Abstract

Introduction: Despite the potential to shorten waitlists for life-saving transplants, infant organ donation is rare globally (1). Infant donors (less than one year of age) can reduce waitlist mortality for both infants and children who require size-matched organs like hearts and lungs, and adults who can receive kidney transplants from infant donors (2). Infants can donate their organs after death by circulatory criteria (DDCC) (i.e., the heart stops beating)(1) if the death follows the withdrawal of life-sustaining measures (WLSM) (i.e., mechanical ventilation and hemodynamic supports like vasopressors). However, donation rates are very low(2). Providers have reported rarely offering donation due to concerns about how to introduce the topic of organ donation without causing additional distress to the family(3). Understanding bereaved parents’ perspectives on infant organ donation and how this option could be discussed with them is an important first step in guiding practice, but no studies have explored parent perspectives on infant DDCC. Understanding these perspectives is essential to improving family-centred care and donation counselling practices.

Method: We are conducting a study using interpretive description to explore parent perspectives on infant organ donation and the process of DDCC in NICUs and PICUs. This study has been co-designed with two parent partners. We are conducting individual, semi-structured interviews with parents of an infant who died after a planned WLSM about their perspectives on the potential for and process of infant DDCC. Data analysis is an iterative and evolving process involving in vivo and then axial coding, merging codes into categories and categories into higher-level themes.

Results: Parent partners have contributed meaningfully to the study's design. Preliminary results from interviews will be available by the time of the conference.

Conclusion: This co-designed interpretive description study seeks to illuminate bereaved parent perspectives on infant organ donation and the process of DDCC. By involving parent partners throughout, the study prioritizes family-centered research. Findings will inform donation counseling practices and policies that align more closely with family needs and values in NICU and PICU settings. The collaborative approach offers a model for meaningful parent engagement in sensitive pediatric research.

Notes

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References:

1. Weiss M, Sherry W, Hornby L. Pediatric donation after circulatory determination of death (pDCD): A narrative review. Paediatr Respir Rev. 2019;29:3-8. doi:10.1016/j.prrv.2018.03.006

2. St Louis J, Weiss M, Al-Ayass S, et al. Infant organ donation after circulatory death: A literature scoping review. Pediatr Crit Care Med. 2025;in press.

3. Ali F, Chant K, Scales A, Sellwood M, Gallagher K. An exploration of neonatal staff knowledge and attitudes towards neonatal organ donation. J Neonatal Nurs. 2025;31(2):101589. doi:10.1016/j.jnn.2024.11.004

Description

Infant organ donation can save lives but remains rare worldwide. This study explores bereaved parents’ perspectives on infant organ donation to inform family-centred counselling practices. Using interpretive description, we are conducting semi-structured interviews with parents whose infants died following planned WLSM. The study was co-designed with two bereaved parent partners. The project also demonstrates a model for meaningful parent engagement in pediatric end-of-life research.

Author Details

Julia St Louis, RN, PhD(c); Amy L. Wright, PhD, NP; Sonny Dhanani, MD; Charles Keown-Stoneman, PhD; Jennifer Woolfsmith; Danielle Joseph; Kimberley Widger, PhD

Sigma Membership

Non-member

Lead Author Affiliation

University of Toronto, Toronto, Ontario, Canada

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Qualitative Research

Keywords:

Hospice, Palliative Care, End-of-Life, Acute Care, Ethics, Organ Donation, Parent Attitudes, Organ Donation & Ethics, Infant Organ Donation

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-07-22

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Parent Perspectives on the Potential for and Process of Infant Organ Donation

Toronto, Ontario, Canada

Introduction: Despite the potential to shorten waitlists for life-saving transplants, infant organ donation is rare globally (1). Infant donors (less than one year of age) can reduce waitlist mortality for both infants and children who require size-matched organs like hearts and lungs, and adults who can receive kidney transplants from infant donors (2). Infants can donate their organs after death by circulatory criteria (DDCC) (i.e., the heart stops beating)(1) if the death follows the withdrawal of life-sustaining measures (WLSM) (i.e., mechanical ventilation and hemodynamic supports like vasopressors). However, donation rates are very low(2). Providers have reported rarely offering donation due to concerns about how to introduce the topic of organ donation without causing additional distress to the family(3). Understanding bereaved parents’ perspectives on infant organ donation and how this option could be discussed with them is an important first step in guiding practice, but no studies have explored parent perspectives on infant DDCC. Understanding these perspectives is essential to improving family-centred care and donation counselling practices.

Method: We are conducting a study using interpretive description to explore parent perspectives on infant organ donation and the process of DDCC in NICUs and PICUs. This study has been co-designed with two parent partners. We are conducting individual, semi-structured interviews with parents of an infant who died after a planned WLSM about their perspectives on the potential for and process of infant DDCC. Data analysis is an iterative and evolving process involving in vivo and then axial coding, merging codes into categories and categories into higher-level themes.

Results: Parent partners have contributed meaningfully to the study's design. Preliminary results from interviews will be available by the time of the conference.

Conclusion: This co-designed interpretive description study seeks to illuminate bereaved parent perspectives on infant organ donation and the process of DDCC. By involving parent partners throughout, the study prioritizes family-centered research. Findings will inform donation counseling practices and policies that align more closely with family needs and values in NICU and PICU settings. The collaborative approach offers a model for meaningful parent engagement in sensitive pediatric research.