中国西北地区对心脏死亡后器官捐献的当前态度。

Pan Xiaoming, Liu Linjuan, Xiang Heli, Ding Chenguang, Ren Li, Xue Wujun

Nephropathy Center, First Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China; Institute of Organ Transplantation, First Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China. Email:

Coordination Group of Shaanxi Red Cross Organization, Xi'an, Shaanxi 710018, China.

Chin Med J (Engl). 2014;127(5):835-8.

BACKGROUND

People's attitude toward organ donation after cardiac death (DCD) has not come to an agreement in different countries and regions. Influenced by the local culture in China for thousands of years, the general public has different ideas about this issue. The purpose of this study was to investigate the current attitudes trend and characteristics of transplantation with organs donated after cardiac death in northwest China.

METHODS

This largest single-center cohort study was performed by an interview or by telephone using a questionnaire. The family members of potential DCD donors were recruited from the First Affiliated Hospital, medical college of Xi'an Jiaotong University located in a metropolitan area of northwest China. The 12-item attitude questionnaire was specifically developed from the literature review with coordinator, physician, and donor's family feedback. The participants were asked to rate the queries on a 5-point Likert intensity scale.

RESULTS

The 174 participants included 56 (32.2%) women and 118 (67.8%) men. Most people were aged between 41 and 50 years (n = 63, 36.2%), 31 and 40 years (n = 59, 33.9%), and less than 30 years (n = 36, 20.7%). The top five attitudes of participants were the best person to suggest organ donation to a family was ranked as the DCD coordinator of Red Cross Organization (RCO, n = 160, 92%), donor is a hero (n = 143, 82.2%), honor to be a donor's family member (n = 136, 78.2%), improved relationship with colleagues (n = 124, 71.3%), and with recipient after donation (n = 123, 70.7%). The best person to suggest organ donation to a family was ranked as the coordinator of RCO (n = 160, 92%), doctor unrelated to transplantation (n = 104, 59.8%), social worker (n = 36, 20.7%), and doctor related to transplantation (n = 25, 14.4%). The top two reasons for non-consent to donation were that the family insisted on intact body after patient death and did not want to have surgery again (n = 51, 41.5%), and feared that they would be misunderstood by neighbors, relatives, and friends about donation (n = 28, 22.8%).

CONCLUSIONS

This study revealed initial attitudes toward DCD in China. Some data afford insight into the decision-making procedure. The concerns of potential DCD donors and their families may help professionals provide better interventions in the future.

背景

不同国家和地区的人们对心脏死亡后器官捐献（DCD）的态度尚未达成一致。受中国数千年本土文化的影响，普通公众对这个问题有不同的看法。本研究的目的是调查中国西北地区心脏死亡后器官捐献移植的当前态度趋势和特点。

方法

这项最大规模的单中心队列研究通过访谈或电话问卷的方式进行。潜在DCD捐献者的家属来自位于中国西北大都市地区的西安交通大学医学院第一附属医院。这份包含12个项目的态度问卷是在文献综述的基础上，经协调员、医生和捐献者家属反馈后专门制定的。参与者被要求按照5级李克特强度量表对问题进行评分。

结果

174名参与者中，女性56名（32.2%），男性118名（67.8%）。大多数人的年龄在41至50岁之间（n = 63，36.2%），31至40岁之间（n = 59，33.9%），以及30岁以下（n = 36，20.7%）。参与者的前五种态度是，向家属建议器官捐献的最佳人选被认为是红十字会组织（RCO）的DCD协调员（n = 160，92%），捐献者是英雄（n = 143，82.2%），作为捐献者家属感到荣幸（n = 136，78.2%），与同事关系改善（n = 124，71.3%），以及捐献后与受者关系改善（n = 123，70.7%）。向家属建议器官捐献的最佳人选被认为是RCO协调员（n = 160，92%），非移植相关医生（n = 104，59.8%），社会工作者（n = 36，20.7%），以及移植相关医生（n = 25，14.4%）。不同意捐献的前两个原因是，家属坚持患者死后身体完整，不想再进行手术（n = 51，41.5%），以及担心邻居、亲戚和朋友会因捐献而误解他们（n = 28，22.8%）。