{
  "abstract": "IntroductionEach year, between 250 and 300 children are listed for organ transplantation in Germany, while approximately 30 children donate organs. Despite identified barriers to pediatric organ donation, comprehensive data on characteristics and clinical management of pediatric deaths in German pediatric intensive care units (PICUs), especially among organ donors, remains limited. This study aims to analyze the epidemiology of in-PICU deaths and the characteristics of pediatric organ donors within a multicenter network of German PICUs.MethodsRetrospective analysis of data anonymously collected in 33 PICUs participating in the Pediatric Intensive Care Admission Network (PIA) between May 1, 2023 and July 31, 2025. Patients included were children older than 27 days and younger than 18 years who died during their PICU stay.ResultsOf 11,095 children recorded, 219 died (overall case-fatality rate:19.7/1,000). Median age at death was 6 years (IQR, 1– 13). Death occurred after withdrawal (30.1%) or limitation of life-sustaining treatment (20.5%), failed maximal therapy (26.5%) and failed cardiopulmonary resuscitation (12.8%). 21/219 (9.6%) children met neurologic criteria for death. Of these, 11 children became organ donors (52.4%). Median age of organ donors was 4 years (IQR 1–13).DiscussionThis first multicenter analysis from a nationwide German PICU network shows comparable mortality rates but substantially lower rates of death by neurologic criteria (DNC) in German PICUs than in international multicenter studies. This gap may indicate missed opportunities for organ donation. More structured donor identification, enhanced training for DNC diagnosis, and development of evidence-based guidelines for pediatric donor management may enhance quality of care and increase pediatric organ donation in Germany.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pediatrics, Neonatology and Pediatric Intensive Care Medicine, Marburg University, Marburg, Germany",
    "Department of Pediatrics, Pediatric Intensive Care Medicine, University Clinic Carl Gustav Carus, TU Dresden, Dresden, Germany",
    "Department of Pediatrics I, Neonatology, Pediatric Intensive Care Medicine, and Pediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany",
    "Department of Pediatrics, Klinikum Dritter Orden Munich, Munich, Germany",
    "Pediatric Intensive Care Unit, Dr. von Hauner Children’s Hospital, LMU Munich, Munich, Germany",
    "Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany",
    "Department of Child and Adolescent Medicine, Neonatal and Pediatric Intensive Care Section, University Hospital Jena, Jena, Germany"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nadine Mand"
    },
    {
      "affs": [
        0
      ],
      "name": "Carolin Donath"
    },
    {
      "affs": [
        0
      ],
      "name": "Franziska König"
    },
    {
      "affs": [
        1
      ],
      "name": "Sebastian Brenner"
    },
    {
      "affs": [
        2
      ],
      "name": "Nora Bruns"
    },
    {
      "affs": [
        2
      ],
      "name": "Christian Dohna-Schwake"
    },
    {
      "affs": [
        3
      ],
      "name": "Florian Hoffmann"
    },
    {
      "affs": [
        4
      ],
      "name": "Martin Olivieri"
    },
    {
      "affs": [
        5
      ],
      "name": "Michael Urschitz"
    },
    {
      "affs": [
        5
      ],
      "name": "Diana Perera Cutiño"
    },
    {
      "affs": [
        6
      ],
      "name": "Richard Biedermann"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2xa4p7trkdhve.bib",
  "cited_by": 0,
  "doi": "10.3389/fped.2026.1890906",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fped.2026.1890906/full",
  "id": "2xa4p7trkdhve",
  "issns": [
    "2296-2360"
  ],
  "landing_url": "https://doi.org/10.3389/fped.2026.1890906",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RJ1-570"
    ],
    [
      "openalex",
      "2739|Organ Donation and Transplantation"
    ]
  ],
  "openalex": "W7223365177",
  "pdf_url": "https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2026.1890906/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": "Frontiers Media S.A.",
  "ris": "https://research.draconitic.com/paper/2xa4p7trkdhve.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:43:48Z",
      "native_id": "9e75775e42194fcb81820b3eb8bc6be1",
      "source": "doaj",
      "url": "https://doi.org/10.3389/fped.2026.1890906"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Organ Donation and Transplantation",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Death by neurologic criteria and organ donation in German pediatric intensive care units—data from the PIA network",
  "title_text": "Death by neurologic criteria and organ donation in German pediatric intensive care units—data from the PIA network",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:48Z",
  "url": "https://research.draconitic.com/paper/2xa4p7trkdhve",
  "venue": "Frontiers in Pediatrics",
  "versions": []
}