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.