欧洲移植组织区域的肾脏获取政策。“选择加入”与“选择退出”。

Kidney procurement policies in the Eurotransplant region. 'Opting in' versus 'opting out'.

作者信息

Kokkedee W

机构信息

De Brauw Blackstone Westbroek, Lawyers and Civil Law Notaries, Amsterdam, The Netherlands.

出版信息

Soc Sci Med. 1992 Jul;35(2):177-82. doi: 10.1016/0277-9536(92)90164-l.

DOI:10.1016/0277-9536(92)90164-l

PMID:1509306

Abstract

A shortage of kidneys has been part of kidney transplantation ever since it evolved from its experimental stage and became a therapeutic possibility. However, at present this shortage is more acute than ever before. Post mortem kidney procurement policies can be distinguished into 'opting in' and 'opting out' systems. In the five countries cooperating in Eurotransplant, systems of both kind have been implemented. In this paper the relation between these procurement policies and kidney availability in the Eurotransplant region is examined. The opting out system turns out to be more favourable to kidney procurement than the opting in system. The approach of the next of kin with the donation question happens to be an important barrier for kidney procurement in the opting in system, but fails to appear under opting out. In the epilogue some remarks are made on the possibilities of introduction of the opting out system in countries now applying opting in.

摘要

自肾脏移植从实验阶段发展成为一种治疗手段以来，肾脏短缺问题就一直存在。然而，目前这种短缺比以往任何时候都更加严重。尸检肾脏获取政策可分为“选择加入”和“选择退出”系统。在参与欧洲移植协作组织的五个国家中，这两种系统都已实施。本文探讨了这些获取政策与欧洲移植区域肾脏供应之间的关系。结果表明，“选择退出”系统比“选择加入”系统更有利于肾脏获取。在“选择加入”系统中，近亲对捐赠问题的态度恰好是肾脏获取的一个重要障碍，但在“选择退出”系统中则不存在这一问题。在结语中，对目前采用“选择加入”系统的国家引入“选择退出”系统的可能性进行了一些讨论。