Postmortal Organ Donation in pediatric Patients – general Aspects and Single Center Experience

Sivatharsiny Thavarajah¹, Nagoud Schukfeh¹, Thomas Breidenbach², Jutta Weiss², Martin Metzelder¹, Carmen Kirchner¹, Andreas Paul¹, Gernot Kaiser¹

¹General-, Visceral- and Transplantsurgery, University Hospital Essen, Essen, Germany, ²Deutsche Stiftung Organspende, Frankfurt, Germany

Background: In times of urgent need for pediatric transplantations the shortage of adequate organs is still challenging. In comparison to adult transplantations the problem of proper size of the organ is a major limiting factor in pediatric transplantation. At all there is no age-restriction for organ donation in Germany.

Methods: The organ donors after brain death in Germany up to the age of 15 between 2007 and 2012 were analyzed. 2012 there was a further division into three age groups (< 2 years, 2 – 5 years, 6 – 15 years) with evaluation of the number of realized organ donations out of the potential organ donors and the results of the discussions with the relatives/parents. Additionally we analyzed the pediatric livers transplanted at our center between 2007 and 2012 independently to the age of the recipient.

Results: The overall percentage of pediatric organ donation was 3,2% (2007 – 2012) in Germany. 2012 only 55% of potential pediatric organ donors became realized as donors, which is significantly lower comparison to adults (donors > 15 years: 66,4%). The discussions with the relatives of the potential organ donors lead to a clearly higher rate of refusal for pediatric organ donors (42%) than adult donors (28%). At our center we received 42 livers from pediatric donors (2007 – 2012) with a median age of 5 (range 0 – 15) resulting in promising long-term results.

Conclusion: Although children only are a small percentage among the potential organ donors, there is a special need for pediatric recipients. To increase the comparatively low rate of consent in the age group under 16 years, a better education of the relatives as well as the medical staff seems to be necessary.