title: Maternal organ donation and acute injuries in surviving children.
abstract: OBJECTIVE
  The purpose of this study is to test whether maternal deceased organ donation is associated with rates of subsequent acute injuries among surviving children after their mother's death.
  
  
  METHODS
  This is a longitudinal cohort analysis of children linked to mothers who died of a catastrophic brain event in Ontario, Canada, between April 1988 and March 2012. Surviving children were distinguished by whether their mother was an organ donor after death. The primary outcome was an acute injury event in surviving children during the year after their mother's death.
  
  
  RESULTS
  Surviving children (n=454) had a total of 293 injury events during the year after their mother's death, equivalent to an average of 65 events per 100 children per year and a significant difference comparing children of mothers who were organ donors to children of mothers who were not organ donors (21 vs 82, P<.001). This difference in subsequent injury rates between groups was equal to a 76% relative reduction in risk (95% confidence interval, 62%-85%).
  
  
  CONCLUSIONS
  Deceased organ donation was associated with a reduction in excess acute injuries among surviving children after their mother's death. An awareness of this positive association provides some reassurance about deceased organ donation programs.
authors.affiliation: Department of Medicine, University of Toronto, Ontario, Canada; Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Ontario, Canada; Institute for Clinical Evaluative Sciences in Ontario, Ontario, Canada; Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Center for Leading Injury Prevention Practice Education & Research, Ontario, Canada. Electronic address: dar@ices.on.ca.
authors.forename: Donald A
authors.initials: DA
authors.lastname: Redelmeier
authors.affiliation: Department of Medicine, University of Toronto, Ontario, Canada; Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Ontario, Canada; Institute for Clinical Evaluative Sciences in Ontario, Ontario, Canada. Electronic address: jason.woodfine@mail.utoronto.ca.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Woodfine
authors.affiliation: Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Ontario, Canada; Institute for Clinical Evaluative Sciences in Ontario, Ontario, Canada. Electronic address: deva.thiruchelvam@ices.on.ca.
authors.forename: Deva
authors.initials: D
authors.lastname: Thiruchelvam
authors.affiliation: Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Interdepartmental Division of Critical Care, University of Toronto, Ontario, Canada. Electronic address: damon.scales@sunnybrook.ca.
authors.forename: Damon C
authors.initials: DC
authors.lastname: Scales
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001930:Brain Injuries / Q000401:mortality; D002423:Cause of Death; D002543:Cerebral Hemorrhage / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D063130:Maternal Death / Q000523:psychology*; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D012959:Socioeconomic Factors; D013345:Subarachnoid Hemorrhage / Q000401:mortality; D017741:Survivors / Q000706:statistics & numerical data*; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology*
keywords: Bereavement; Brain death; Child welfare; Organ transplantation; Tissue and organ procurement; Wounds and injuries