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. 2021 Jun;147(6):e2020009506.
doi: 10.1542/peds.2020-009506. Epub 2021 May 7.

Predictors of Deceased Organ Donation in the Pediatric Population

Justin Godown  1 , Alison Butler  2 , Daniel J Lebovitz  3   4 , Gretchen Chapman  2
Affiliations

Predictors of Deceased Organ Donation in the Pediatric Population

Justin Godown et al. Pediatrics. 2021 Jun.

Abstract

Background: A shortage of donor organs represents the major barrier to the success of solid organ transplantation. This is especially true in the pediatric population for which the number of organ donors has decreased over time. With this study, we aimed to assess the factors associated with deceased organ donor consent in the pediatric population and determine the variability in consent rates across organ procurement organizations (OPOs).

Methods: All eligible pediatric deaths were identified from the Scientific Registry of Transplant Recipients (2008-2019). The rate of organ donor consent was determined, and multivariable logistic regression was used to assess the factors independently associated with successful donor recruitment. The probability of donor consent was determined for each OPO after adjusting for patient demographics.

Results: A total of 11 829 eligible pediatric deaths were approached to request consent for organ donation. Consent was successful in 8816 (74.5%) subjects. Consent rates are lower in the pediatric population compared with young adults and are directly related to patient age such that eligible infant deaths have the lowest rate of successful donor consent. There is significant variability in donor consent rates across OPOs, independent of population demographic differences.

Conclusions: OPO is predictive of pediatric deceased organ donor consent independent of demographic differences, with some regions having consistently higher consent rates than others. Sharing best practices for pediatric deceased donor recruitment may be a strategy to increase organ availability in the pediatric population.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Flowsheet of pediatric eligible deaths.
FIGURE 2
FIGURE 2
Pediatric deceased donor consent rate over time (N = 11 829 eligible deaths approached to request consent).
FIGURE 3
FIGURE 3
Regional variation in pediatric consent rates by subject age group.
FIGURE 4
FIGURE 4
Probability of organ donation consent by OPO after adjusting for year, age, median household income, race, ethnicity, circumstances of death, sex, and timely referral. Bars represent the 95% confidence interval. The reference line represents the median probability of donation across all OPOs. Red, yellow, and green markers indicate the first, second, and third tertiles, respectively.
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References

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