Allow parents to donate the organs of babies who die, urge doctors

http://www.theguardian.com/society/2014/mar/17/parents-donate-babies-organs-urge-doctors

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Doctors at Great Ormond Street children's hospital are calling for the rules to be changed to allow parents to donate the organs of newborn babies who die, in the hope of saving the lives of other sick children.

Guidelines in the UK do not permit babies to be certified as brain-stem dead under the age of two months, which is not the case in most western European countries, the US and Australia.

That means, doctors say, that the organs of babies who were not born prematurely but who later die in intensive care cannot be transplanted to help other babies and small children. They would like parents to be given the choice.

The Academy of Medical Royal Colleges' guidelines, laid down in 1992, state that it is "rarely possible to confirm death using neurological criteria in infants under two months of age", even though it is done in other countries.

Donation is allowed to take place after death is confirmed using "circulatory criteria", but in that case the heart – the organ that sick babies can only obtain from another infant because size is crucial – is not generally usable.

In a paper in the journal Archives of Disease in Childhood: foetal and neonatal edition, three experts at St George's medical school and Great Ormond Street make the case for a rethink on the guidelines.

They say the situation is "bizarre". Organs donated by babies under two months old from abroad are sometimes transplanted into UK infants, but the reverse never happens.

In the six years to 2012, the experts say, just over half (54%) of the 84 infants who died in Great Ormond Street were suitable to be organ donors. Eleven could have been donors after a certification of brain-stem death, while organs from 34 others could have been used after a circulatory-death decision.

"This research provides us with a glimpse of what might be possible in the UK if our guidelines around diagnosis of death in very young babies were brought into line with other countries," said Dr Joe Brierley, intensive care specialist, organ donation expert and one of the authors of the paper.

"At Great Ormond Street, we witness firsthand the urgent need for organs for children of all ages – but small babies particularly have the odds stacked against them because they need to be matched with similarly aged children.

"Organ donation is a very emotive topic, particularly when it involves children, but I believe it is an option that should be available to a family if they decide it is the right choice for them.

"The loss of a child will always be an extremely tragic and heartbreaking experience but a lot of parents who decide to donate their child's organs later find some comfort in the knowledge that, at this most tragic time for their own family, they were able to do something extraordinarily kind."