Shafer T, Schkade L L, Warner H E, Eakin M, O'Connor K, Springer J, Jankiewicz T, Reitsma W, Steele J, Keen-Denton K
LifeGift Organ Donation Center of North Texas, Fort Worth 76107.
JAMA. 1994;272(20):1607-13.
The object of this research is to determine the nature and extent of the loss of donor organs during a 3-year period that are otherwise medically suitable for organ transplantation owing to nonrelease by a local medical examiner or coroner.
In a retrospective study of the effects of medical examiner/coroner donor release practices, a detailed survey was mailed to every organ procurement organization (OPO) in the United States. This survey collected specific data (eg, number of cases denied per year), as well as descriptive information.
Of the 2670 organ donors reported by 39 OPO respondents in 1990, 62.1% were medical examiner cases, and 129 (7.2%) of these cases were denied recovery by the local medical examiner/coroner. The number of denials increased to 181 (9.6% of medical examiner cases) in 1991 and to 251 (11.4% of medical examiner cases) in 1992. It is estimated that the population of medical examiner/coroner denials from 1990 through 1992 may be as many as 884. Twenty percent of the OPO respondents reported that no cases were denied recovery by a local medical examiner/coroner. A comparative analysis reveals that the proportion of total reported potential medical examiner/coroner cases that were denied increased by 65% from 1990 to 1992, while medical examiner/coroner cases released declined slightly.
Since an average of 3.37 organs were recovered per donor in 1992, it is possible that as many as 2979 people may have been denied transplants from 1990 through 1992 owing to medical examiners'/coroners' denials. There were no donor denials in 10 geographical areas of the United States, nor was there any instance of violation of case law or any documentation of flawed autopsies or collection of forensic evidence in donor cases released. These two factors suggest that the loss of human life from denials is not needed to protect the judicial process. Increased cooperation between medical examiner offices and OPOs could significantly increase the availability of transplantable organs.
本研究的目的是确定在三年期间，因当地法医或验尸官未放行而在医学上适合器官移植的供体器官损失的性质和程度。
在一项关于法医/验尸官供体放行做法影响的回顾性研究中，向美国的每个器官获取组织（OPO）邮寄了一份详细的调查问卷。该调查收集了具体数据（例如每年被拒绝的案例数量）以及描述性信息。
1990年，39个OPO受访者报告的2670名器官供体中，62.1%是法医案例，其中129例（7.2%）被当地法医/验尸官拒绝回收。1991年，拒绝数量增加到181例（占法医案例的9.6%），1992年增加到251例（占法医案例的11.4%）。据估计，1990年至1992年期间被法医/验尸官拒绝的案例数量可能多达884例。20%的OPO受访者报告称，没有案例被当地法医/验尸官拒绝回收。一项比较分析显示，从1990年到1992年，报告的潜在法医/验尸官案例中被拒绝的比例增加了65%，而被放行的法医/验尸官案例略有下降。
由于1992年每个供体平均回收3.37个器官，从1990年到1992年，可能多达2979人因法医/验尸官的拒绝而被拒绝移植。美国10个地理区域没有供体被拒绝的情况，也没有违反判例法的情况，也没有在放行的供体案例中存在有缺陷的尸检或法医证据收集的记录。这两个因素表明，为保护司法程序而导致的生命损失并非必要。法医办公室与OPO之间加强合作可以显著增加可移植器官的供应量。
