Rowiński W, Ostrowski K, Adadyński L, Barcikowska B, Lao M, Lisik W, Lagiewska B, Madej K, Michalak G, Wałaszewski J
Transplantation Institute, Warsaw, Poland.
Ann Transplant. 1996;1(1):18-22.
The shortage of donor organs has been the main obstacle to the expansion of transplantation programs. Recent public opinion survey documented acceptance of the cadaveric kidney procurement in our country but some reluctance to brain death and presumed consent concepts. Recently, the survey was carried out within the medical community to find out whether the level of knowledge and the attitude toward donation has an influence on the slow development of the transplantation program. A questionnaire was addressed to: 1010 general practitioners, neurosurgeons and anesthesiologists; 926 ICU and neurosurgical nurses and 1760 students of 12 medical schools of the country. Vast majority of doctors, nurses and last year medical students accept retrieval and transplantation of kidneys and the heart, but not of the liver. Acceptance of this procedure among junior medical students and university students was lower (78% vs 98%). Most of the respondents would agree to donate their kidneys and other organs, but 20% would protest against harvesting of the organs from their relatives. 100% of the physicians and 80% of medical students and nurses accept the brain death concept(which is accepted only by 60% of non medical university students) but only 44% of the doctors are prepared to switch off the respirator after diagnosis of brain death if harvesting is not taking place. Only half of the physicians would notify the transplantation unit about the possibility of organ retrieval. The reasons mentioned for such decision included fear of negative judgment of the local community and problems with deceased relatives. 60% of physicians talking to the family about retrieval would ask for the relatives' consent despite the fact, that the transplantation law in Poland is based on the presumed consent of each individual. The results of the knowledge survey among medical students documented inadequate medical education concerning problems of transplantation. Educational campaign is needed to promote and extend the cadaveric organ transplantation in our country.
供体器官短缺一直是移植项目扩大的主要障碍。最近的一项民意调查显示，我国民众接受尸体肾获取，但对脑死亡和推定同意的概念有些抵触。最近，在医学界开展了一项调查，以了解知识水平和对捐赠的态度是否对移植项目的缓慢发展有影响。向1010名全科医生、神经外科医生和麻醉医生、926名重症监护病房和神经外科护士以及该国12所医学院的1760名学生发放了问卷。绝大多数医生、护士和即将毕业的医科学生接受肾脏和心脏的获取及移植，但不接受肝脏的获取及移植。低年级医科学生和大学生对这一程序的接受度较低（分别为78%和98%）。大多数受访者会同意捐献自己的肾脏和其他器官，但20%的人会反对从其亲属身上摘取器官。100%的医生、80%的医科学生和护士接受脑死亡概念（只有60%的非医科大学生接受这一概念），但只有44%的医生在诊断脑死亡后且不进行器官获取时准备关掉呼吸机。只有一半的医生会通知移植单位器官获取的可能性。做出这种决定的原因包括担心当地社区的负面评价以及与已故亲属相关的问题。尽管波兰的移植法基于每个人的推定同意，但60%与家属谈论器官获取事宜的医生仍会征求亲属的同意。对医科学生的知识调查结果表明，关于移植问题的医学教育不足。我国需要开展教育活动来促进和扩大尸体器官移植。
