Grenvik A
Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh School of Medicine and Health Center, PA.
Crit Care Med. 1988 Oct;16(10):1012-8. doi: 10.1097/00003246-198810000-00014.
Since the first successful organ transplantation in 1953, we have seen an explosive development in transplantation surgery, particularly during the 1980s. With it followed an abundance of legal controversies and ethical dilemmas. Optimal use of viable organs necessitated precise definition of brain death in heart-beating cadavers with artificially maintained ventilation and circulation. Viable organs must remain well perfused to be suitable for procurement and transplantation into carefully selected recipients on an equal-opportunity basis. Due consideration must be given to both medical and social indications. At present, homografts dominate the field of organ transplantation; however, because of the shortage of human organs, both artificial organs (especially hearts) and xenografts are expected to become increasingly common in the near future. No doubt, the use of such modern technology will introduce additional ethical problems.
自1953年首次成功进行器官移植以来，我们目睹了移植手术的迅猛发展，尤其是在20世纪80年代。随之而来的是大量的法律争议和伦理困境。要优化使用可存活器官，就必须精确界定在通过人工维持通气和循环的心跳尸体中的脑死亡。可存活器官必须保持良好的灌注，才适合获取并在机会均等的基础上移植给精心挑选的受者。必须充分考虑医学和社会指征。目前，同种移植在器官移植领域占据主导地位；然而，由于人体器官短缺，人工器官（尤其是心脏）和异种移植在不久的将来预计会越来越普遍。毫无疑问，使用此类现代技术将带来更多的伦理问题。
