.
3. Martin DE, Nakagawa TA, Siebelink MJ, et al. Pediatric deceased donation-A report of the transplantation society meeting in geneva. Transplantation. 2015;99(7):1403-1409.
4. Rodrigue JR, Cornell DL, Howard RJ. Pediatric organ donation: What factors most influence parents' donation decisions? Pediatr Crit Care Med. 2008;9(2):180-185.
5. Antommaria AH, Trotochaud K, Kinlaw K, Hopkins PN, Frader J. Policies on donation after cardiac death at children's hospitals: A mixed-methods analysis of variation. JAMA. 2009;301(18):1902-1908.
6. Siebelink MJ, Albers MJ, Roodbol PF, van de Wiel HB. Key factors in paediatric organ and tissue donation: An overview of literature in a chronological working model. Transpl Int. 2012;25(3):265-271.
7. Curley MA, Harrison CH, Craig N, Lillehei CW, Micheli A, Laussen PC. Pediatric staff perspectives on organ donation after cardiac death in children. Pediatr Crit Care Med. 2007;8(3):212-219.
8. Kolovos NS, Webster P, Bratton SL. Donation after cardiac death in pediatric critical care. Pediatr Crit Care Med. 2007;8(1):47-49.
9. Sarnaik AA. Neonatal and pediatric organ donation: Ethical perspectives and implications for policy. Front Pediatr. 2015;3:100.
10. Meyer K, Bjork IT, Eide H. Intensive care nurses' perceptions of their professional competence in the organ donor process: A national survey. J Adv Nurs. 2012;68(1):104-115.
11. Nakagawa TA, Shemie SD, Dryden-Palmer K, Parshuram CS, Brierley J. Organ donation following neurologic and circulatory determination of death. Pediatr Crit Care Med. 2018;19(8S Suppl 2):S26-S32.
12. Siebelink MJ, Albers MJ, Roodbol PF, Van de Wiel HB. Children as donors: A national study to assess procurement of organs and tissues in pediatric intensive care units. Transpl Int. 2012;25(12):1268-1274.
13. Vileito A, Hulzebos CV, Toet MC, Baptist DH, Verhagen EA, Siebelink MJ. Neonatal donation: Are newborns too young to be recognized? Eur J Pediatr. 2021;180(12):3491-3497.
14. Vileito A, Siebelink MJ, Vermeulen KM, Verhagen AAE. Lack of knowledge and experience highlights the need for a clear paediatric organ and tissue donation protocol in the netherlands. Acta Paediatr. 2020.
15. Eurotransplant. Statistics report library, deceased donors. https://statistics.eurotransplant.org/index.php?search_type=donors&search_organ=&search_region=by+country&search_period=2021&search_characteristic=donor+age&search_text=&search_collection=. Accessed 04/04, 2022.
16. Overheid.nl. Wet op de orgaandonatie. https://wetten.overheid.nl/BWBR0008066/2014-01-06#Hoofdstuk3. Accessed 04/04, 2022.
17. Siebelink MJ, Geerts EA, Albers MJ, Roodbol PF, van de Wiel HB. Children's opinions about organ donation: A first step to assent? The European Journal of Public Health. 2012;22(4):529-533.
18. Vileito A, Siebelink MJ, Verhagen A. Literature overview highlights lack of paediatric donation protocols but identifies common themes that could guide their development. Acta Paediatr. 2018.
19. American Academy of Pediatrics.Committee on Hospital Care, Section on Surgery, and Section on Critical Care. Policy statement--pediatric organ donation and transplantation. Pediatrics. 2010;125(4):822-828.
20. Cowl AS, Cummings BM, Yager PH, Miller B, Noviski N. Organ donation after cardiac death in children: Acceptance of a protocol by multidisciplinary staff. Am J Crit Care. 2012;21(5):322-327.
21. American Academy of Pediatrics. Pediatric organ donation and transplantation: Policy statement: Organizational principles to guide and define the child health care system and/or improve the health of all children: Committee on hospital care and section on surgery. american academy of pediatrics. Pediatrics. 2002;109(5):982-984.
22. Harrison CH, Laussen PC. Controversy and consensus on pediatric donation after cardiac death: Ethical issues and institutional process. Transplant Proc. 2008;40(4):1044-1047.
23. Darlington AS, Long-Sutehall T, Randall D, Wakefield C, Robinson V, Brierley J. Parents' experiences of requests for organ and tissue donation: The value of asking. Arch Dis Child. 2019;104(9):837-843.
24. Weiss MJ, Hornby L, Witteman W, Shemie SD. Pediatric donation after circulatory determination of death: A scoping review. Pediatr Crit Care Med. 2016;17(3):e87-e108.
25. NTS. Modelprotocol postmortale orgaan- en weefseldonatie. https://www.transplantatiestichting.nl/sites/default/files/modelprotocol_postmortale_orgaan-_en_weefseldonatie.pdf.