Abstract
Background: Organ donation after brain death in children younger than 15 years old has been accepted since the revised organ transplant law was passed on July 13th 2010 in Japan. Objective: To determine the incidence of brain death in the pediatric intensive care unit (PICU) of Nagano Children's Hospital and whether organ donation is possible in children requiring end-of-life care in the PICU. Methods: This study is a retrospective, single center study. Study period was from January 1st, 2001 to January 31th, 2011. The medical records of patients who died in the PICU were reviewed to determine if the patients had findings of brain death. Patients who met the exclusion criteria according to the revised organ transplant guideline were also assessed. Thus, the number of patients who could probably be considered organ donors was determined. Results: Of the 3,031 patients admitted during the 10 year study period, 100 died. In all, 31 patients had findings of brain death. Of these patients, 18 met the exclusion criteria. Therefore, the number of probable organ donors was 13 (13% of dead patients, 0.4% of total admissions). Annual number of probable organ donors was 1.3 patients in the PICU. The causes of death in the probable organ donors were hypoxic encephalopathy (46%), cerebral infarction (31%), and intracranial hemorrhage (23%). Conclusions: The probable organ donors in this study were 13% of dead children and 0.4% of total admissions in our PICU.
