Featured Research

from universities, journals, and other organizations

Policies On Organ Donation After Cardiac Death Vary Considerably Among Children's Hospitals

Date:
May 12, 2009
Source:
JAMA and Archives Journals
Summary:
Although a large number of children's hospitals have developed or are developing policies regarding organ donation after cardiac death, there is considerable variation among policies, including the criteria for declaring death.

Although a large number of children's hospitals have developed or are developing policies regarding organ donation after cardiac death, there is considerable variation among policies, including the criteria for declaring death, according to a new study.

Related Articles


Donation after cardiac death (DCD) potentially permits patients who do not meet the neurological criteria for death to donate solid organs. "Controlled DCD occurs following planned withdrawal of life-sustaining treatment, and uncontrolled DCD occurs after unanticipated cardiac arrest. Potential controlled DCD donors include patients with irreversible catastrophic brain injury or end-stage neuromuscular diseases," the authors write. Although the Joint Commission requires all hospitals to address DCD, little is known about actual hospital policies.

Armand H. Matheny Antommaria, M.D., Ph.D., of the University of Utah School of Medicine, Salt Lake City, and colleagues conducted a study to evaluate the development and content of DCD policies at children's hospitals and evaluate variation among policies, which were collected between November 2007 and January 2008 from hospitals in the United States, Puerto Rico, and Canada. Of inquiries to 124 children's hospitals, a response was received from 105 (85 percent). Of these respondents, 72 percent had DCD policies, 19 percent were developing policies, and 7 percent neither had nor were developing policies.

The researchers received and analyzed 73 approved policies. Sixty-one (84 percent) specify criteria or tests for declaring death, including electrocardiogram (ECG) findings, pulselessness, apnea, and unresponsiveness. Four policies require total waiting periods prior to organ recovery at variance with professional guidelines: 1 less than 2 minutes and 3 longer than 5 minutes. Sixty-four policies (88 percent) preclude transplant personnel from declaring death and 51 percent prohibit them from involvement in premortem (taking place immediately before death) management.

While 65 policies (89 percent) indicate the importance of palliative care, only 7 percent recommend or require palliative care consultation. Thirty-two policies (44 percent) preclude the use of medications with the intention to hasten death.

Policies differ in the location of withdrawal of life-sustaining treatment. Sixty-eight policies (93 percent) specify the location, with the majority (54 percent) requiring withdrawal of treatment to occur in the operating room. Other potential locations include areas adjacent to the operating room (19 percent), the emergency department (4 percent), or the intensive care unit (4 percent).

"This study demonstrates that, consistent with a national emphasis on increasing the supply of transplantable organs, a large number of children's hospitals have developed or are developing DCD policies," the authors write.

"The policies exhibit notable variation both within those we studied and compared with authoritative reports and statements. Further research will be required to determine the importance of variation in the tests for declaring death or the processes for withdrawing life-sustaining treatment. In the long run, public policy may need to address strategies to promote adherence to recommendations for DCD processes based on sufficient clinical evidence and/or ethical justification."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Antommaria et al. Policies on Donation After Cardiac Death at Children's Hospitals: A Mixed-Methods Analysis of Variation. JAMA The Journal of the American Medical Association, 2009; 301 (18): 1902 DOI: 10.1001/jama.2009.637

Cite This Page:

JAMA and Archives Journals. "Policies On Organ Donation After Cardiac Death Vary Considerably Among Children's Hospitals." ScienceDaily. ScienceDaily, 12 May 2009. <www.sciencedaily.com/releases/2009/05/090512192920.htm>.
JAMA and Archives Journals. (2009, May 12). Policies On Organ Donation After Cardiac Death Vary Considerably Among Children's Hospitals. ScienceDaily. Retrieved November 20, 2014 from www.sciencedaily.com/releases/2009/05/090512192920.htm
JAMA and Archives Journals. "Policies On Organ Donation After Cardiac Death Vary Considerably Among Children's Hospitals." ScienceDaily. www.sciencedaily.com/releases/2009/05/090512192920.htm (accessed November 20, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, November 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

UN Says It Will Scale Up Its Ebola Response

UN Says It Will Scale Up Its Ebola Response

AFP (Nov. 20, 2014) UN Resident Coordinator David McLachlan-Karr and WHO representative in the country Daniel Kertesz updated the media on the UN Ebola response on Wednesday. Duration: 00:51 Video provided by AFP
Powered by NewsLook.com
Takata Offers "sincerest Condolences" To Victims of Malfunctioning Airbag

Takata Offers "sincerest Condolences" To Victims of Malfunctioning Airbag

Reuters - US Online Video (Nov. 20, 2014) U.S. Congress hears from a victim and company officials as it holds a hearing on the safety of Takata airbags after reports of injuries. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com
Obesity Costs Almost As Much As War And Terrorism

Obesity Costs Almost As Much As War And Terrorism

Newsy (Nov. 20, 2014) The newest estimate of the cost of obesity is pretty jarring — $2 trillion. But how did researchers get to that number? Video provided by Newsy
Powered by NewsLook.com
Calling All Men: Here's Your Chance to Experience Labor Pains

Calling All Men: Here's Your Chance to Experience Labor Pains

Reuters - Light News Video Online (Nov. 20, 2014) Chinese hospital offers men a chance to experience the pain of child birth via electric shocks. Sharon Reich reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins