Department of Paediatric Nephrology, Great Ormond Street Hospital for Children, London, UK.
NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health, London, UK.
Pediatr Transplant. 2022 Nov;26(7):e14331. doi: 10.1111/petr.14331. Epub 2022 Jul 18.
Professionals working in pediatric transplantation commonly encounter complex ethical dilemmas. Most ethical research in transplantation is related to adult practice. We aimed to gain insight into ethical issues faced by transplant professionals when dealing with pediatric transplant recipients.
A two-stage study was designed; the first part was a questionnaire completed by 190 (80%) members of the International Pediatric Transplant Association (IPTA) from over 30 different countries. This was followed by a multidisciplinary focus group that explored the preliminary data of the survey.
A total of 38% (56 of 149) respondents of the questionnaire had experienced an ethical issue between 2016 and 2018. Surgeons were more likely to have encountered an ethical issue as compared with physicians (60% vs. 35.7%, p = .035). Clinicians from Europe were more likely to have experienced an ethical issue in living organ donation compared with those from North America (78.9% vs. 52.5%, p = .005), with common ethical concerns being psychosocial evaluation and follow-up care of donors. The focus group highlighted the importance of a multidisciplinary approach to ethical issues.
The results of this study can direct future research into pediatric transplantation ethics with the aim of producing educational resources, policies, and ethical guidelines.
从事儿科移植工作的专业人员经常会遇到复杂的伦理困境。大多数与移植相关的伦理研究都与成人实践有关。我们旨在深入了解移植专业人员在处理儿科移植受者时所面临的伦理问题。
设计了一个两阶段的研究；第一部分是由来自 30 多个不同国家的 190 名（80%）国际儿科移植协会（IPTA）成员完成的问卷。随后进行了多学科焦点小组讨论，以探讨调查的初步数据。
共有 149 名问卷回答者中的 38%（56 名）在 2016 年至 2018 年期间遇到了伦理问题。与内科医生相比，外科医生更有可能遇到伦理问题（60%比 35.7%，p=0.035）。与来自北美的医生相比，来自欧洲的临床医生更有可能在活体器官捐献中遇到伦理问题（78.9%比 52.5%，p=0.005），常见的伦理问题是对供体的社会心理评估和随访护理。焦点小组强调了多学科方法处理伦理问题的重要性。
这项研究的结果可以指导未来儿科移植伦理学的研究，旨在产生教育资源、政策和伦理准则。
