Paediatric donation after cardiac death: Another opportunity to safe lives when resuscitation is not successful

Purpose: In selected cases of out-of-hospital patients who suffer a cardiorespiratory arrest (CRA) and unsuccessful resuscitation after advanced life support (ALS), there is anotherway to heal other patients: the procedure of Donation After Cardiac Death (DCD). We analyzed the DCD activity in our service related to paediatric patients as a group with special features. Materials andmethods:Weperformed a cross-sectional analysis of CRA in children (from 24h to 18 years) assisted by SAMUR-PC from 2006 to 2013. Data were recorded according to the Utstein style. The variables were age, gender, time of cardiopulmonary resuscitation (CPR), organs obtained, relatives agreement, reasons that avoided the organ donation and graft evolution in the recipient informed by the Hospital. Statistical: quantitative measures of centre and dispersion qualitative absolute frequencies. Results: Therewere 41 cardiac arrests attended among children and 5 were activated as DCD after ALS. Cardiac arrest was due to trauma in 3 cases. The mean age was 15.8 years old (14–17). Mean ALS-time was 58min 34 s (35min to 74min 19 s). In one case it was not possible to obtain the agreement of the family for organ donation. Theorganswere transplanted toadult patients inall cases (≥18 years). Conclusions: Of 5 patients activated as pediatric DCD by SAMUR-PC, 2 became organ donor in the Hospital. In the same time frame, there are registered 9 infants DCD donors in Spain. Organ donation after cardiac death is a well-established and recognised field in the Spanish inand out-of-hospital medical community. The cost–benefit ratio must not be quantified in terms of the cost of each donation process, but as the useful years recovered and the costs saved in long-term medical treatment for chronic patients who became healthy after organ transplantation.