White Sarah L, Hirth Richard, Mahíllo Beatriz, Domínguez-Gil Beatriz, Delmonico Francis L, Noel Luc, Chapman Jeremy, Matesanz Rafael, Carmona Mar, Alvarez Marina, Núñez Jose R, Leichtman Alan
Sydney Medical School, Charles Perkins Centre, The University of Sydney, New South Wales 2006, Australia .
Department of Health Management and Policy, University of Michigan, Ann Arbor, United States of America (USA).
Bull World Health Organ. 2014 Nov 1;92(11):826-35. doi: 10.2471/BLT.14.137653. Epub 2014 Aug 22.
Rising incomes, the spread of personal insurance, lifestyle factors adding to the burden of illness, ageing populations, globalization and skills transfer within the medical community have increased worldwide demand for organ transplantation. The Global Observatory on Donation and Transplantation, which was built in response to World Health Assembly resolution WHA57.18, has conducted ongoing documentation of global transplantation activities since 2007. In this paper, we use the Global Observatory's data to describe the current distribution of - and trends in - transplantation activities and to evaluate the role of health systems factors and macroeconomics in the diffusion of transplantation technology. We then consider the implications of our results for health policies relating to organ donation and transplantation. Of the World Health Organization's Member States, most now engage in organ transplantation and more than a third performed deceased donor transplantation in 2011. In general, the Member States that engage in organ transplantation have greater access to physician services and greater total health spending per capita than the Member States where organ transplantation is not performed. The provision of deceased donor transplantation was closely associated with high levels of gross national income per capita. There are several ways in which governments can support the ethical development of organ donation and transplantation programmes. Specifically, they can ensure that appropriate legislation, regulation and oversight are in place, and monitor donation and transplantation activities, practices and outcomes. Moreover, they can allocate resources towards the training of specialist physicians, surgeons and transplant coordinators, and implement a professional donor-procurement network.
收入增加、个人保险普及、生活方式因素加重疾病负担、人口老龄化、全球化以及医学界的技能转移，这些因素使得全球范围内对器官移植的需求不断上升。全球捐赠与移植观察站是应世界卫生大会第WHA57.18号决议而设立的，自2007年以来一直在持续记录全球移植活动。在本文中，我们利用该观察站的数据来描述当前移植活动的分布情况及趋势，并评估卫生系统因素和宏观经济因素在移植技术传播中的作用。然后，我们思考研究结果对器官捐赠和移植相关卫生政策的影响。在世界卫生组织的成员国中，大多数国家目前都开展了器官移植活动，2011年有超过三分之一的国家进行了尸体捐赠移植。总体而言，开展器官移植的成员国比未开展器官移植的成员国更容易获得医生服务，人均卫生总支出也更高。尸体捐赠移植的开展与高人均国民收入水平密切相关。政府可以通过多种方式支持器官捐赠和移植项目的道德发展。具体而言，政府可以确保制定适当的立法、监管和监督措施，并对捐赠和移植活动、做法及结果进行监测。此外，政府可以将资源分配用于培训专科医生、外科医生和移植协调员，并建立专业的供体获取网络。
