Care of the pediatric organ donor

L. W. Brink and A. Ballew
Department of Pediatrics, University of Texas Southwestern Medical School, Children's Medical Center of Dallas.

Solid organ transplantation has become an accepted therapeutic option in pediatrics. Many previously fatal diseases have become current indications for organ transplantation. A major limitation to the growth of this therapeutic option is the availability of suitable organs. With organ supply falling far short of demand, recruitment of donors has been stressed. In addition to recruiting donors, physicians are responsible for maintaining optimal organ function in a beating heart organ donor to ensure that all organs that could potentially be harvested are in a condition suitable for transplant. Current information demonstrates numerous physiologic changes resulting from cerebral death. Therapeutic interventions must focus on maintenance of function in all potentially transplantable organs, including kidneys, heart, lungs, liver, and pancreas. Physicians should recognize the interventions that might compromise the use of an organ in transplant. Criteria for organ use are constantly changing, and the implications of different therapeutic interventions must still be evaluated.