Latour T
Memorial Lutheran Hospital in Milwaukee, Wis., USA.
Nephrol News Issues. 1998 Aug;12(8):41-3.
UNOS reported that the number of cadaveric organs procured in 1997 was 5,429, virtually unchanged from the previous year. Meanwhile, the number of patients waiting for an organ transplant, the majority of them dialysis patients, has topped 50,000. How do we make up for the disparity in demand versus the supply? The Department of Health and Human Services has announced a new initiative to increase donation by 20%. And a new HCFA regulation now requires hospitals to report all deaths to its designated organ procurement organization in an effort to identify more potential organ donors. The method has proven successful in improving organ procurement in two states already. But studies have shown that improving organ donation has more deep-seated obstacles: a public that supports organ donation in surveys and polls but may not carry through on the actual donation when a loved one is a potential candidate, and a medical staff that is not trained or remains uncomfortable with asking families to donate at a time of grieving. Should we simplify the process and institute presumed consent laws or strengthen the legal utility of the organ donor card? In this section, dialysis patient Theodore Latour, now awaiting a donor kidney, suggests we take a more aggressive approach resembling presumed consent. Two transplant coordinators--Alesha Sinclair, RN, CCTC, and Pete Walczak, RN, CCTC--offer a response to his views.
器官共享联合网络（UNOS）报告称，1997年获取的尸体器官数量为5429个，与上一年基本持平。与此同时，等待器官移植的患者人数，其中大多数是透析患者，已超过5万。我们如何弥补供需差距呢？卫生与公众服务部宣布了一项新举措，旨在将捐赠量提高20%。而且，医疗保健财务管理局（HCFA）的一项新规定现在要求医院向其指定的器官获取组织报告所有死亡情况，以便识别更多潜在的器官捐赠者。该方法已在两个州成功提高了器官获取量。但研究表明，改善器官捐赠存在更多深层次障碍：在调查和民意测验中支持器官捐赠的公众，在亲人成为潜在捐赠候选人时，可能不会实际进行捐赠；以及未接受过培训或在亲人悲痛时仍不愿向家属提出捐赠请求的医务人员。我们应该简化流程并制定推定同意法，还是加强器官捐赠卡的法律效力呢？在本节中，正在等待肾移植的透析患者西奥多·拉图尔建议我们采取一种更积极的类似推定同意的方法。两位移植协调员——注册护士、认证临床移植协调员阿莱莎·辛克莱和彼得·瓦尔恰克——对他的观点作出了回应。
