Pediatric staff perspectives on organ donation after cardiac death in children*

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Abstract
Objectives: The aims of this project were to describe whether pediatric clinical staff members believe that a donation after cardiac death (DCD) program could be consistent with the mission and core values of a children's hospital and to identify what staff consider essential to the acceptability of such a program. Design: Qualitative study. Setting: Children's hospital. Subjects: Pediatric clinical staff. Interventions: Data were gathered from pediatric clinical staff during eight focus groups conducted in a children's hospital in March and April 2005. Measurements and Main Results: Eighty-eight staff members participated. Six major themes emerged from qualitative analysis of the data: a) identifying children who could be candidates for DCD; b) considering the best interests of the dying child; c) approaching parents about DCD; d) preparing parents for their child's DCD; e) doing DCD well; and f) maintaining program integrity. Themes were used to construct a conceptual framework describing a model pediatric DCD program. Pediatric staff voiced numerous concerns. However, they identified “making it happen for families” who voice a desire to participate in organ donation as the primary reason for program adoption. Conclusions: This study provides a framework for understanding pediatric staff perspectives on DCD programs in children. Results suggest several possible elements that may be helpful in framing interdisciplinary dialogue and informing institutional practices in the design of a pediatric DCD program.