Format

Send to

Choose Destination
Curr Opin Organ Transplant. 2012 Oct;17(5):520-4. doi: 10.1097/MOT.0b013e3283570478.

Decision-making in the face of end-stage organ failure: high-risk transplantation and end-of-life care.

Author information

1
Department of Paediatrics, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. anne.dipchand@sickkids.ca

Abstract

PURPOSE OF REVIEW:

Pediatric solid organ transplantation numbers have been increasing over the years. Research and the medical literature tends to focus on advancing the field and innovation - which often leads to higher risk and more complex procedures. How do we decide when it is too much - too much risk; too much uncertainty? Who makes that decision? Literature is scarce and usually focuses on end-of-life decision-making. This article does not purport to have the answers, but will highlight the depth and breadth of points that must be taken into consideration.

RECENT FINDINGS:

There are many factors that contribute to the decision-making in the context of high-risk solid organ transplantation in children. Focus needs to include quality of life in the pediatric context, in addition to survival. End-of-life discussions should be included early in the process. Societal factors must be considered in an era of donor organ shortages. Shared decision-making should be the approach.

SUMMARY:

The key guiding principle is to make a decision about what is best for a child requiring a high-risk transplant based not only on survival, but also on an acceptable quality of life on the background of optimal utilization of a scarce societal resource.

PMID:
22890041
DOI:
10.1097/MOT.0b013e3283570478
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center