Solid organ procurement from burned children.
BACKGROUND
Burns have constituted a traditional contraindication to solid organ procurement because of concerns that such organs may be damaged by burn shock associated splanchnic ischemia and contaminated by burn wound manipulation associated bacteremia.


METHODS
Over a 5-year period, we attempted solid organ procurement from five burned children who had suffered concurrent anoxic brain injury.


RESULTS
These four boys and one girl had an average age of 8.1 years (range, 2.5-12 years) and burn size of 29% (range, 4-70%). All were injured in house fires and four of five (80%) required prehospital external cardiac compressions. Brain death was declared an average of 35 hours (range, 2.75-77 hours) after injury. Solid organs procured and successfully transplanted from this group were 4 livers, 10 kidneys, and 2 hearts. Two of the livers and one heart were placed into pediatric recipients. Procured tissues included three sets of cardiac valves, and two corneas. All solid organs transplanted were functional at 6 months, although longer follow-up is not available.


CONCLUSIONS
Early identification and diagnosis of brain death during resuscitation of burn patients with anoxic brain injury, combined with careful resuscitation and support of the brain dead potential organ donor, can result in the recovery of suitable solid organs and tissues for transplantation.
Sheridan
R L
RL
Shriners Burns Hospital, Boston, Massachusetts 02114, USA. sheridan.robert@mgh.harvard.edu
Uberti
E
E
Frank
K T
KT
DelMonico
F L
FL
D000061:Accidents, Home; D001900:Boston; D001926:Brain Death / Q000175:diagnosis; D002056:Burns / Q000150:complications* / Q000628:therapy; D002263:Carboxyhemoglobin / Q000032:analysis; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002534:Hypoxia, Brain / Q000097:blood / Q000209:etiology*; D017053:Infection Control; D008297:Male; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000379:methods / Q000706:statistics & numerical data*; D016896:Treatment Outcome
D002263:Carboxyhemoglobin