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在急诊科实现心脏死亡后捐赠:克服临床、法律和伦理问题。

Enabling Donation after Cardiac Death in the Emergency Department: Overcoming Clinical, Legal, and Ethical Concerns.

作者信息

Dailey Michael, Geary Sean P, Merrill Stefan, Eijkholt Marleen

机构信息

Department of Emergency Medicine, Albany Medical Center Hospital, Albany, New York.

Department of Medical Humanities, Davidson College, Davidson, North Carolina.

出版信息

J Emerg Med. 2017 Apr;52(4):588-592. doi: 10.1016/j.jemermed.2016.11.025. Epub 2017 Jan 19.

Abstract

BACKGROUND

In light of the growing gap between candidates for organ donation and the actual number of organs available, we present a unique case of organ donation after cardiac death. We hope to open a discussion regarding organ procurement from eligible donors in the prehospital and emergency department setting.

CASE

This case study, involving an otherwise healthy man who, after suffering an untimely death, was able to successfully donate his organs, highlights the need to develop an infrastructure to make this type of donation a viable and streamlined option for the future.

DISCUSSION

Given the departure from traditional practice in United States transplantation medicine, we bring forth legal and ethical considerations regarding organ donation in the emergency department. We hope that this case discussion inspires action and development in the realm of transplant medicine, with the aim of honoring the wishes of donors and the families of those who wish to donate in a respectful way, while using our medical skills and technologies to afford candidates who are waiting for organs a second chance.

CONCLUSIONS

We believe that this case shows that donation after cardiac death from the emergency department, while resource-intensive is feasible. We recognize that in order for this to become a more attainable goal, additional resources and systems development is required.

摘要

背景

鉴于器官捐赠候选者与实际可用器官数量之间的差距日益增大,我们呈现一例心脏死亡后器官捐赠的独特案例。我们希望开启一场关于在院前和急诊科环境中从符合条件的捐赠者获取器官的讨论。

病例

本案例研究涉及一名原本健康的男子,在意外死亡后成功捐赠了他的器官,凸显了建立一种基础设施以使此类捐赠在未来成为可行且简化选项的必要性。

讨论

鉴于与美国移植医学传统做法的背离,我们提出了关于急诊科器官捐赠的法律和伦理考量。我们希望这个案例讨论能激发移植医学领域的行动和发展,目的是以尊重的方式尊重捐赠者及其家属的意愿,同时运用我们的医疗技能和技术为等待器官的候选者提供第二次机会。

结论

我们认为该案例表明,尽管急诊科心脏死亡后的捐赠资源密集,但却是可行的。我们认识到,为了使其成为一个更可实现的目标,需要额外的资源和系统开发。

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