title: Brain death and organ donation of children.
abstract: We aimed to define the demographic characteristics, clinical features and outcome of patients with brain death, and to emphasize the importance of organ donation from children. Data for the period from September 2009 to October 2012 were collected retrospectively. Twenty children who were diagnosed as brain death were included. Data including demographics, major cause leading to brain death, duration of brain death evaluation, ancillary tests used to confirm brain death, complications and outcome, duration of hospitalization and organ donation were collected for statistical evaluation. The mean age was 6.2 years, and the male/female ratio 1.85. The major cause leading to brain death was most often traumatic brain injury, seen in 11 patients (55%). The mean duration of brain death evaluation was 6.7 and 1.7 days in Centers I and II respectively. The mean duration of hospitalization was 12.5 days. Electroencephalography (EEG) was used in 18 patients (90%). Complications included hyperglycemia in 13 cases and diabetes incipitus in 7 cases (65% and 35%, respectively). Mean duration of survival was 9.8 days. In Center I, one of the patients' parents gave consent to organ donation, while four parents in Center II agreed to organ donation. The study demonstrated that the duration of brain death evaluation was longer in Center I than in Center II (p<0.05). When both centers were compared, there was no significant difference in regard to obtaining consent for organ donation, survival after diagnosis of brain death and length of stay in the PICU (p>0.05). Early diagnosis of brain death and prompt evaluation of patients by ICU physicians once the diagnosis is taken into consideration will probably yield better organs and reduce costs. Training PICU physicians, nurses and organ donation coordinators, and increasing children's awareness of the need for organ donation via means of public communication may increase families' rate of agreement to organ donation in the future.
authors.affiliation: Pediatric Intensive Care Unit, Ankara Children's Hematology-Oncology Training and Research Hospital, Ankara, Turkey. coskungunduz@gmail.com.
authors.forename: Ramiz Coşkun
authors.initials: RC
authors.lastname: Gündüz
authors.forename: Şanlıay
authors.initials: Ş
authors.lastname: Şahin
authors.forename: Mutlu
authors.initials: M
authors.lastname: Uysal-Yazıcı
authors.forename: Ganime
authors.initials: G
authors.lastname: Ayar
authors.forename: Halil İbrahim
authors.initials: Hİ
authors.lastname: Yakut
authors.forename: Alkım Öden
authors.initials: AÖ
authors.lastname: Akman
authors.forename: İbrahim Murat
authors.initials: İM
authors.lastname: Hirfanoğlu
authors.forename: Gökhan
authors.initials: G
authors.lastname: Kalkan
mesh_terms: D001926:Brain Death / Q000175:diagnosis*; D002648:Child; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D012189:Retrospective Studies; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000458:organization & administration*