Organ Donation and Transplantation in Paediatrics

Deceased donors, transplants and active transplant list in the UK

Paediatrics only (<18 yrs)

Transplant waiting lists

Paediatric patients (<18 yrs) on active transplant list at 9 July 2015

KIDNEY

Paediatric patients (<18 yrs) on active transplant list at 9 July 2015

HEART

Paediatric patients (<18 yrs) on active transplant list at 9 July 2015

LUNG

Paediatric patients (<18 yrs) on active transplant list at 9 July 2015

LIVER

Paediatric patients (<18 yrs) on active transplant list at 9 July 2015

SMALL BOWEL

Possible and actual organ donors

Deceased paediatric donors (<18 yrs), by donor type

Deceased paediatric donors (<2 yrs), by donor type

5 years: 1 April 2010 – 31 March 2015

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Number of paediatrics (<2 yrs) at each stage of DBD donation process

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5 years: 1 April 2010 – 31 March 2015

Number of paediatrics (<2 yrs) at each stage of DBD donation process, by year

Number of paediatrics (<2 yrs) at each stage of DBD donation process, by age group

5 years: 1 April 2010 – 31 March 2015

Number of paediatrics (<2 yrs) at each stage of DCD donation process

5 years: 1 April 2010 – 31 March 2015

Number of paediatrics (<2 yrs) at each stage of DCD donation process, by year

Number of paediatrics (<2 yrs) at each stage of DCD donation process, by age group

5 years: 1 April 2010 – 31 March 2015

Reasons for lack of family approach and for family refusal

Reasons for families of eligible DBD donors not being approached

   Age group  

< 2 months 2-6 months 6-12 months 12-24 months Total

Coroner/Procurator Fiscal refused permission

0 7 7 5 19

Other 0 1 1 3 5Family considered too upset to approach

0 1 0 1 2

Not identified as a potential donor / organ donation not considered

0 1 0 0 1

Other medical reason 0 0 0 1 1

Patient's general medical condition

0 0 0 1 1

Total 0 10 8 11 29

Coroner refusals due to non-accidental deaths and police investigations, and social services involvement.

Text stated under ‘other’ text for 5 cases includes information regarding police investigations and legal objections

5 years: 1 April 2010 – 31 March 2015

  Age group  

<1 month 1-2 months 2-6 months 12-24 months 6-12 months Total

Not identified as a potential donor / organ donation not considered

15 19 16 16 18 84

Patient outside age criteria 28 26 21 1 1 77Other 18 13 14 13 11 69Patient's general medical condition 11 9 11 7 4 42

Coroner/Procurator Fiscal refused permission 1 4 5 3 3 16

Other medical reason 2 3 5 2 2 14Family considered too upset to approach 1 1 1 2 1 6

Family stated that they would not consent/authorise before they were formally approached

0 0 0 3 1 4

Resource failure 0 0 1 0 0 1Total 76 75 74 47 41 313

Reasons for families of eligible DCD donors not being approached

Coroner refusals due to need to examine all organs for PM, social services/police involvement, some CODs not explained

Text stated under ‘other’ text includes information regarding donors being too young for DCD donation (local criteria quoted as 6 months up), too small, police investigations, and no suitable recipients

5 years: 1 April 2010 – 31 March 2015

  Age group  < 2 months 2-6 months 6-12 months 12-24

monthsTotal

Strong refusal - probing not appropriate 0 2 2 2 6

Family felt the body needs to be buried whole (unrelated to religious or cultural reasons)

0 1 1 3 5

Family did not want surgery to the body 0 0 2 1 3Other 0 0 2 1 3Family felt it was against their religious/cultural beliefs 0 0 2 0 2

Family wanted to stay with the patient after death 0 0 0 2 2

Family felt the length of time for donation process was too long 0 0 1 0 1

Total 0 3 10 9 22

Reasons for family consent/authorisation not given for DBD donation

Text stated under ‘other’ text for 3 cases includes no reason given by Consultant following their approach, and emotional reasons from family members

5 years: 1 April 2010 – 31 March 2015

Reasons for family consent/authorisation not given for DCD donation

Age group<1 month 1-2

months2-6

months12-24

months6-12

monthsTotal

Family felt the length of time for donation process was too long

5 1 4 2 9 21

Strong refusal - probing not appropriate 2 2 5 3 8 20Other 3 1 3 1 6 14Family did not want surgery to the body 3 1 2 0 4 10Family wanted to stay with the patient after death

1 1 1 4 3 10

Family felt the patient had suffered enough 0 1 0 1 4 6

Family felt it was against their religious/cultural beliefs

1 0 0 1 1 3

Family felt the body needs to be buried whole (unrelated to religious or cultural reasons) 0 1 1 0 1 3

Family were divided over the decision 0 1 0 0 2 3Family concerned that organs may not be transplanted

0 0 1 0 0 1

Family did not believe in donation 0 0 0 0 1 1Total 15 9 17 12 39 92

Text stated under ‘other’ text for 14 cases includes emotional reasons from family, child’s size, and contesting of medical decision RE WLST leading to a court case

5 years: 1 April 2010 – 31 March 2015