Lee Grace S, Potluri Vishnu S, Reese Peter P
aDepartment of Surgery, Hospital of the University of Pennsylvania bDepartment of Medical Ethics and Health Policy cRenal-Electrolyte and Hypertension Division, Department of Medicine, Hospital of the University of Pennsylvania dCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Curr Opin Organ Transplant. 2017 Apr;22(2):184-188. doi: 10.1097/MOT.0000000000000389.
Imminent death donation (IDD) is a proposal to procure organs from patients prior to the withdrawal of life support, which is anticipated to lead to death. In this review, we outline substantial concerns that the transplant community should consider when deliberating the possibility of practicing IDD.
Although there are several compelling theoretical and intuitive reasons to support IDD, its application has been hindered because of inadequate definitions or protocols. A lack of published reports limits empirical data about the practice. Discussion on the topic has not adequately addressed potential harms to the donor, involvement of stakeholders, or the threat to public trust.
Although IDD has been proposed as a method to increase the number of organs or improve end-of-life care, the proposal currently poses more risk than benefit for patients and the transplant community. Until the major barriers to implementation of IDD are addressed, the transplant community should invest its efforts to increase the organ supply elsewhere.
即将死亡捐献（IDD）是一项在撤除生命支持之前从患者身上获取器官的提议，预计这将导致患者死亡。在本综述中，我们概述了移植界在考虑实施IDD可能性时应考虑的重大问题。
尽管有几个令人信服的理论和直观理由支持IDD，但由于定义或方案不完善，其应用受到了阻碍。缺乏已发表的报告限制了关于该做法的实证数据。关于该主题的讨论尚未充分解决对捐赠者的潜在危害、利益相关者的参与或对公众信任的威胁。
尽管IDD已被提议作为增加器官数量或改善临终护理的一种方法，但目前该提议对患者和移植界带来的风险大于益处。在IDD实施的主要障碍得到解决之前，移植界应致力于在其他方面增加器官供应。
