title: Effect of a specialized pediatric institutional setting on organ recovery from potential donors.
abstract: BACKGROUND
  The relationship between accessibility to the full range of subspecialty care available at freestanding pediatric hospitals and organ donor management and recovery rates has not been studied.
  
  
  OBJECTIVE
  To examine current rates of recovery of organs from children for transplantation at free-standing pediatric hospitals versus all other hospitals.
  
  
  METHODS
  Data from the hospitals served by Mid-America Transplant Services from January 2000 to July 2003 were reviewed. Organ recovery rates from freestanding children's hospitals were compared with the rates from other types of institutions. Patients were included if their organs were considered medically suitable at the time of referral for donation.
  
  
  RESULTS
  Overall, 66% (210/318) of the potential organs were recovered. The type of institution in which the potential donor was managed did not influence the proportion of organs recovered: 67% (96/144) at freestanding children's hospitals versus 66% (114/174) at all other hospitals. A greater proportion of livers were recovered at other donor institutions than at children's hospitals (100% vs 85%, P< or =.01).
  
  
  CONCLUSIONS
  The organ recovery rate from potential pediatric donors is low. In general, this rate does not appear to be affected by the type of managing pediatric institution except for liver recovery, which favors institutions that are not freestanding children's hospitals. The low rate of recovery suggests that although suitable donors are identified, appropriate referrals are made, and families provide consent for donation, major obstacles remain to the successful recovery of organs.
authors.affiliation: The Division of Critical Care Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO 63110, USA. mld6826@bjc.org
authors.forename: Marcella
authors.initials: M
authors.lastname: Donkin
authors.forename: Nikoleta
authors.initials: N
authors.lastname: Kolovos
authors.forename: Paul A
authors.initials: PA
authors.lastname: Checchia
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000458:organization & administration* / Q000706:statistics & numerical data; D014481:United States