(375) Enhancing Organ Donation Consent Rates in the Pediatric Intensive Care Unit: A Proposed Guideline

Introduction: Organ donation consent rates vary, and there are no standardized guidelines to improve the rates in pediatrics. We compared organ donation consent rates between the national average rate with the rate at our pediatric intensive care unit (PICU). We developed a guideline to follow in possible organ donor candidates to achieve higher consent rates.

Methods: In this retrospective observational study, we evaluated the impact of integrating a brain death declaration protocol in end-of-life discussions and organ donation rates in our PICU at a teaching tertiary hospital. We reviewed medical records from July 2013 to June 2021 of pediatric patients (one month to 20 years) who had death by neurological criteria (brain death). We developed guidelines for the consent process of organ donation based on our practice.

Results: We identified 41 patients with confirmed brain death (BD) diagnosis, of those, 30 met inclusion criteria. Eight patients did not meet the criteria for organ donation. A total of 22 patients were candidates for donation, and 95% accepted organ donation. PICU mortality rate during the study period was 2.3%, with a prevalence of BD of 17.8%

Conclusions: Our institution's high organ donation consent rate suggests that our protocol is effective in promoting parental acceptance of organ donation. Based on our experience, we proposed a guideline for effective engagement and application of evidence-based practices developed in the last eight years in our institution.