Bruzzone P
Sapienza Università di Roma, Rome, Italy.
Transplant Proc. 2012 Sep;44(7):1857-8. doi: 10.1016/j.transproceed.2012.05.065.
ELPAT (Ethical, Legal, and Psychologic Aspects of Organ Transplantation) coordinated the distribution to European liver transplant centers of an electronic questionnaire regarding the definition of extended-criteria liver donation (ECD) and its implication for informed consent by transplant recipients. Completed questionnaires were received from 30 centers in 13 countries including 28 who accepted ECD liver donors. The criteria to define a liver donor as ECD were: steatosis in 24 centers (85%); age up to 80 years in 23 centers (82%); serum sodium >165 mmol/L in 17 centers (60%); ICU stay with ventilation >7 days in 16 centers (57%); serum glutamic oxaloacetic transaminas >90 U/L, in 12 centres (42%); body mass index >30 kg/m(2) in 10 centers (35%); serum glutamate pyruvate transaminase >105 U/L in 10 centers (35%); serum bilirubin >3 mg/dL in 10 centers (35%); and other criteria in 13 centers (46%). Twenty-three centers informed the transplant candidate of the ECD status of the donor: 10 (43%) when the patient registered for transplantation, 3 (14%) when an ECD liver became available, and 10 (43%) on both occasions. Ten centers required the liver transplant candidate to sign a special consent form. Ten centers informed the potential recipient of the donor's serology. Only 3 centers informed the potential recipient of any high-risk behavior of the donor.
器官移植的伦理、法律和心理问题(ELPAT)协调向欧洲肝脏移植中心分发了一份电子调查问卷,内容涉及扩大标准肝脏捐赠(ECD)的定义及其对移植受者知情同意的影响。来自13个国家的30个中心回复了完整问卷,其中28个中心接受ECD肝脏供体。将肝脏供体定义为ECD的标准如下:24个中心(85%)为脂肪变性;23个中心(82%)供体年龄达80岁;17个中心(60%)血清钠>165 mmol/L;16个中心(57%)在重症监护病房接受机械通气超过7天;12个中心(42%)血清谷草转氨酶>90 U/L;10个中心(35%)体重指数>30 kg/m²;10个中心(35%)血清谷丙转氨酶>105 U/L;10个中心(35%)血清胆红素>3 mg/dL;13个中心(46%)有其他标准。23个中心向移植候选人告知了供体的ECD状态:10个中心(43%)在患者登记移植时告知,3个中心(14%)在有ECD肝脏可用时告知,10个中心(43%)在上述两种情况下均告知。10个中心要求肝脏移植候选人签署一份特殊同意书。10个中心向潜在受者告知了供体的血清学情况。只有3个中心向潜在受者告知了供体的任何高危行为。