Paediatric donation after cardiac death The story of Max

Anne-Maree Holmes¹

¹Nambour Hospital- Intensive care, Nambour Hospital/ Donatlife Queensland, Nambour, Australia

Donation after cardiac death the story of  Max

Only a small percentage of the organ donor pool is from the paediatric population approximately ten percent of donors were paediatric in 2010. Still in the early stages of the introduction of the Donation after Cardiac Death (DCD) process a 3yr old boy MAX was admitted with severe hypoxia to the Paediatric Intensive care unit with a grossly abnormal MRI and a GCS of 3. Overtime his parents were given a poor prognosis and unlikely survivability. Discussions moved to focus on withdrawal of life supporting therapies.

Max’s parents introduced the idea of organ and tissue donation. A perfusion scan showed limited perfusion to the brain .Donation form cardiac death would be the pathway to facilitate max becoming an organ donor.

The decision to follow the DCD pathway was easy as Max’s parents were highly motivated they wanted Max to be able to help other children and to prevent another family having to deal with the loss of a child.  Both the State medical director and the Director of Genetics were engaged where no reason was found for donation after cardiac death not to proceed.

With supportive enthusiastic staff we were able to proceed with the donation after cardiac death. Many staff had limited or no experience and sop were wary of the process ofDCD but with small education sessions and support from the donatelife staff everyone worked well and the donation was a success.

Max was extubated at 04:19 and death was declared at 04:27. Max donated both his kidneys to recipients who now 3 years later are doing well and his heart valves that were donated have also been used.