Transcript Document
Anencephalic Donation Possibilities Breakout Session B Presenters: Leandra McHargue, RN, BSN, Loma Linda University Medical Center Becky Hill, CPTC, OneLegacy Sarah Grays, RNC-NIC, CPTC, OneLegacy Moderator: Lynn Willis, MHA, UC Irvine Health Objectives: • Understand the possible donation opportunities for anencephalic babies • Learn the practical steps that can be taken to help families of neonatal/anencephalic infants Questions to Run On: What can I do at my hospital to begin helping parents of anencephalic infants incorporate donation into end of life care? Turning a “No” Into a “Maybe” Anencephalic & Neonatal Donation Possibilities Leandra McHargue, RN, BSN Becky Hill, CPTC Sarah Grays, RNC-NIC, CPTC Agenda • The past: brief donation history • The present Why re-examine now? Colin’s Story What we learned Arriana’s Story • Looking to the future Past: Brief History • 1980s: LLUMC formed an aggressive anencephalic donation program Baby Gabriel Focus was thoracic organs • Debates on consciousness and brain death • 1994: AMA recommended use of anencephalic infants as donors pre-death • 1995: AMA suspended that policy Present: Why Re-Examine Now? • Current possibilities and basic criteria Liver for hepatocyte cell infusion: Cytonet • Birth weight greater than 2kg • Recovery within three hours of cardiac standstill En-bloc kidneys: UC Davis • Birth weight approximately 2kg • Intubated at birth, done as DCD recovery Heart Valves: tissue transplantation • Weight greater than 3.6kg Present: Why Re-Examine Now? Crossroads of medicine and the desire of these families to donate. Colin’s Story Leandra McHargue, RN BSN NICU Bereavement Coordinator Loma Linda University Medical Center The Perry Family Colin’s Story Colin’s Story Colin’s Story What We Learned • Education & collaboration Hospital staff, L&D, NICU, OR Surgeons and recovering team • Challenges of assessing a donor that has not yet been born • Preparation for possible intubation/kidney recovery scenario Cytonet Liver Perfusion Criteria O2 Sat 3 consecutive hours < 80% of O2 Sats < 80% Cardiac Standstill Opportunities for liver donation Occurs within 3 hours Does not occur within 3 hours of last O2 Sat < 80% of last O2 Sat < 80% Liver must be flushed (in OR) within 3 hours of last O2 Sat < 80% Liver is a medical rule-out due to poor perfusion Arriana’s Story Sarah Grays, OneLegacy Megan Aberl, Arriana’s Mom Megan’s Family Arriana’s Story Arriana’s Story Arriana was born on December 11 at 2252 to proud parents Megan & Ignacio Arriana’s Story Arriana’s Gift Arriana became the 20th anencephalic infant to donate in the US in 2012 Looking to the Future • Families have the desire to donate • Five potential donors in one year Each baby and hospital team inspired & educated • Future potential: Pediatric DCD heart: Loma Linda University Medical Center Organs for research: International Institute of Medicine Thank You Loma Linda University Medical Center Providence Saint Joseph Medical Center Riverside County Regional Medical Center Kaiser Permanente Riverside Medical Center Riverside Community Hospital Questions to Run On: What can I do at my hospital to begin helping parents of anencephalic infants incorporate donation into end of life care?