Organ Donation in Pediatric Patients with Severe Anoxic Brain Injury

Anoxic brain injury in children is a rare and devastating occurrence. Families are shocked by the unexpected nature of their child's neurologic injury, which may be the result of a sudden and prolonged cardiac arrest. Organ donation in these children is subject to much discussion and controversy. Recently, we encountered three pediatric patients with anoxic brain damage who progressed to brain death within a few days of admission. Pediatric palliative care was involved from the time of arrival to the hospital in all the patients. The team served as a critical conduit to support families and helped in managing end-of-life decisions including organ donation. All three families consented to organ donation. We discuss here the patients, the palliative care involvement, and the factors responsible for successful donation.