人类器官移植供体来源的发展历程

History of organ donation

移植器官来源模式是科学技术发展和人文精神升华完美结合的产物。移植器官来源经历了异种动物、死刑遗体、亲属活体、脑死亡供体、亲属活体+非亲属活体、心死亡供体、多种来源这7个不同的历史阶段。异种移植离临床应用遥远;死刑来源倍受批评;活体移植伤害健康人。器官捐献移植发展史证明,公民逝世后器官捐献值得大力推广。以美国全脑死亡器官捐献和英国脑干死亡器官捐献为代表的美-欧模式,均为生前自愿同意,且绝对无偿。公民认为任何形式的补偿都会改变捐献行为本来的性质。心死亡器官捐献是脑死亡器官捐献的补充,适用于既不符合脑死亡标准又无法救治,同时家属又有强烈捐献意愿者。

Organ donation is a special practice resulted from perfect merger of modern technology and humanistic spirit.Its history can be generally divided into 7 stages:xenograft,execution,living related-Ⅰ,brain death,living-Ⅱ,cardiac death,and multiple sources.Xenograft is far from clinical application,the execution has been condemned,and the living transplantation offends the basic rule of 'first,do no harm'.Deceased organ donation including brain death and cardiac death might be the right approach toward the organ donation and transplantation.Donors of whole brain death in the US and donors of brainstem death in the UK represent the main form of organ donation in western countries and this practice is based on patients' concern and absolutely free of incentives.Any form of compensation may change the intrinsic nature of donation in the eyes of the public.Donors of cardiac death are supplementary to brain death organ donation,who are irreversible but not identified as brain death and their family members have strong will to donate their organs to transplant candidates.