P0453 / #1084: DO DISCUSSIONS REGARDING ORGAN DONATION OCCUR IN PAEDIATRIC AND NEONATAL TRANSPORT WHEN WITHDRAWAL OF CARE IS ADVISED IN DISTRICT GENERAL HOSPITALS?

Abstract

Aims & Objectives:According to NHS Blood and Transplant (NHSBT) in September 2019, 192 children were awaiting an organ across the UK1. Children pending transplant wait longer than adults1. Discussing organ donation in a child is seen as a difficult conversation2due to high emotional stakes; consequently staff fear upsetting parents2. The audit aims to identify patients referred from district general hospitals to Embrace, Yorkshire and Humber Infant and Children’s Transport Service, a specialised critical care transport team in the UK, who were too unstable or had severe brain injury and were unlikely to survive and reorientation of care was advocated and analyse whether organ donation was discussed. Methods:Retrospective analysis of Embrace transport records from December 2009-July 2019, where care was reoriented and no transfer happened. These notes were reviewed to see whether organ donation discussions occurred. Results: 1347 cases of uplift in care where no transport occurred were identified. 267 cases met inclusion criteria. Only 10 had clear documentation that organ donation was mentioned/discussed. One child became a donor. Conclusions: This audit suggests that few organ donation conversations occur. Given the need for paediatric organ donors, this needs further exploration. Interventions to increase awareness, education and acceptability of paediatric organ donation amongst healthcare professions and the wider public may enable the embedding of organ donation into paediatric end of life care, as recommended by NHSBT1.