Bendorf Aric, Kerridge Ian H, Stewart Cameron
Crit Care. 2013 May 23;17(3):316. doi: 10.1186/cc12553.
Organ donation after brain death provides the most important source for deceased organs for transplantation, both because of the number of potential organ donors that it makes available and also because of the unparalleled viability of the organs retrieved. Analysis of worldwide deceased organ donation rates demonstrates that all countries with high deceased organ donation rates (>20 donors per million population per year) have high brain death rates (>40 brain deaths per million population per year). This analysis makes it clear that countries striving to increase their deceased organ donor rates to world leading levels must increase the rates of donation after brain death. For countries with end-of-life care strategies that stress palliation, advance care planning and treatment withdrawal for the terminally ill, the adoption of initiatives to meaningfully raise deceased donor rates will require increasing the rate at which brain death is diagnosed. This poses a difficult, and perhaps intractable, medical, ethical and sociocultural challenge as the changes that would be required to increase rates of brain death would mean conjugating an intimate clinical and cultural focus on the dying patient with the notion of how this person's death might be best managed to be of benefit to others.
脑死亡后的器官捐献是 deceased 器官移植最重要的来源，这既是因为它能提供潜在器官捐献者的数量，也是因为所获取器官具有无与伦比的活力。对全球 deceased 器官捐献率的分析表明，所有 deceased 器官捐献率高的国家（每年每百万人口中捐献者超过20人）脑死亡率都高（每年每百万人口中脑死亡超过40人）。这一分析清楚地表明，努力将 deceased 器官捐献率提高到世界领先水平的国家必须提高脑死亡后的捐献率。对于那些临终关怀策略强调姑息治疗、预先护理计划和为绝症患者撤掉治疗的国家，要切实提高 deceased 捐献率，就需要提高脑死亡诊断率。这带来了一个困难的，甚至可能是棘手的医学、伦理和社会文化挑战，因为提高脑死亡率所需的改变意味着要将对临终患者密切的临床和文化关注与如何最好地利用此人的死亡造福他人的观念结合起来。
