Paediatric Organ and Tissue Donation: Developing a Comprehensive Protocol for Effective Donation Procedures in the Netherlands

Abstract

The waiting list for children needing organ and tissue transplantation increases yearly; some die while waiting for a suitable transplant. Most of them need small organs or tissues from paediatric donors. Paediatric donation is a unique and extremely sensitive process that requires specific knowledge and competencies. Because paediatric donation is relatively rare and complex, gaining knowledge and experience in this field is difficult. This article describes essential facts about donation and transplantation concerning children in the Netherlands and summarises studies reporting on the various factors influencing paediatric donation. The methodology used combines various research methods, including literature review, online survey, face-to-face interviews, and retrospective study, to evaluate the organ and tissue donation protocols for the paediatric population in Dutch Paediatric Intensive Care Units and Neonatal Intensive Care Units. The studies provide insights into the current process and limitations of paediatric donation and offer recommendations for the development of a paediatric donation protocol. Recurrent themes that emphasise the importance of a robust paediatric donation process were identified and later used to form the groundwork for a paediatric donation protocol. Healthcare professionals lack knowledge and experience with donation procedures. Work experience at the Paediatric Intensive Care Unit or Neonatal Intensive Care Unit is not related to the gained experience in the organ or tissue donation procedure. Paediatric Intensive Care nurses had significantly less experience than Paediatric Intensivists. The survey respondents confirmed needing more guidance on the paediatric donation process. They further agreed there was a need for an easily accessible and clear guidelines document for paediatrics known as “the children's protocol” to cover all types of paediatric donation procedures (Donation after Brain Death, Donation after Circulatory Death and tissue donation). Neonatal Intensive Care Unit donation potential is limited. A new donation protocol for paediatrics was designed using the results of all the above studies. The comprehensive protocol for paediatric organ donation in the Netherlands aims to assist healthcare professionals in identifying potential donors and referring them to an Organ Procurement Organization in a timely manner. Additionally, the protocol will support healthcare professionals in conducting sensitive yet necessary discussions with the family regarding the possibility of organ and tissue donation. Finally, while using the protocol, healthcare professionals provide the appropriate state-of-the-art support to the parents during a challenging and emotional time.