The Giving Tree

1. The Giving Tree Working With Our Pediatric Partners to Improve Pediatric Donation

2. Watering Both Sides of the Tree Pediatric Consortium Pediatric Donation and Transplantation Conference

3. Pediatric Donation and Transplantation Conference

4. The GOAL was simple: To strengthen the bonds between the OPO, local pediatric hospitals and transplant centers by focusing on our common goal… SAVING CHILDREN’S LIVES!!

5. Pediatric Donation and Transplantation Conference • Full day event in collaboration with the Az Hospital and Healthcare Association • Multi-disciplinary Approach • CNEs and CMEs given with attendance and completed evaluations • Collaborative approach with all 3 Estates represented • Working conference- tables reported out for prizes • EVERYTHING WAS FREE 

6. TOPICS • Foundations of a Donation Program • Physician’s Panel Discussion • Care of the Pediatric Donor • Pediatric Brain Death • Medical Examiner/Child Abuse Case Study • Pediatric Liver Transplantation • Pediatric DCD – “The Tragic Trifecta” • End of Life Family Care • A Donor Father’s Story

7. Multi-disciplinary Speakers • Physician Speakers: • Dr. Marc Berg (Peds Intensivist – U of A Med Ctr) • Dr. Leslie Wallis (Maricopa Office of Medical Examiner) • Dr. MuditMathur (Peds Intensivist – Loma Linda Med Ctr) • Dr. Richard Perez (Transplant Surgeon – UC Davis Med Ctr) • Dr. Winston Hewitt (Transplant Surgeon – Phoenix Children’s Hospital/Mayo Clinic) • Child Life Specialists • Chaplain • Donor Family Advocate • Organ Recovery Coordinators • Donor Father and Pediatric Recipients

8. What was accomplished • Myths were debunked • Highlighted the donor process and why it matters • We made a connection to cause for many • New relationships were formed • Existing relationships were strengthened • Networking As an OPO it gave us a platform to publicly edify those who are doing a great job!

9. Pediatric Consortium

10. The Need: Significant variation amongst Pediatric Intensivists that included: • incomplete adherence to the published national guidelines for pediatric brain death • lack of applicable hospital policies specific to pediatric brain death in all institutions • limited adoption of standardized documentation forms for pediatric brain death.

11. The Plan: To gather OPO Leadership and Pediatric Intensivists from each PICU throughout the State of Arizona and identify stumbling points to the current process of declaring pediatric patients brain dead and promote consistency.

12. The Specifics • Each PICU in the State of Arizona had representation via: • Physical attendance • Video conferencing • Telephone conferencing • Dr. Andy Theodorou and Dr. Robyn Meyer lead the discussions • University of Arizona Medical Center graciously hosted the meetings • The Consortium Members met on two different occasions

13. …and after much discussion and debate on Ancillary tests Overdose patients “five half lives” Not needing urine tox screens Wait times between exams Neonates Pediatric patients in “adult facilities” Challenges in remote vs. urban hospitals

14. A Consensus Statement was reached! Results Physician representatives from every PICU in the state participated in each of the conferences. A consensus document summarizing the group’s recommendations was developed and distributed electronically to all participants in the conference. The pediatric intensivists from each hospital committed to promote and develop appropriate hospital policies and procedures that align with the consensus document and their institutional resources.

15. How have both events changed our DSA? • A renewed strength in our pediatric partnerships • A clarity in purpose and process regarding pediatric brain death declaration • Increased knowledge of the OPO and Intensivists “role” and expertise in the donation process • Subsequent education with our recovery coordinators with all that we learned!

16. Thank you!