Antoine Corinne, Brun Frédéric, Tenaillon Alain, Loty Bernard
Direction médicale et scientifique, agence de la biomédecine, 93212 Saint-Denis-la-Plaine cedex, France.
Nephrol Ther. 2008 Feb;4(1):5-14. doi: 10.1016/j.nephro.2007.07.005. Epub 2007 Oct 24.
Despite a significant increase in procurement and transplantation activities observed in France in the last eight years, the shortage in grafts is on the rise and demand keeps being much higher than supply. Since 1968 and until now, procurement was limited to heart beating brain donors. The results of kidneys transplanted from non-heart-beating donors have significantly improved and are nowadays comparable to those of kidney transplantations from brain death donors, thanks to a more accurate selection of donors and recipients, to better respect of preventing cold and warm ischemia times and to several major therapeutic innovations. Procurement on non-heart-beating donors are therefore being reconsidered under considerations of feasibility, results and ethical and legal consequences, under a specific medical protocol issued by the agency of biomedicine with the pilot hospital center agreement to comply with the protocol. Referring to foreign experiences, this program is likely to decrease the organ shortage, which is jeopardizing the treatment of a large number of patients awaiting transplantation.
尽管在过去八年里法国的器官获取和移植活动显著增加,但移植物短缺问题仍在加剧,需求一直远高于供应。自1968年至今,器官获取仅限于心脏仍在跳动的脑死亡供体。由于对供体和受体的选择更加精准,对冷缺血和热缺血时间的预防有了更好的把控,以及一些重大治疗创新,非心脏跳动供体的肾脏移植结果有了显著改善,如今已与脑死亡供体的肾脏移植结果相当。因此,在生物医学机构发布的特定医疗协议下,并经试点医院中心同意遵守该协议,正在从可行性、结果以及伦理和法律后果等方面重新考虑非心脏跳动供体的器官获取问题。参考国外经验,该计划可能会减少器官短缺的情况,而器官短缺正危及大量等待移植患者的治疗。