Whalen Lesta D, Hsu Benson, Nakagawa Thomas A
Department of Pediatrics, University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota.
Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Florida College of Medicine-Jacksonville, Florida.
Pediatr Rev. 2025 Jan 1;46(1):13-23. doi: 10.1542/pir.2023-006307.
Pediatricians follow patients longitudinally and hold a unique position to address multiple issues, medical and psychosocial, that affect organ donation and transplantation. They are wellpositioned to provide anticipatory guidance during well-child visits and during care for children with end-stage organ failure and can either assist these patients with ongoing medical management or refer these patients for organ transplantation assessment. A pediatrician's trusted relationship with families and patients allows for guidance on medical and ethical issues surrounding brain death, organ donation, and transplantation. A clear understanding of end-of-life care, criteria for the determination of neurologic and circulatory death, the process of organ donation, and posttransplant management is vital for pediatricians. The American Academy of Pediatrics (AAP) recognizes and supports the important role of the pediatrician in the global need for organ donation and transplantation awareness. This article, as well as the updated AAP policy on Pediatric Organ Donation and Transplantation and the revised American Academy of Neurology consensus statement for the determination of neurologic death for children and adults, provides guidance to help shape public opinion, public policy, and care of the pediatric organ donor and the transplant recipient.
儿科医生对患者进行长期跟踪，在解决影响器官捐献和移植的多种医学及心理社会问题方面具有独特地位。他们在儿童健康检查期间以及对终末期器官衰竭患儿的护理过程中，能够很好地提供前瞻性指导，既可以协助这些患者进行持续的医疗管理，也可以将这些患者转介进行器官移植评估。儿科医生与家庭及患者之间建立的信任关系，有助于就围绕脑死亡、器官捐献和移植的医学及伦理问题提供指导。对临终关怀、神经和循环系统死亡的判定标准、器官捐献过程以及移植后管理有清晰的认识，对儿科医生至关重要。美国儿科学会（AAP）认识到并支持儿科医生在提高全球器官捐献和移植意识这一需求方面所发挥的重要作用。本文以及更新后的AAP关于儿科器官捐献和移植的政策，还有修订后的美国神经病学学会关于儿童和成人神经死亡判定的共识声明，都为塑造公众舆论、公共政策以及儿科器官捐献者和移植受者的护理提供了指导。
