Jansen Nichon E, Haase-Kromwijk Bernadette J J M, van Leiden Hendrik A, Weimar Willem, Hoitsma Andries J
Dutch Transplant Foundation, Leiden, The Netherlands.
Transpl Int. 2009 Nov;22(11):1064-72. doi: 10.1111/j.1432-2277.2009.00930.x. Epub 2009 Jul 21.
Conversion of potential organ donors to actual donors is negatively influenced by family refusals. Refusal rates differ strongly among countries. Is it possible to compare refusal rates in order to be able to learn from countries with the best practices? We searched in the literature for reviews of donor potential and refusal rates for organ donation in intensive care units. We found 14 articles pertinent to this study. There is an enormous diversity among the performed studies. The definitions of potential organ donors and family refusal differed substantially. We tried to re-calculate the refusal rates. This method failed because of the influence caused by the registered will on donation in the Donor Register. We therefore calculated the total refusal rate. This strategy was also less satisfactory considering possible influence of the legal consent system on the approach of family. Because of lack of uniform definitions, we can conclude that the refusal rates for organ donation can not be used for a sound comparison among countries. To be able to learn from well-performing countries, it is necessary to establish uniform definitions regarding organ donation and registration of all intensive care deaths.
潜在器官捐献者转变为实际捐献者会受到家属拒绝的负面影响。各国的拒绝率差异很大。是否有可能比较拒绝率，以便能够向最佳实践的国家学习？我们在文献中搜索了关于重症监护病房器官捐献的潜在捐献者和拒绝率的综述。我们找到了14篇与本研究相关的文章。所开展的研究之间存在巨大差异。潜在器官捐献者和家属拒绝的定义有很大不同。我们试图重新计算拒绝率。由于捐赠登记册中登记意愿对捐赠的影响，这种方法失败了。因此，我们计算了总拒绝率。考虑到法律同意系统对家属态度的可能影响，这一策略也不太令人满意。由于缺乏统一的定义，我们可以得出结论，器官捐献的拒绝率不能用于各国之间的合理比较。为了能够向表现出色的国家学习，有必要就器官捐献和所有重症监护死亡病例的登记建立统一的定义。
