站在亚洲看世界:亚洲视角下脑死亡器官捐献的可持续健康发展

With a focus on Asia and a global perspective:sustainable development of donation after brain death

器官短缺是全球移植界面临的共同难题,世界卫生组织呼吁所有国家通过减少疾病负担和扩充符合伦理原则的有效器官来源以实现器官移植的自给自足。在全球范围内,脑死亡器官捐献(DBD)仍是移植器官的主要来源。近几年,包括中国在内的一些亚洲国家积极推动死亡器官捐献事业的发展,这些举措正逐步改变亚洲地区以活体捐献为移植器官主要来源的格局。2020年新型冠状病毒肺炎疫情的暴发放缓了全球器官捐献和移植数量近十年的增长趋势。在疾病负担和移植需求未有显著降低的前提下,我国器官捐献和移植工作在“人民至上,生命至上,坚持动态清零”的疫情防控总方针和相关政策的指引下稳步开展。这一定程度证明了在人民群众医疗诉求和移植需求的持续驱动下,我国已经形成一个有韧性的、有抗压能力的、并具运作惯性且行业赖以生存的器官捐献与移植工作体系。站在中国看亚洲,站在亚洲看世界。本文通过整理全球及亚洲器官捐献与移植相关数据,重点剖析在全球器官移植发展新潮流下亚洲器官捐献和移植整体格局的变化,并结合我国自身发展特征及实践经验,探索脑死亡器官捐献的影响因素,并提出针对性的应对策略,以期为亚洲及我国器官捐献和移植的可持续健康发展提供专业参考。

Organ shortage is a prevalent problem within the global transplantation community.World Health Organization(WHO)calls on all countries to achieve self-sufficiency in organ transplantation by reducing the burden of diseases and expanding the effective source of organs in line with ethical principles.Donation after brain death(DBD)remains the major source of transplant organs.In recent years,some Asian countries,including China,have actively promoted the development of donation from deceased organs,which are gradually reshaping the situation of living organ donation as the main source of transplant organs in Asia.The outbreak of COVID-19 in 2020 slowed down the growth trend of global organ donation and transplantation in the past decade.On the premise that the burden of disease and the need for transplantation have not been significantly reduced,the work of organ donation and transplantation in China has been steadily carried out under the guidance of the general policy of epidemic prevention and control and relevant policies of“Put people and their lives first,and adhere to the dynamic zero-Covid policy”.This proves to a certain extent that under the continuous drive of the people’s medical demands and transplant demands,China has formed an organ donation and transplant work system with resilience,pressure resistance,operational inertia and the survival of the industry.Look at Asia from China,and look at the world from Asia.In this article,by compiling relevant data of organ donation and transplantation in Asia and around the world,the changes of the overall pattern of organ donation and transplantation in Asia during the new developmental trend of global organ transplantation were illustrated,the influencing factors of DBD were identified by analyzing the developmental characteristics and practical experience,and corresponding effective strategies were proposed,aiming to provide professional reference for sustainable and healthy development of organ donation and transplantation in China and throughout Asia.