Spital A
University of Rochester School of Medicine, New York 14607, USA.
Transplantation. 1996 Feb 15;61(3):374-7. doi: 10.1097/00007890-199602150-00007.
Stimulated by a severe organ shortage and an improving ability to successfully transplant poorly matched donor-recipient pairs, many transplant centers are now willing to accept emotionally related (but genetically unrelated) people (e.g., spouses) as kidney donors. To see whether this practice is encouraged, a survey was mailed to all 209 adult renal transplant centers in the United States. Of the 154 (74%) responding centers, 90% said they accept emotionally related donors and 60% said they actually encourage this practice. Nearly 40% prefer spouses to cadavers, while only 21% prefer friends to cadavers. To further explore the degree to which emotionally related donation is encouraged, a second questionnaire was sent to a sample of centers (n = 51) that support this practice; 94% responded. While only 44% said they encourage the use of friends, nearly all of these preselected centers said they encourage spouses to donate. On the other hand, judging from their stated approach to this issue, only about half of these supportive centers seem to actively encourage emotionally related donation. These data suggest that, overall, at most only about one third of U.S. transplant centers actively encourage spousal donation and at most about one quarter encourage the use of friends. Consistent with these results, emotionally related donors contribute only a small fraction of all kidneys transplanted in this country. If the large potential contribution of emotionally related donors is ever to be realized, transplant centers must go beyond simply accepting such individuals and begin to actively encourage their participation. Medical and ethical considerations strongly support this proposal.
受严重的器官短缺以及成功移植配型不佳的供受者对的能力不断提高的刺激，许多移植中心现在愿意接受有情感关系（但无血缘关系）的人（如配偶）作为肾脏供体。为了解这种做法是否受到鼓励，向美国所有209家成人肾移植中心邮寄了一份调查问卷。在154家（74%）回复的中心中，90%表示他们接受有情感关系的供体，60%表示他们实际上鼓励这种做法。近40%的中心更喜欢配偶供体而非尸体供体，而只有21%的中心更喜欢朋友供体而非尸体供体。为了进一步探究鼓励有情感关系捐赠的程度，向支持这种做法的一部分中心（n = 51）发送了第二份问卷；94%的中心回复了。虽然只有44%的中心表示他们鼓励使用朋友作为供体，但几乎所有这些预先选定的中心都表示他们鼓励配偶捐赠。另一方面，从他们对这个问题的既定态度来看，这些支持性中心中似乎只有大约一半积极鼓励有情感关系的捐赠。这些数据表明，总体而言，美国最多只有约三分之一的移植中心积极鼓励配偶捐赠，最多约四分之一的中心鼓励使用朋友作为供体。与这些结果一致的是，有情感关系的供体在该国所有移植的肾脏中所占比例很小。如果要实现有情感关系的供体的巨大潜在贡献，移植中心必须不仅仅是简单地接受这些人，而是要开始积极鼓励他们参与。医学和伦理考量强烈支持这一建议。
