Daniels D E, Smith K, Parks-Thomas T, Gibbs D, Robinson J
Department of Applied Health Science at Indiana University, Bloomington, USA.
Ann Transplant. 1998;3(2):22-4.
The Task Force on Organ Transplantation (DHHS,1986) addressed the issue of increasing organ donation. The Report of the Task Force recommended that "educational efforts aimed at increasing organ donation among minority populations be developed and implemented, so that the donor population will more closely reflect the ethnicity of potential transplant recipients, in order to gain the advantage of improved donor and recipient immunologic matching (DHHS,1986). Donor rates for minorities has increased as follows: 16% in 1988 to 23% in 1995 among cadaveric donors and 24% in 1988 to 28% in 1995 among living donors. The improvement in donor rates among minorities may positively affect the transplantation success rate experienced by organ recipients of the same race. Strategies must be implemented that will increase the effectiveness and frequency of communication between minority patients and the medical community. An increase in the effectiveness of communication between potential minority donor families and the health care community will contribute to the process of Consciousness Raising as discussed by Prochasksa. The result of increased awareness of the organ donation and transplantation process may have a favorable impact on organ donation. The media has, through public service announcements, paid advertising and entertainment programming, attempted to promote discussion of organ donation in the community and within families. Johnson et al. discussed Mexican-American and Anglo-American Attitudes Toward Organ Donation. The primary impediment contributing to the disparity of consent rates between Mexican-American and Anglo-American population occurs with regard to the donation of organs of relatives. Johnson stated that this impediment to organ donation can be effectively addressed by promoting family discussion. Communication within families will inform surviving next of kin of the desire of the deceased to be an organ donor and hence improve the likelihood of the donor family consenting to organ donation (Johnson et al., 1988). The promotion of communication within families must continue to be a goal of the transplant community regardless of race/ethnicity. Despite the efforts of the government, the transplant community, the media and the corporate sector to address the critical shortage of donors in the United States, the reality is that no community has the supply of donor organs suitable to meet the need.
器官移植特别工作组(美国卫生与公众服务部,1986年)探讨了增加器官捐赠的问题。特别工作组的报告建议“开展并实施旨在增加少数族裔群体器官捐赠的教育活动,以使捐赠者群体能更紧密地反映潜在移植受者的种族构成,从而获得改善供体与受体免疫匹配的优势(美国卫生与公众服务部,1986年)。少数族裔的捐赠率增长如下:尸体捐赠者中,从1988年的16%增至1995年的23%;活体捐赠者中,从1988年的24%增至1995年的28%。少数族裔捐赠率的提高可能会对同种族器官接受者的移植成功率产生积极影响。必须实施相关策略,以提高少数族裔患者与医疗界之间沟通的有效性和频率。潜在的少数族裔捐赠者家庭与医疗保健界之间沟通有效性的提高,将有助于如普罗查斯卡所讨论的提高意识的进程。器官捐赠和移植过程意识的提高可能会对器官捐赠产生有利影响。媒体通过公益广告、付费广告和娱乐节目,试图在社区和家庭内部推动对器官捐赠的讨论。约翰逊等人讨论了墨西哥裔美国人和英裔美国人对器官捐赠的态度。导致墨西哥裔美国人和英裔美国人同意率存在差异的主要障碍在于亲属器官捐赠方面。约翰逊指出,通过促进家庭讨论可以有效解决这一器官捐赠障碍。家庭内部的沟通将告知在世的近亲死者希望成为器官捐赠者的意愿,从而提高捐赠者家庭同意器官捐赠的可能性(约翰逊等人,1988年)。无论种族/族裔如何,促进家庭内部沟通都必须继续作为移植界的目标。尽管政府、移植界、媒体和企业部门都努力解决美国捐赠者严重短缺的问题,但现实情况是,没有哪个社区的捐赠器官供应能满足需求。