Aruga Tohru, Kitahara Takao, Yokota Hiroyuki
Department of Emergency and Clinical Care Medicine, Showa University School of Medicine.
Nihon Rinsho. 2005 Nov;63(11):2037-46.
The authors have referred to several issues encountered in the neuroemergency and critical care facilities in our country through the declaration of brain death to the successful removal of organs for donation. One of the most important is the fact that the legal validity of death in brain dead patients is only assured when the patient shows the advance directive for organ donation in Japan. So far as the selection of the recipient is not started until the brain death is declared legally, longer than 12 hours are to be spent in vain between the declaration of brain death and the beginning of the operation of removing the organs for donation. As there remain such several problems to be solved as mentioned above for organ donation in Japan, so it is suggested that the medical sciences and ethics should be respected and adopted in the rules for the organ donations by the national government.
作者通过脑死亡宣告到成功摘取供体器官,提及了我国神经急症和重症监护机构中遇到的几个问题。其中最重要的一点是,在日本,只有当患者出示器官捐赠预先指示时,脑死亡患者死亡的法律效力才能得到保证。由于在脑死亡得到法律宣告之前不会开始受体的选择,因此在脑死亡宣告和开始摘取供体器官的手术之间会白白浪费超过12个小时。由于日本器官捐赠仍存在上述几个有待解决的问题,因此建议国家政府在器官捐赠规则中尊重并采用医学科学和伦理。