{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T09:12:58Z","timestamp":1762852378650,"version":"build-2065373602"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There remains a critical shortage of pediatric organ donors and there is a gap in understanding of optimal perioperative management to optimize donor organ outcomes for this valuable resource.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To survey practice patterns for intraoperative management of pediatric (age\u2009&lt;\u200918\u2009years) brain\u2010dead donors during organ recovery procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study included organ recovery cases from 24 centers included in the Multicenter Perioperative Outcomes Group (MPOG) cohort in the United States from 2014 to 2020. Practice variation was evaluated using descriptive statistics, Fleiss' kappa, and logistic regression for between\u2010group comparisons for volume\u2010based analysis (case volume\u2009&lt;\u200910 or \u2265\u200910) without adjustment for multiple comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 231 cases were included in this analysis. The median case volume for the Higher\u2010Volume (\u2265\u200910 cases) group was 25 [IQR 17, 46] cases and 7 [IQR 3, 8] cases for the Lower\u2010Volume (&lt;\u200910 cases) group. Descriptive analyses identified differences in case volume, race, and administration of steroids and vasoactives (bolus and infusion). The Fleiss' kappa scores were negative across all medications administered, suggesting a lack of within\u2010group agreement. The odds ratio for steroid administration in the Lower\u2010Volume group was 0.319 (95% CI: 0.116\u20130.745,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study found substantial practice variation across MPOG centers grouped based on case volume frequency for organ recovery procedures in pediatric donation after brain death. A major limitation of this study is the inability to correlate perioperative management with organ recipient outcomes. The main takeaway is an opportunity to improve consistency in perioperative management for brain\u2010death donors from case classification to medication administration that reflects an understanding of brain death physiology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pan.70064","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T11:23:42Z","timestamp":1759317822000},"page":"1063-1070","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Practice Variation in Intraoperative Management of Pediatric Organ Donation After Brain Death: A Retrospective Observational Multicenter Perioperative Outcomes Group Study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1069-5665","authenticated-orcid":false,"given":"Phil Y.","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Pediatric Anesthesiology Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Anesthesiology and Pain Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhijit V.","family":"Lele","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Souter","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily A.","family":"Vail","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyao G.","family":"deGrauw","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine T.","family":"Fong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhiken I.","family":"Naik","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Virginia Health System  Charlottesville Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert B.","family":"Schonberger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Yale University  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikas N.","family":"O'Reilly\u2010Shah","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Anesthesiology and Pain Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"MPOG Collaborators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"\u201cNational Data\u2014OPTN \u201daccessed June 17 2024 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