Van Bakel A B
Department of Medicine, Medical University of South Carolina, Charleston 29425-2221, USA.
Am J Med Sci. 1997 Sep;314(3):153-63. doi: 10.1097/00000441-199709000-00004.
In the previous 2 decades, there have been many advances in the treatment of coronary and valvular heart disease. However, these treatments remain imperfect, and more patients are surviving only to have congestive heart failure develop later in life. During the same 2 decades, advances in surgical techniques and immunosuppression made cardiac transplantation the treatment of choice for severe, end-stage heart failure. Despite concomitant legislation designed to promote organ donation, there remains a severe shortfall in the number of organ donors compared with the number of potential recipients. This article discusses identification of the potential organ donor, assessment of the heart for donation, medical management of the brain-dead organ donor from pronouncement to procurement, and finally, some of the ethical issues raised in the wake of further efforts to increase the potential donor pool.
在过去的20年里，冠心病和心脏瓣膜病的治疗取得了许多进展。然而，这些治疗仍存在不足，越来越多的患者存活下来，但随后在晚年患上了充血性心力衰竭。在同一20年期间，手术技术和免疫抑制方面的进展使心脏移植成为严重终末期心力衰竭的首选治疗方法。尽管有旨在促进器官捐赠的相关立法，但与潜在受者的数量相比，器官捐赠者的数量仍然严重短缺。本文讨论了潜在器官捐赠者的识别、供体心脏的评估、从宣布脑死亡到器官获取过程中脑死亡器官捐赠者的医疗管理，最后还讨论了在进一步努力增加潜在捐赠者库之后引发的一些伦理问题。
