Daar A S
Department of Surgery, College of Medicine, Sultan Qaboos University, Muscat, Oman.
Ann Acad Med Singap. 1991 Jul;20(4):443-52.
There continues to be a shortage of kidneys for transplantation even in countries with developed cadaver donor programmes. It is becoming clearer that cadaver donation will probably never satisfy the demand for kidneys, and living donor transplants are bound to play an important role in transplantation, more so in developing countries. Living non-related donation played a significant role in the early days of clinical renal transplantation, but fell into disrepute partly because of the activities of a few individuals and a few transplant centers that profited from commerce in human organs. However, it has always been recognised that living non-related donor (LNRD) renal transplantation per se was ethically acceptable. With the improvement in the results of renal transplantation, the persistent shortage has led to a reassessment of LNRD transplantation. Evidence indicates that both the public and the profession are in favour of this source of donation, although many transplant units are still reluctant to use it. However, more and more units, in both the developed and the developing world, are now performing such transplants. Where this is done ethically, the results appear to be excellent. We strongly believe that spouses, distant relatives and genetically non-related individuals who have an enduring relationship should be permitted to donate.
即使在那些拥有成熟尸体供体项目的国家，用于移植的肾脏仍然短缺。越来越明显的是，尸体捐赠可能永远无法满足对肾脏的需求，活体供体移植必然会在移植中发挥重要作用，在发展中国家更是如此。非亲属活体捐赠在临床肾移植早期发挥了重要作用，但部分由于一些个人和一些移植中心从事人体器官商业交易而声名狼藉。然而，一直以来人们都认识到非亲属活体供体（LNRD）肾移植本身在伦理上是可以接受的。随着肾移植结果的改善，持续的短缺促使人们对非亲属活体捐赠移植进行重新评估。有证据表明，公众和专业人士都支持这种捐赠来源，尽管许多移植单位仍然不愿采用。然而，无论是在发达国家还是发展中国家，越来越多的单位现在都在进行此类移植。在符合伦理的情况下进行这种移植，结果似乎非常理想。我们坚信，应该允许配偶、远亲以及有持久关系的非血缘关系个人进行捐赠。
