Trends in Specific Family Refusals for Pediatric Organ and Tissue Donation: A Cross‐Sectional Study.

Background: When a family decides to donate the organs or tissues of their child with brain death, it is necessary to consider which organs or tissues will be donated. This phenomenon presents an ethical dilemma that is underexplored in the scientific literature, making it essential to examine this context to understand how refusals occur within donations. Objective: To analyze the rates and trends of specific refusals for each organ and tissue from pediatric donors with brain death occurring between 2001 and 2020 in an Organ Procurement Organization in the State of São Paulo, Brazil. Methods: This was a cross‐sectional, exploratory, retrospective, quantitative study. Data were derived from a database consisting of copies of organ and tissue donation authorization forms, organized, and subjected to descriptive and inferential analyses. This study adhered to international ethical guidelines. Results: Data from 109 real donors were analyzed. The bones, skin, and blood vessels had the highest refusal rates among tissues, as well as the pancreas and lungs for solid organs. Most organs and tissues showed a decreasing refusal trend except for the corneas, liver, and kidneys, which exhibited a stationary trend. Conclusions: This study illustrates the refusals within real donations, with high refusal rates for tissues compared to solid organs. [ABSTRACT FROM AUTHOR]