[Transplantation in children: selection of donors and organization of organ procurement]

Abstract

The rise of organ transplantation in children has resulted in an acute donor shortage. In 1987, a study was undertaken by the French-speaking Group of Paediatric Intensive Care with a triple goal: to evaluate the number of potential organ donors, to list and count the organs that have effectively been removed and to sensitize the teams of intensive care units (ICU) to the transplantation problem. This study showed that brain death occurs in one-third of the infants and children who die (i.e. about 200 each year). As a result of this study, over a two-years period the number of children whose organs had been removed (42 in 1988) as well as the number of organ procurement centres and multiple organ procurements have increased. One-half of the non-procurements are due to the parents' refusal, so that further advances are possible by sensitizing not only ICU teams but also the general public. It seems that the best solution would be to set up local organizations that would enable procurements to be performed within Paediatric ICU's. France-Transplant is of invaluable help to identify organ receivers and co-ordinate the activities of procurement teams.