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成人对成人活体肝移植的伦理问题。

Ethical issues surrounding adult-to-adult living donor liver transplantation.

作者信息

Shapiro R S, Adams M

机构信息

Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.

出版信息

Liver Transpl. 2000 Nov;6(6 Suppl 2):S77-80. doi: 10.1053/jlts.2000.19014.

DOI:10.1053/jlts.2000.19014
PMID:11084091
Abstract
  1. The ethical principle of utility is enhanced by living donor liver transplantation (LDLT). LDLT carries the potential to optimize efficient use of organs, minimize pretransplant morbidity and mortality, and increase availability of cadaveric organs. 2. The most serious ethical concerns in LDLT focus on the risks to the donor and relate to the principle of nonmaleficence-"do no harm". Although exact risk remains uncertain, there is potential for significant donor morbidity and even mortality. 3. Careful consideration must be given to development of the best approach to obtaining truly informed consent. 4. Specific criteria for LDLT should be developed for transplant centers, donors, and recipients. Informed consent should be standardized. 5. A national registry for donors and recipients of LDLT is needed.
摘要
  1. 活体肝移植(LDLT)强化了效用的伦理原则。LDLT 有可能优化器官的有效利用,将移植前的发病率和死亡率降至最低,并增加尸体器官的可获得性。2. LDLT 中最严重的伦理问题集中在供体所面临的风险上,这与不伤害原则——“不造成伤害”相关。尽管确切风险仍不确定,但供体有发生严重并发症甚至死亡的可能性。3. 必须认真考虑制定获取真正知情同意的最佳方法。4. 应为移植中心、供体和受体制定 LDLT 的具体标准。知情同意应标准化。5. 需要建立一个全国性的 LDLT 供体和受体登记处。

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Ethical issues surrounding adult-to-adult living donor liver transplantation.成人对成人活体肝移植的伦理问题。
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2
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引用本文的文献

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Living-Donor Liver Transplantation-The Need for Greater Transparency.活体肝移植——更高透明度的必要性
J Clin Exp Hepatol. 2025 Mar-Apr;15(2):102507. doi: 10.1016/j.jceh.2025.102507. Epub 2025 Jan 21.
2
Special Techniques of Liver Transplantation: Living Donor Liver Transplantation With Right Posterior Sector Grafts and Extended Left Lobe Grafts; Auxiliary Partial Orthotopic Liver Transplantation, and Dual-Lobe Liver Transplantation.肝移植的特殊技术:带右后叶移植物和扩大左外叶移植物的活体供肝肝移植;辅助性部分原位肝移植及双叶肝移植。
J Clin Exp Hepatol. 2025 Mar-Apr;15(2):102451. doi: 10.1016/j.jceh.2024.102451. Epub 2024 Nov 15.
3
Analysis of donor motivations in living donor liver transplantation.
活体肝移植中供体动机分析
Front Surg. 2014 Jul 8;1:25. doi: 10.3389/fsurg.2014.00025. eCollection 2014.
4
[Living donor liver transplantation].[活体供肝肝移植]
Chirurg. 2008 Feb;79(2):135-43. doi: 10.1007/s00104-007-1461-y.
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Ethical issues in living donor liver transplantation.活体供肝肝移植中的伦理问题。
Curr Gastroenterol Rep. 2003 Feb;5(1):26-30. doi: 10.1007/s11894-003-0006-x.
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Adult-to-adult Right Hepatic Lobe Living Donor Liver Transplantation.成人对成人右肝叶活体供肝肝移植
Curr Treat Options Gastroenterol. 2002 Dec;5(6):491-501. doi: 10.1007/s11938-002-0037-7.
7
Liver transplantation for chronic liver disease: advances and controversies in an era of organ shortages.慢性肝病的肝移植:器官短缺时代的进展与争议
Postgrad Med J. 2002 Mar;78(917):135-41. doi: 10.1136/pmj.78.917.135.