The Turkish Journal of Pediatrics
2014 , Vol 56 , Num 6
Brain Death and Organ Donation of Children
1Pediatric Intensive Care Unit, Ankara Children’s Hematology-Oncology Training and Research Hospital, 2 Department
of Pediatric Intensive Care, Hacettepe University İhsan Doğramacı Children’s Hospital, 3Department of Neonatology and
4Pediatric Intensive Care Unit, Gazi University Faculty of Medicine, Ankara, Turkey. E-mail: coskungunduz@gmail.com
We aimed to define the demographic characteristics, clinical features and
outcome of patients with brain death, and to emphasize the importance of
organ donation from children. Data for the period from September 2009
to October 2012 were collected retrospectively. Twenty children who were
diagnosed as brain death were included. Data including demographics, major
cause leading to brain death, duration of brain death evaluation, ancillary
tests used to confirm brain death, complications and outcome, duration of
hospitalization and organ donation were collected for statistical evaluation.
The mean age was 6.2 years, and the male/female ratio 1.85. The major
cause leading to brain death was most often traumatic brain injury, seen
in 11 patients (55%). The mean duration of brain death evaluation was
6.7 and 1.7 days in Centers I and II respectively. The mean duration of
hospitalization was 12.5 days. Electroencephalography (EEG) was used in
18 patients (90%). Complications included hyperglycemia in 13 cases and
diabetes incipitus in 7 cases (65% and 35%, respectively). Mean duration of
survival was 9.8 days. In Center I, one of the patients’ parents gave consent
to organ donation, while four parents in Center II agreed to organ donation.
The study demonstrated that the duration of brain death evaluation was longer
in Center I than in Center II (p<0.05). When both centers were compared,
there was no significant difference in regard to obtaining consent for organ
donation, survival after diagnosis of brain death and length of stay in the PICU
(p>0.05). Early diagnosis of brain death and prompt evaluation of patients by
ICU physicians once the diagnosis is taken into consideration will probably
yield better organs and reduce costs. Training PICU physicians, nurses and
organ donation coordinators, and increasing children’s awareness of the need
for organ donation via means of public communication may increase families’
rate of agreement to organ donation in the future.
Keywords :
brain death, children, organ donation, pediatric intensive care unit.