Ansari S, Bromberg M B, Gibson S B
University of Utah, School of Medicine, Department of Neurology, Salt Lake City, UT, United States.
Clin Neurol Neurosurg. 2017 Sep;160:125-129. doi: 10.1016/j.clineuro.2017.07.004. Epub 2017 Jul 5.
Patients with Amyotrophic Lateral Sclerosis (ALS) have expressed desire to become living organ donors but are unable to do so with current organ donation policies. Our objective is to assess ALS patient's interest in organ donation, and perceived concerns of this practice by ALS neurologists.
An electronic survey was administered to ALS neurologists across the United States regarding living organ donation in ALS patients prior to respiratory failure.
52 complete responses were received from 121 invites. 67% (35/52) of neurologists expressed no concerns about living organ donation in ALS patients, and 33% had concerns. The concerns related to respiratory failure, anesthesia exposure and renal dysfunction. With their concerns addressed, 71% of neurologists reported that they would endorse living organ donation. 49% of neurologists reported being asked by a patient for information regarding living organ donation. ALS neurologists felt that 22.8% of ALS patients (median 19%) would be interested in learning more about organ donation, while only 6% of neurologists broach this subject with their patients.
Our results indicate that 1 in every 4 ALS patients may be interested in exploring options for living organ donation, and this topic is not routinely addressed by ALS clinics. These results indicate an unexplored area of patient interest. To honor a patient's wishes to donate, the transplant community will have to accommodate living organ donation from terminally ill patients, and address neurologist concerns. Such a practice could benefit two groups of patients.
肌萎缩侧索硬化症(ALS)患者表示希望成为活体器官捐赠者,但现行器官捐赠政策不允许他们这样做。我们的目的是评估ALS患者对器官捐赠的兴趣,以及ALS神经科医生对这种做法的担忧。
针对美国各地的ALS神经科医生进行了一项关于ALS患者在呼吸衰竭前进行活体器官捐赠的电子调查。
在121份邀请中收到了52份完整回复。67%(35/52)的神经科医生表示对ALS患者进行活体器官捐赠没有担忧,33%表示有担忧。担忧涉及呼吸衰竭、麻醉暴露和肾功能障碍。在担忧得到解决后,71%的神经科医生报告称他们会支持活体器官捐赠。49%的神经科医生报告称曾被患者询问有关活体器官捐赠的信息。ALS神经科医生认为22.8%的ALS患者(中位数为19%)会有兴趣了解更多关于器官捐赠的信息,而只有6%的神经科医生会与他们的患者谈及这个话题。
我们的结果表明,每4名ALS患者中可能有1名对探索活体器官捐赠选项感兴趣,而ALS诊所通常不会涉及这个话题。这些结果表明了一个未被探索的患者兴趣领域。为了尊重患者的捐赠意愿,移植界将不得不接纳绝症患者的活体器官捐赠,并解决神经科医生的担忧。这样的做法可能会使两组患者受益。