Observed vs. Expected organs transplanted in pediatric donors at Saint Francis hospital

• Effective communication between hospital staff and organ procurement organizations can significantly impact the number of organs successfully transplanted. • If stabilized, trauma patients with extensive injuries may be able to save multiple lives through organ donation. • The findings show that it is possible to achieve an observed-to-expected ratio greater than 1, indicating the potential to increase the number of transplantable organs. This retrospective case study aims to clarify the roles played by various factors in determining the actual versus expected number of organs procured from pediatric trauma patients. Trauma patients often have injuries so extensive that there is no hope of recovery. However, if they are stabilized, they may be able to save lives through organ donation. The more organs are procured, the more lives may be saved. In this retrospective study, we reviewed the records of pediatric organ donors from Saint Francis Children's Hospital from 2018 to 2022 and identified seven interesting cases involving children younger than 15 years old that showed the actual and expected numbers of organs transplanted. We examined the number of organs that we expected to transplant compared with how many organs were actually transplanted and which clinical data may have affected the ability to transplant. The data analysis included but was not limited to the observed-to-expected ratio, donor management goals, hospital lab and biometric values before the time of referral, cause of death, age, sex, race, body mass index, blood type, kidney donor profile index, referral timeliness, donation conversations, donation conversation outcomes, hospital attending, pre-mentions of donation to potential families, referral and donation milestone date-time stamps, donor outcomes, organs recovered, organs transplanted, organs discarded, organs submitted to research, and survey responses. Based on the seven identified cases, this study shows that an observed-to-expected ratio greater than 1 is achievable. Identifying factors that affect increased observed organ procurement will increase the potential of transplantable organs, thus leading to a higher number of lives saved.