Departments of Psychiatry and Surgery, Virginia Commonwealth University, Richmond, Virginia 23298-0268, USA.
Curr Opin Organ Transplant. 2010 Apr;15(2):241-4. doi: 10.1097/MOT.0b013e328337352a.
To summarize recent practices and views regarding children as living organ donors in the USA.
Living donors have become an increasingly important source of organs for transplantation. Concern for the rights of donors has resulted in reconsideration of the use of minors as living organ donors. Most commentators have voiced concerns that minors deserve extraordinary protection, but are unwilling to ban the practice of living donation by minors outright. Instead, factors to be considered in individual situations have been enumerated, and safeguards recommended. These same safeguards have also been recommended to be extended to adults, as attainment of legal age does not in itself confer immunity from exploitation. Developmental factors of importance include brain maturation affecting decision making, executive function and impulse control; the dependent status of minors, usually on the persons who may most want them to be donors; youthful idealism and sense of invulnerability; and incomplete identity formation.
Fewer children in the USA have become living donors in the past decade. Preadolescent children in particular should probably be considered as potential donors only in extraordinary circumstances. Safeguards protect not only children, but transplant physicians, programs and the image of the transplant endeavor.
总结美国儿童作为活体器官捐献者的最新实践和观点。
活体捐献者已成为器官移植的重要来源。出于对供体权利的关注，人们重新考虑了未成年人作为活体器官捐献者的问题。大多数评论员都表示，未成年人应得到特别保护，但不愿完全禁止未成年人的活体捐献。相反，已经列举了在个别情况下需要考虑的因素，并提出了相应的保障措施。这些同样的保障措施也被建议扩展到成年人，因为达到法定年龄本身并不能使其免受剥削。重要的发育因素包括影响决策、执行功能和冲动控制的大脑成熟；未成年人的依赖地位，通常是在那些最希望他们成为捐赠者的人身上；年轻的理想主义和无所不能的感觉；以及不完全的身份认同。
过去十年，美国的儿童活体捐献者数量有所减少。特别是青春期前的儿童，可能只有在特殊情况下才应被视为潜在的捐献者。保障措施不仅保护了儿童，还保护了移植医生、项目和移植工作的形象。
