Flodén A, Kelvered M, Frid I, Backman L
Department of Transplantation and Liver Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Transplant Proc. 2006 Oct;38(8):2619-21. doi: 10.1016/j.transproceed.2006.07.031.
Several studies have shown that over 70% of the population is positive to donate their organs after their death. Despite this it is not unusual for organ donation to be not performed. The aim of this overview was to identify factors that may have an influence on this failure despite the deceased being positive. This is a review of 343 abstracts and 23 scientific publications between 1977 and 2005 dealing with various aspects of donation. In the analysis there were some topics that were associated with the prevention of donation: medical contraindications, inability to identify a potential organ donor and provide optimal medical care, the treatment and care of next of kin, how the question of consent was addressed to the next of kin, the attitude of intensive care unit (ICU) staff toward the process, the behavior of the transplant team during organ recovery. The most crucial act to increase donation is early identification of a potential subject. Early identification and optimal medical care occur more frequent when there is a good, positive attitude of the ICU staff toward the process. A positive attitude of the questioner and good care of the next of kin frequently resulted in a positive attitude when the question of consent was raised. Transplant units could improve the attitude in the ICUs by serving as a good model, giving feedback and education to the ICU staff.
多项研究表明,超过70%的人表示愿意在死后捐献器官。尽管如此,器官捐献未实施的情况并不罕见。本综述的目的是确定尽管死者表示愿意,但可能影响器官捐献失败的因素。这是一项对1977年至2005年间涉及捐献各个方面的343篇摘要和23篇科学出版物的综述。分析中发现了一些与阻止捐献相关的主题:医学禁忌、无法识别潜在器官捐献者以及提供最佳医疗护理、对近亲的治疗和护理、向近亲提出同意问题的方式、重症监护病房(ICU)工作人员对该过程的态度、器官获取期间移植团队的行为。增加捐献的最关键行为是尽早识别潜在对象。当ICU工作人员对该过程持有良好、积极的态度时,早期识别和最佳医疗护理会更频繁地出现。询问者的积极态度和对近亲的妥善照顾,在提出同意问题时,往往会带来积极的态度。移植单位可以通过树立良好榜样、向ICU工作人员提供反馈和教育来改善ICU中的态度。