The Alliance

Spotlight Series

The Alliance Spotlight Series is a recurring one-page publication for front-line healthcare professionals, offering quick-takes on critical topics affecting the field of organ donation and transplantation. We encourage you to download these issues and share them with your front-line colleagues and partners.

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Pediatric Organ Donation Fb
Successful pediatric donation results from blending the PICU care team's expertise with the Organ Procurement Organization's (OPO) expertise.

Optimizing Pediatric Neurologically Deceased Donor Care

The Situation




Opportunities for a Joint Approach in Pediatric Donor Care:

  1. Authorization Process:  Prior to engaging the family in a donation conversation, it is crucial that the OPO and the patient’s physician / hospital care team meet to discuss the plan for introducing the opportunity for organ donation to the family. It is important to recognize that presenting the donation opportunity to the family is not “doing something to the family”, rather, it is “offering something to the family” that can bring healing through providing a sense of purpose in their loss and a legacy of their loved one.
  2. Clinical / Donor Management:  The clinical management is about identifying strategies to maintain and optimize organ function despite the damage from the underlying disease, illness or injury and the negative physiologic sequelae of brain death. Reversible organ dysfunction may improve when addressed with aggressive resuscitation and frequent re-evaluation. Maintaining appropriate organ perfusion is vital to allow for maximum recovery of organs and therefore stewardship of the gift. (Find specific donor management resources and parameters for each organ system here.) The physiologic end points are:Parameters
  3. Post Donation:  A joint after action review (AAR) between the OPO and hospital care team to discuss effective processes and lessons learned, as well as to identify opportunities for improvement for future cases, will help with process improvement and helps to keep the lines of communication open. The goal of the AAR should be to continuously evaluate how to ensure the process is as smooth as possible, first and foremost for the family, and secondly for both the hospital care team/physician and OPO team. Also, the OPO will continue to remain in contact with the family and will engage the family in memory-making activities, as well as events to honor the memory of their child long after the gift of donation occurs. The OPO will continue to check in with the family periodically and support the questions the family may have, including the potential for communication with the recipients of their loved one’s gifts.

Blending Our Expertise

Throughout the entire process the OPO should be asking themselves how well they are keeping the hospital team and physicians involved, and the hospital team should be asking themselves how well they are interacting with the OPO team. A continuum of care must be maintained to ensure the best stewardship of the precious gift the family is making. Collectively, as a medical community, we have a responsibility to perform pediatric donation well and ultimately:


Helpful Resources

Questions & Comments

Please send all questions and/or feedback to [email protected].

A special thanks to Dr. Dan Lebovitz (Pediatric Intensivist, Associate Medical Director for OurLegacy) for his contribution to this Spotlight.

This Spotlight is based on a presentation titled “We Have Authorization…Now What?”, given by Dr. Lebovitz and Lori Markham (Vice President & Chief Clinical Officer, Midwest Transplant Network) delivered at the 2023 National Pediatric Donation & Transplantation Summit.

Access the presentation through The Alliance at: 2023 Pediatric National Organ Donation  & Transplantation Summit Learning Pathway.

Worth Sharing
Volume IX, Issue 6

A Special Thanks to This Series’ Contributors

Hedi Aguiar
Hedi Aguiar
Program Consultant
Organ Donation and Transplantation Alliance
Deanna Fenton
About the Editor |
Deanna Fenton

Deanna is a knowledgeable and versatile professional with diverse experiences in healthcare, client relations, marketing, project management and demonstrated skills in leadership and advocacy. Prior to joining The Alliance, she worked in Hospital Development at her local OPO in the state of New Jersey where she served as the clinical liaison to a number of Level 1 Trauma & Neuroscience centers as well as community hospitals. Her personal connection as a donor family and friend fuels her passion to support her colleagues across the donation-transplantation continuum through the development of valuable educational resources that ultimately boost performance and improve outcome measures. Deanna holds a Bachelor of Arts in Psychology and a minor degree in Public Health from Montclair State University. In her spare time, Deanna enjoys visiting vineyards, spending time with her family, and traveling in hopes of visiting all seven wonders of the world.

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