Patterns of organ donation in children in Australia and New Zealand.

OBJECTIVES Paediatric organ donation (OD) represents a small proportion of total OD in Australia and New Zealand. Our aim was to describe the patterns of paediatric OD, specifically, the demographic characteristics and donation outcomes over two time periods. DESIGN We performed a retrospective study using national OD and intensive care registry data from intensive care units in Australia and New Zealand from 1 January 2000 to 31 December 2015. Data were analysed between two time periods. Paediatric data were compared with adult data. PARTICIPANTS Organ donors aged under 16 years in paediatric and mixed adult and paediatric ICUs. RESULTS There were 267 paediatric organ donors, representing 5.4% of all donors. The rate of OD as a percentage of ICU deaths was comparable to adults (6.0% v 4.6%; P < 0.001). Over the entire period, donations after brain death totalled 244 (91.4%), and donations after circulatory death (DCDs) totalled 23 (8.6%). DCDs increased from 0.7% to 17% between the time periods (P < 0.001). Children aged under 2 years had a lower rate of donation than the general paediatric cohort (1.2% v 6.0%; P < 0.001). CONCLUSIONS Paediatric OD rates have not changed over time but are comparable to adults when expressed as a percentage of ICU deaths. Paediatric DCD has increased significantly over time.