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利用不匹配的活体肾脏捐赠者交换匹配的肾脏:与肾脏交换链相关的法律和伦理问题。

BARTERING FOR A COMPATIBLE KIDNEY USING YOUR INCOMPATIBLE, LIVE KIDNEY DONOR: LEGAL AND ETHICAL ISSUES RELATED TO KIDNEY CHAINS.

作者信息

Tenenbaum Evelyn M

出版信息

Am J Law Med. 2016;42(1):129-69. doi: 10.1177/0098858816644719.

Abstract

Kidney chains are a recent and novel method of increasing the number of available kidneys for transplantation and have the potential to save thousands of lives. However, because they are novel, kidney chains do not fit neatly within existing legal and ethicalframeworks, raising potential barriers to their full implementation. Kidney chains are an extension of paired kidney donation, which began in the United States in 2000. Paired kidney donations allow kidney patients with willing, but incompatible, donors to swap donors to increase the number of donor/recipient pairs and consequently, the number of transplants. More recently, transplant centers have been using non-simultaneous, extended, altruistic donor ("NEAD") kidney chains--which consist of a sequence of donations by incompatible donors--to further expand the number of donations. This Article fully explains paired kidney donation and kidney chains and focuses on whether NEAD chains are more coercive than traditional kidney donation to a family member or close friend and whether NEAD chains violate the National Organ Transplant Act's prohibition on the transfer of organs for valuable consideration.

摘要

肾脏链是一种新近出现的增加可用于移植的肾脏数量的创新方法,有挽救数千人生命的潜力。然而,由于其新颖性,肾脏链并不完全符合现有的法律和伦理框架,这对其全面实施构成了潜在障碍。肾脏链是配对肾脏捐赠的延伸,配对肾脏捐赠于2000年在美国开始。配对肾脏捐赠允许有意愿但不匹配的肾脏患者交换捐赠者,以增加捐赠者/受赠者对的数量,从而增加移植数量。最近,移植中心一直在使用非同时、延长、利他性捐赠者(“NEAD”)肾脏链——由不匹配的捐赠者进行的一系列捐赠组成——以进一步扩大捐赠数量。本文全面解释了配对肾脏捐赠和肾脏链,并重点探讨了NEAD链是否比向家庭成员或亲密朋友进行的传统肾脏捐赠更具强制性,以及NEAD链是否违反了《国家器官移植法》关于禁止以有价值的对价转让器官的规定。

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