Children and organ donation in the United kingdom: A literature review
Summary The Hoffenberg Report (1988) points to the technical difficulties of attempting to transplant small livers or kidneys into larger, older recipients and the inappropriateness of transplantation for neonatal renal or hepatic failure. This is in contrast to findings from other regions that are achieving success in transplantation in the neonate. Chronic rejection of any organ means that the younger the recipient, the greater is the likelihood that he or she will eventually be in need of a second, third, or fourth organ replacement, leading to increased future demand on organ resources. This article has shown the evolution of transplantation in childhood organ failure. Using available data from the United States and Europe, it has illustrated the ever-expanding variety of conditions that are rapidly increasing the demand for organs in this section of the population. The elimination of other methods of obtaining organs for infants and the older child has been examined in the context of the difficulties inherent in matching principles of justice and beneficence. The complexities of addressing BSD, particularly in its application to children, highlights the problems that emerge in trying to find new sources to address an escalating need. It also points toward some of the deficiencies in devising a coherent policy and the measures sometimes taken to circumvent conventional practice (Zaner, 1989) to facilitate organ retrieval. Freeman and Ferry (1988) advise against too heavy a reliance on invalidated “guidelines” that may become the accepted dogma (e.g., the Task Force on Brain Death in Children, 1987) and gain eventual acceptance as the “gold standard” for many lay and professional individuals and groups.
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