Department of Nephrology and Transplantation, University Hospitals Birmingham, Birmingham, United Kingdom.
Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom.
Transpl Int. 2022 Apr 7;35:10339. doi: 10.3389/ti.2022.10339. eCollection 2022.
Improving organ acceptance and utilization rates is critical to ensure we maximize usage of donated organs as a scarce resource. Many factors underlie unnecessary discard of viable organs. Declined transplantation opportunities for candidates is associated with increased wait-list mortality. Technological advancements in organ preservation may help bridge the gap between donation and utilization, but an overlooked obstacle is the practice of risk aversion by transplant professionals when decision-making under risk. Lessons from behavioral economics, where experimental work has outlined the impact of loss or risk aversion on decision-making, have not been translated to transplantation. Many external factors can influence decision-making when accepting or utilizing organs, which are potentially amendable if external conditions are improved. However, attitudes and perceptions to risk for transplant professionals can pervade decision-making and influence behaviour. If we wish to change this behavior, then the underlying nature of decision-making under risk when accepting or utilizing organs must be studied to facilitate the design of targeted behavior change interventions to convert risk aversion to risk tolerance. To ensure optimal use of donated organs, we need more research into decision-making under risk.
提高器官接受率和利用率对于确保我们最大限度地利用捐赠器官这一稀缺资源至关重要。许多因素导致有活力的器官被不必要地丢弃。候选者的移植机会减少与等待名单上的死亡率增加有关。器官保存方面的技术进步可能有助于缩小捐赠和利用之间的差距，但一个被忽视的障碍是移植专业人员在风险决策下的避险做法。行为经济学的经验教训已经概述了损失或风险规避对决策的影响，但这些经验教训尚未转化为移植领域。在接受或利用器官时，许多外部因素会影响决策，如果外部条件得到改善，这些决策是可以调整的。然而，移植专业人员对风险的态度和看法会影响决策行为。如果我们希望改变这种行为，那么就必须研究在接受或利用器官时的风险决策的本质，以便设计有针对性的行为改变干预措施，将风险规避转化为风险容忍。为了确保捐赠器官的最佳利用，我们需要对风险下的决策进行更多的研究。
