‘A donation involving a child is always extra emotional’

If a patient in the intensive care unit passes away suddenly, the doctor consults with an ODC to see if they might be a potential organ donor. Very occasionally, this involves a child. Marjan Bijmolen (ODC) shares her experiences with this.

Nice to be able to quickly read through the protocol

‘First of all, it is nice that the procedure for a child is described separately in the 'Child as donor' protocol. This provides guidance. I have had to deal with it twice now. You are always under time pressure at such a moment. In such an acute situation, it is nice to be able to quickly read up on how things work. For children aged 12 and older, for example, you must always consult the Donor Register, because a child of that age can already be listed in it.'

'Regarding brain death, there are also matters you must pay close attention to with very young children. For instance, with children in their first week of life, you must wait 48 hours after brain death has been established. For children up to two months, that is 24 hours, and for children up to 12 months, 12 hours. All of that is neatly written out in the protocol.'

Less uncertainty among doctors

'When the NTS calls because a doctor wants to consult about a child donor, I read through the protocol. That way, I am quickly up to date again. Organ donation in children does not happen often. This sometimes causes uncertainty for a pediatric ICU doctor. Organ donation coordinators are there to take away that uncertainty and answer questions.'

Clear explanation to parents

'Organ donation after brain death is always preferred, but sometimes parents really want to be present when their child's heart stops. That is possible. In that case, we choose a DCD procedure (Donation after Circulatory Death).'

'The parents are given a clear explanation that after the heart stops, they have 5 minutes to say goodbye, after which we must quickly head to the operating room to preserve the quality of the organs as much as possible. This is also described in the protocol.'

Keeping your own emotions in check

‘Donation procedures are always emotional. But when it involves a child, the burden is even greater. You do prepare yourself for that when you go there. You often feel a lump in your throat or your eyes get wet, but you obviously cannot start crying along with them.'

'You really have to be able to flip a switch and keep your own emotions under control. That takes a lot of energy. But a well-completed procedure with, given the circumstances, satisfied parents, also gives you energy in return.’