anencephalic donation possibilities
DESCRIPTION
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:. - PowerPoint PPT PresentationTRANSCRIPT
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Anencephalic Donation Possibilities
Breakout 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
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• Understand the possible donation opportunities for anencephalic babies• Learn the practical steps that can be taken to
help families of neonatal/anencephalic infants
Objectives:
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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:
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Turning a “No” Into a “Maybe”Anencephalic & Neonatal Donation Possibilities
Leandra McHargue, RN, BSNBecky Hill, CPTC
Sarah Grays, RNC-NIC, CPTC
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• 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
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• 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
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• 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?
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Crossroads of medicine andthe desire of these families to donate.
Present: Why Re-Examine Now?
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Leandra McHargue, RN BSNNICU Bereavement Coordinator
Loma Linda University Medical Center
Colin’s Story
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The Perry Family
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Colin’s Story
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Colin’s Story
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Colin’s Story
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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
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Sarah Grays, OneLegacyMegan Aberl, Arriana’s Mom
Arriana’s Story
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Megan’s Family
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Arriana’s Story
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Arriana was born on December 11 at 2252
to proud parents Megan & Ignacio
Arriana’s Story
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Arriana’s Story
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Arriana’s Gift
Arriana became the 20th anencephalic infant to
donate in the US in 2012
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• 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
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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
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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:
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