Department of Surgery, Columbia University, New York, NY, USA.
Am J Transplant. 2010 Dec;10(12):2577-81. doi: 10.1111/j.1600-6143.2010.03341.x.
Donor safety is of paramount importance in living donor transplantation. Yet, living donor deaths occur. We believe that problems exist in our system of live donor transplantation that can be summarized in a series of simple statements: (1) Donor mortality can never be completely eliminated; (2) Live donor risk has not been mitigated so that it is as low as possible; (3) After a donor death, systematic reviews are not routinely performed to identify correctable causes; (4) The lessons learned from any donor death are not adequately communicated to other programs and (5) The administrative mechanisms and resources are not universally available at all transplant centers to implement lessons learned. To rectify these problems, we propose the following: (1) A national living donor death task force be established with the purpose of performing systematic reviews of any donor death. (2) Findings of these reviews be disseminated to all institutions performing live donor transplants on a secure, password-protected website. (3) A no-fault donor death indemnity fund be established to provide a financial imperative for institutions to cooperate with this external peer-review. These measures will serve the best interests of the involved institutions, the transplant community, and most importantly, the patients and their families.
供体安全在活体器官移植中至关重要。然而，活体器官捐献者死亡的情况仍时有发生。我们认为，活体器官捐献移植体系中存在一些问题，可以用一系列简单的陈述来概括：（1）不能完全消除供体死亡的风险；（2）活体捐献者的风险尚未降到最低；（3）在供体死亡后，没有系统地进行审查以确定可纠正的原因；（4）没有将从任何供体死亡中吸取的经验教训充分传达给其他项目；（5）并非所有移植中心都普遍具备实施经验教训的行政机制和资源。为了解决这些问题，我们提出以下建议：（1）成立一个国家活体供体死亡特别工作组，目的是对任何供体死亡进行系统审查。（2）将这些审查结果在一个安全的、受密码保护的网站上分发给所有进行活体器官移植的机构。（3）建立一个无过错供体死亡赔偿基金，为机构提供与外部同行审查合作的财务动力。这些措施将符合相关机构、移植界以及最重要的是患者及其家属的最大利益。
