Department of Medicine, University of British Columbia, Vancouver, Canada.
University of Alberta, Edmonton, Canada.
Am J Kidney Dis. 2014 Jan;63(1):133-40. doi: 10.1053/j.ajkd.2013.08.029. Epub 2013 Nov 5.
Unlike the United States, the potential to increase organ donation in Canada may be sufficient to meet the need for transplantation. However, there has been no national coordinated effort to increase organ donation. Strategies that do not involve payment for organs, such as investment in health care resources to support deceased donor organ donation and introduction of a remuneration framework for the work of deceased organ donation, should be prioritized for implementation. Financial incentives that may be permitted under existing legislation and that pose little risk to existing donation sources should be advanced, including the following: payment of funeral expenses for potential donors who register their decision on organ donation during life (irrespective of the decision to donate or actual organ donation) and removal of disincentives for directed and paired exchange living donation, such as payment of wages, payment for pain and suffering related to the donor surgery, and payment of directed living kidney donors for participation in Canada's paired exchange program. In contrast, it would be premature to contemplate a regulated system of organ sales that would require a paradigm shift in the current approach to organ donation and legislative change to implement.
与美国不同，加拿大增加器官捐献的潜力可能足以满足移植需求。然而，加拿大尚未采取全国性的协调措施来增加器官捐献。应该优先考虑实施不涉及器官付费的策略，例如投资医疗保健资源以支持已故供体器官捐献，并为已故器官捐献者的工作引入薪酬框架。应推进在现有立法下可能允许的、对现有捐献来源风险较小的经济激励措施，包括以下方面：为在生前登记器官捐献决定（无论是否决定捐献或实际捐献器官）的潜在捐献者支付丧葬费，以及消除对定向和配对活体捐献的不利因素，例如支付工资、与捐献者手术相关的疼痛和痛苦的赔偿，以及为参与加拿大配对交换计划的定向活体肾脏捐献者支付报酬。相比之下，考虑实施需要彻底改变当前器官捐献方式并进行立法改革的器官销售监管制度还为时过早。
