The UK has performed its first successful organ transplants from a newborn baby. The donor was a 6-day-old baby girl who was born with severe brain damage. The doctors say thanks to the “extreme generosity” of the parents; a patient with kidney failure has received their baby’s kidneys and another sick patient has received her liver cells.
The donor baby was born in the neonatal unit of Imperial College Healthcare NHS Trust’s Hammersmith Hospital in London. She weighed just over 3 kg (6.6 lbs) and was delivered via emergency Cesarean section.
The baby was very sick and unresponsive to treatment. The doctors say her brain had been starved of oxygen for a period during the pregnancy.
The infant was unable to make any spontaneous movements, did not respond to stimuli and her pupils were fixed and dilated.
When it was clear the baby girl would not survive, the team looking after her discussed the possibility of organ donation with her parents. This proceeded to a fuller discussion with the hospital’s psychologist, the NHS Blood and Transplant’s organ donation team and the hospital’s nursing staff.
The parents gave consent for their baby daughter’s kidneys and liver cells to be used for the benefit of other sick patients.
Six days after the baby girl was born and her death was confirmed, her organs were retrieved with the help of an experienced surgeon from the National Organ Retrieval Service.
Dr. Gaurav Atreja, consultant neonatologist at the Trust, praised the parents and the staff:
“It is due to the extreme generosity of the parents and wonderful professional collaboration between the neonatal team and the organ donation team that this process was successful.”
He says many families who experience the heartbreaking loss of a baby or any loved one get a “huge sense of comfort” from knowing that donating their organs can help other sick people.
The news highlights the fact that in the UK, a significant proportion of the newborns that pass away in neonatal units could be organ donors, but doctors say the current guidelines are hampering progress.
A 2014 BMJ review of the state of organ donations from newborns in the UK finds while babies are a small proportion of the patients waiting for transplants, they have the highest risk of death – mainly because of a lack of suitable donors.
Very young babies who need organ transplants cannot always use organs donated by adults; babies need organs donated by babies because of their size.
Figures from NHS Blood and Transplant show that in the UK, there are currently 194 young people under the age of 18 years waiting for a transplant – 15 of whom are babies under the age of 2 years.
Doctors say the current UK guidelines for diagnosing brain stem death in children under 2 months old make it difficult to identify newborn organ donors.
The guidelines have not been revised since 1991 and are at odds with current practice in other countries, such as the US, Australia, Canada and many European countries, where donation after an infant has died because their heart has stopped beating, rather than after brain death, is possible.
A review of the guidelines by the Royal College of Paediatrics and Child Health in the UK is expected to be released very soon, says Prof. James Neuberger, associate medical director for Organ Donation and Transplantation at NHS Blood and Transplant. He adds:
“We welcome any clarification that will ensure organ donation can take place where appropriate and support medical developments that increase the number of organs available for transplant, particularly where the parents of potential donors are keen to have something good come out of their own personal tragedy.”
Meanwhile, Medical News Today has recently learned that Australia – which has one of the highest success rates for organ transplantation in the world – is issuing new ethical guidelines on organ transplantation and has just released a draft for public consultation.