Department of Pediatrics, University of Chicago, Chicago, IL.
J Pediatr. 2021 Aug;235:6-9. doi: 10.1016/j.jpeds.2021.05.046. Epub 2021 May 21.
Historically, individuals with intellectual disability and end-stage organ disease were discriminated against by transplant professionals and often excluded from transplantation waitlists. Despite antidiscrimination legislation, some transplant programs continue to include intellectual disability as a relative, if not an absolute, contraindication to listing for an organ; this is true for both pediatric and adult individuals in end-stage organ disease. This commentary opposes the absolute exclusion of patients with intellectual disability and end-stage organ disease from transplantation waitlists provided that the candidates are expected to gain a predefined minimum benefit threshold of life-years and quality-adjusted-life years. Intellectual disability is one of many factors that should be considered in determining transplant eligibility and each candidate should have an individualized interdisciplinary assessment.
从历史上看，智障患者和终末期器官疾病患者受到移植专业人员的歧视，往往被排除在移植等候名单之外。尽管有反歧视立法，但一些移植项目仍将智力障碍作为相对禁忌症，即使不是绝对禁忌症，也将其列入器官移植等候名单；对于患有终末期器官疾病的儿童和成人患者来说，情况都是如此。本评论反对将智障和终末期器官疾病患者绝对排除在移植等候名单之外，前提是候选人预计将获得预先确定的最低生存年限和质量调整生存年限的获益阈值。智力障碍是决定移植资格的众多因素之一，每个候选人都应该进行个体化的跨学科评估。
