Bramstedt Katrina A, Young James B
Department of Bioethics, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio 44195, USA.
Telemed J E Health. 2006 Jun;12(3):359-62. doi: 10.1089/tmj.2006.12.359.
Organ transplantation is an ethically complex technology, in part because organs are very scarce and supply does not meet demand. Organ allocation must use a process that is fair, and the process should be open for public review and revision. We explored the transparency of the heart transplant patient selection process in the United States terming transparency as hospital use of their transplant program Web site to disclose their policies to potential patients. The Web sites of all heart transplant centers belonging to the U.S. Organ Procurement and Transplantation Network were reviewed for content pertaining to patient selection criteria for placement on the transplant waiting list. All 132 heart transplant centers have a Web site that discusses their transplant program; however, 84% (n = 111) do not publish their medical listing criteria on their Web site. Only 15% (n = 20) expressly indicate the requirement for a psychosocial evaluation. Few centers (n = 9) utilize their Web site to discuss use of a formal data review committee to decide which patients to list for transplantation. In order to demystify and correct false assumptions about the transplant listing process, wait listing criteria should be transparent to the public and Internet disclosure can facilitate this end. Our findings lay the foundation for future prospective studies.
器官移植是一项伦理复杂的技术，部分原因在于器官非常稀缺，供不应求。器官分配必须采用公平的程序，且该程序应公开接受公众审查和修订。我们探讨了美国心脏移植患者选择过程的透明度，将透明度定义为医院利用其移植项目网站向潜在患者披露政策。对美国器官获取与移植网络所属的所有心脏移植中心的网站进行了审查，以查找与列入移植等候名单的患者选择标准相关的内容。所有132个心脏移植中心都有一个讨论其移植项目的网站；然而，84%（n = 111）的中心未在其网站上公布其医学列入标准。只有15%（n = 20）明确指出了心理社会评估的要求。很少有中心（n = 9）利用其网站讨论使用正式数据审查委员会来决定哪些患者可列入移植名单。为了消除对移植列入过程的神秘感并纠正错误假设，等候列入标准应向公众透明，而通过互联网披露有助于实现这一目标。我们的研究结果为未来的前瞻性研究奠定了基础。
