心死亡供者器官获取伦理及肝移植临床应用

Ethics of donors of cardiac death and its application in liver transplantation

目前,心死亡供者(DCD)已成为国际上公认的供者三大来源之一,DCD的规范化应用可进一步扩大供者来源,增加移植手术例数,挽救更多濒危患者生命。不同国家对于DCD的监测等待时间、移植小组的介入时间、器官切取方案等有着不同的规定,这些DCD器官捐献的具体实施过程会直接影响其临床效果,因此临床上不仅需要在具体实施上,还要从供者选择、器官保存、移植物活力评估等方面展开综合的研究。本文主要探讨DCD器官捐献的主要工作流程、临床应用细则、医学及伦理学方面存在的问题等。

At present,donors after cardiac death(DCD) have become one of the major sources of donors.The specification of applications of DCD can further expand donor source,raise the number of transplant,and save more lives.Different countries have different definitions of monitor waiting time,the DCD transplant team intervening time,and the organ procurement programs and so on.The concrete implementation of DCD organ donation process will directly affect the clinical effect of transplantation.Consequently,comprehensive researches needed to be done not only on the specific implementation,but on the areas of donor selection,organ preservation,and assessment of graft viability.This article mainly discusses the major work of DCD organ donation process,the specific rules of clinical application,and medical and ethical problems that exist.