Department of Psychiatry, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Curr Opin Organ Transplant. 2012 Apr;17(2):193-7. doi: 10.1097/MOT.0b013e3283510885.
To critically discuss recent studies of living kidney donor candidates with a past or current psychiatric history and to offer guidance for the psychosocial evaluation of such donors.
A global consensus has been developed that active, significant mental illness and substance abuse are absolute contraindications to organ donation due to diminished ability to make a well informed, rational decision about donation or to maintain health status after donation. However, to date, there has been little information published on the suitability for donation and the long-term psychosocial and medical outcomes after donation in donors with mental health issues, especially relatively milder psychiatric disorders, or past significant psychiatric history.
To resolve the ethical dilemma of whether living donor candidates with mental health issues should be allowed to donate as is their right or be considered a vulnerable group in need of protection, we need more information. Information should include careful evaluation, possible intervention and follow-up to optimize donation.
批判性地讨论有过去或当前精神病史的活体肾脏捐献者候选人的最新研究,并为这类供体的社会心理评估提供指导。
目前已经达成全球共识,即由于缺乏对捐赠做出明智、理性决定的能力,或在捐赠后维持健康状况的能力,活跃的、严重的精神疾病和药物滥用是器官捐赠的绝对禁忌症。然而,迄今为止,对于有心理健康问题的供体,特别是相对较轻的精神障碍或过去有严重精神病史的供体,在捐赠的适宜性以及捐赠后的长期社会心理和医疗结果方面,发表的信息很少。
为了解决是否应该允许有心理健康问题的活体供体候选人按照自己的意愿捐赠的伦理困境,或者将他们视为需要保护的弱势群体,我们需要更多的信息。这些信息应包括仔细的评估、可能的干预和随访,以优化捐赠。