Lansom Joshua D, Rowe Simon, Sandroussi Charbel, Harrison James D, Solomon Michael, McCaughan Geoffrey, Crawford Michael
St George Hospital, Sydney, New South Wales, Australia.
Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
ANZ J Surg. 2017 Mar;87(3):177-181. doi: 10.1111/ans.12839. Epub 2014 Sep 11.
This study aimed to (i) investigate the factors that influence donor and recipient decision making in adult-to-adult living donor liver transplantation (AALDLT); (ii) quantify the level of risk that would be acceptable to potential donors; and (iii) determine from whom an individual would be willing to receive a donation.
A self-administered questionnaire using hypothetical scenarios centred on AALDLT was created and administered to participants recruited from the waiting room of an orthopaedic outpatient clinic at a teaching hospital in Sydney (n = 105). The questionnaire asked participants to consider scenarios in which they either (i) were a potential donor for a family member or close friend or (ii) themselves required a liver transplant.
Ninety-five (90%) participants expressed an in-principal willingness to consider living organ donation. The factors most important in deciding to be living liver donors were the probability of a good outcome for the recipient, the likelihood of the potential recipient's survival until a deceased donor liver became available and the risk of donor death. Donor death was also rated as the least acceptable donor outcome. Participants expressed a willingness to receive a donation from all proposed donor groups equally.
The acceptability of hypothetical living organ donation was very high in the population group studied. Participants were also willing to accept significantly higher risks of complications from organ donation than they would actually be exposed to. Clinicians should feel encouraged to discuss the risks and benefits of living donation frankly with patients and their families.
本研究旨在：（i）调查影响成人活体肝移植（AALDLT）中供体和受体决策的因素；（ii）量化潜在供体可接受的风险水平；（iii）确定个体愿意接受谁的捐赠。
设计了一份以AALDLT为中心的假设情景的自填式问卷，并对从悉尼一家教学医院骨科门诊候诊室招募的参与者进行了调查（n = 105）。问卷要求参与者考虑以下情景：（i）他们是家庭成员或亲密朋友的潜在供体，或（ii）他们自己需要肝移植。
九十五名（90%）参与者表示原则上愿意考虑活体器官捐赠。决定成为活体肝供体最重要的因素是受体有良好结局的可能性、潜在受体存活至有 deceased donor liver可用的可能性以及供体死亡风险。供体死亡也被评为最不可接受的供体结局。参与者表示愿意平等地接受所有提议的供体组的捐赠。
在所研究的人群中，假设的活体器官捐赠的可接受性非常高。参与者也愿意接受比他们实际可能面临的更高的器官捐赠并发症风险。临床医生应受到鼓励，与患者及其家属坦率地讨论活体捐赠的风险和益处。
