Olawade David B, Marinze Sheila, Qureshi Nabeel, Weerasinghe Kusal, Teke Jennifer
Department of Allied and Public Health, School of Health, Sport and Bioscience, University of East London, London, United Kingdom; Department of Research and Innovation, Medway NHS Foundation Trust, Gillingham ME7 5NY, United Kingdom.
Department of Surgery, Medway NHS Foundation Trust, Gillingham ME7 5NY, United Kingdom.
Eur J Intern Med. 2025 Mar;133:14-24. doi: 10.1016/j.ejim.2024.11.010. Epub 2024 Nov 20.
Organ transplantation is a critical medical procedure that saves and improves lives, yet the system faces significant challenges that result in many missed opportunities. This comprehensive review examines the factors contributing to these missed opportunities and the concerns of potential donors. The shortage of donors remains a major issue, exacerbated by low registration rates, family consent refusals, and strict medical and health criteria. Inefficiencies within the organ procurement and transplantation process, including logistical delays and suboptimal matching systems, further hinder the availability of organs. Public misconceptions and cultural and religious beliefs also negatively impact donor willingness. Moreover, potential donors and their families face ethical, psychological, and procedural concerns. Ethical dilemmas revolve around issues of autonomy and informed consent, while psychological concerns include fear and anxiety about the donation process and its impact on families. Procedural issues, such as transparency, legal hurdles, and post-donation follow-up, add to the complexities of organ donation. This review explores potential solutions to address these challenges, such as enhancing public education campaigns to dispel myths, and providing incentives for proactive registration. It also recommends improving the performance of organ procurement organizations, optimizing logistics for organ transport, and developing advanced matching algorithms to ensure equitable organ allocation. Addressing donor concerns through robust ethical standards, comprehensive psychological support, and clear communication strategies is essential. By adopting these multifaceted strategies, the organ transplantation system can be made more efficient and supportive, increasing the availability of organs and ultimately saving more lives. This review underscores the need for integrated and targeted approaches to overcome the existing barriers in organ transplantation.
器官移植是一项挽救和改善生命的关键医疗程序,但该系统面临着重大挑战,导致许多机会错失。本全面综述探讨了导致这些机会错失的因素以及潜在捐赠者的担忧。捐赠者短缺仍然是一个主要问题,低登记率、家属同意拒绝以及严格的医学和健康标准加剧了这一问题。器官获取和移植过程中的低效,包括后勤延误和不理想的匹配系统,进一步阻碍了器官的供应。公众的误解以及文化和宗教信仰也对捐赠者意愿产生了负面影响。此外,潜在捐赠者及其家属面临伦理、心理和程序方面的担忧。伦理困境围绕着自主和知情同意问题,而心理方面的担忧包括对捐赠过程及其对家庭影响的恐惧和焦虑。程序问题,如透明度、法律障碍和捐赠后随访,增加了器官捐赠的复杂性。本综述探讨了应对这些挑战的潜在解决方案,例如加强公众教育活动以消除误解,并提供积极登记的激励措施。它还建议提高器官获取组织的绩效,优化器官运输物流,并开发先进的匹配算法以确保公平的器官分配。通过强有力的伦理标准、全面的心理支持和清晰的沟通策略来解决捐赠者的担忧至关重要。通过采用这些多方面的策略,可以使器官移植系统更高效且更具支持性,增加器官的供应并最终挽救更多生命。本综述强调需要采取综合和有针对性的方法来克服器官移植中现有的障碍。