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器官捐献与选择性通气:一项必要策略。

Organ Donation and Elective Ventilation: A Necessary Strategy.

作者信息

Escudero Dolores, Otero Jesus, Menéndez de León Begoña, Perez-Basterrechea Marcos

机构信息

Intensive Care Unit, Central University Hospital of Asturias, Oviedo, Spain; Unit of Transplants, Cell Therapy and Regenerative Medicine, Central University Hospital of Asturias, Oviedo, Spain.

Unit of Transplants, Cell Therapy and Regenerative Medicine, Central University Hospital of Asturias, Oviedo, Spain.

出版信息

Biomed Res Int. 2017;2017:7518375. doi: 10.1155/2017/7518375. Epub 2017 Jan 15.

Abstract

Organ transplantation is the sole treatment to improve or save the life of patients with final-stage organ failure. The shortage of available organs for transplantation constitutes a universal problem, estimating that 10% of patients on waiting lists die. Brain death is an undesirable result; nevertheless, it has beneficial side-effects since it is the most frequent source of organs for transplantation. However, this phenomenon is relatively uncommon and has a limited potential. One of the options that focuses on increasing organ donation is to admit patients with catastrophic brain injuries (with a high probability of brain death and nontreatable) to the Intensive Care Unit, with the only purpose of donation. To perform elective nontherapeutic ventilation (ENTV), a patient's anticipated willingness to donate organs and/or explicit acceptance by his/her relatives is required. This process should focus exclusively on those patients with catastrophic brain injuries and imminent risk of death which, due to its acute damage, are not considered treatable. This article defends ENTV as an effective strategy to improve donation rate, analyzing its ethical and legal basis.

摘要

器官移植是改善或挽救终末期器官衰竭患者生命的唯一治疗方法。可用于移植的器官短缺是一个全球性问题,据估计,等待名单上10%的患者会死亡。脑死亡是一个不良结果;然而,它也有有益的副作用,因为它是最常见的移植器官来源。然而,这种现象相对不常见,潜力有限。关注增加器官捐赠的选择之一是将患有灾难性脑损伤(脑死亡可能性高且无法治疗)的患者收入重症监护病房,唯一目的是进行器官捐赠。要进行选择性非治疗性通气(ENTV),需要患者预期的器官捐赠意愿和/或其亲属的明确接受。这个过程应该只针对那些患有灾难性脑损伤且即将死亡的患者,由于其急性损伤,这些患者不被认为是可治疗的。本文将ENTV作为提高捐赠率的有效策略进行辩护,并分析其伦理和法律依据。

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