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Anencephalic Donation PossibilitiesBreakout Session B
Presenters:Leandra McHargue, RN, BSN, Loma Linda University Medical Center
Becky Hill, CPTC, OneLegacySarah Grays, RNC-NIC, CPTC, OneLegacy
Moderator:Lynn Willis, MHA, UC Irvine Health
• Understand the possible donation opportunities for anencephalic babies• Learn the practical steps that can be taken to
help families of neonatal/anencephalic infants
Objectives:
What can I do at my hospital to begin helping parents of
anencephalic infants incorporate donation into end of life care?
Questions to Run On:
Turning a “No” Into a “Maybe”Anencephalic & Neonatal Donation Possibilities
Leandra McHargue, RN, BSNBecky Hill, CPTC
Sarah Grays, RNC-NIC, CPTC
• The past: brief donation history• The present
Why re-examine now? Colin’s Story What we learned Arriana’s Story
• Looking to the future
Agenda
• 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
Past: Brief History
• 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 andthe desire of these families to donate.
Present: Why Re-Examine Now?
Leandra McHargue, RN BSNNICU Bereavement Coordinator
Loma Linda University Medical Center
Colin’s Story
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
Opportunities for liver
donation
Cardiac Standstill
O2 Sat < 80%
3 consecutive hours of O2 Sats < 80%
Occurs within 3 hours
of last O2 Sat < 80%
Liver must be flushed (in OR)
within 3 hours of last O2 Sat < 80%
Does not occur within 3 hours
of last O2 Sat < 80%
Liver is a medical rule-out due to poor perfusion
Cytonet Liver Perfusion Criteria
Sarah Grays, OneLegacyMegan Aberl, Arriana’s Mom
Arriana’s Story
Megan’s Family
Arriana’s Story
Arriana was born on December 11 at 2252
to proud parents Megan & Ignacio
Arriana’s Story
Arriana’s Story
Arriana’s Gift
Arriana became the 20th anencephalic infant to
donate in the US in 2012
• 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
Looking to the Future
Thank You
Loma Linda University
Medical Center
Kaiser Permanente Riverside Medical
Center
Riverside County Regional Medical
Center
Providence Saint Joseph Medical
Center
Riverside Community
Hospital
What can I do at my hospital to begin helping parents of
anencephalic infants incorporate donation into end of life care?
Questions to Run On: