摘要
活体肝移植术虽部分解决了供肝短缺问题,但需从活的供体身上切取部分肝脏,使其承担手术创伤甚至死亡的风险,故存在诸多伦理问题。本文应用质性研究,对7名与活体肝移植相关的不同领域专家及6名手术相关者进行访谈,采用Nvivo9.0软件辅助对访谈资料进行了分析。探讨活体肝移植的伦理审查、供体选择及心理评估的相关伦理问题。结果显示,尽管活体肝移植手术仍在全国多家医院进行,目前政府对活体肝移植伦理审查和监管更加严格,伦理审查缺少对供体、受体的心理综合评估。因此,建议建立健全并推广死亡器官捐赠注册系统以增加肝源,减少活体肝移植对供体带来的健康风险,并开发适用的心理综合评估工具,评估结果应列入伦理审查范围。
Living donor liver transplantation （LDLT ） technology solves the shortage of donated liver partially and saves the lives of patients ;however ,living donors are faced with risks and /or complications after the surgery .How to protect the health of living donor is an important issue in application of LDLT .A qualitative study was designed and conducted to explore the ethical concerns in LDLT process , including IRB review , selection of living donor , and comprehensive psychological evaluation for donors .Six individuals （2 donors ,2 former recipients and 2 family members of donors） ,and 7 experts （IRB , psychology and transplant surgeon ） were interviewed by researchers in the Peking University Clinical Research Institute .Nvivo9 .0 software was used to analyze the data .From the interview ,we found that the psychological evaluation for donors and recipients before surgery is necessary but absent currently .Applicable psychological evaluation tools should be developed ,and the evaluation results should be included in IRB review .Organ donation registry system is recommended to add more available liver to reduce health risk from LDLT .It is very clear that the trend of government regulation and IRB review to LDLT is getting strict ,pointed by experts .
出处
《医学与哲学（B）》
2014年第7期90-93,共4页
Medicine & Philosophy(B)
基金
首都医学发展科研基金对本项目的资助
