Abstract：
Burkholderia cenocepacia (B cenocepacia) is a gram-negative bacteria associated with significant morbidity and mortality following lung transplantation. Most US transplant programs consider B cenocepacia colonization to be an absolute contraindication to transplantation. This article argues that, if clinicians have good clinical reasons to expect poor outcomes for patients with B cenocepacia, then offering transplantation anyway is an abrogation of clinicians\' fiduciary duties. This article also discusses other fiduciary obligations transplant programs might have to patients with B cenocepacia, such as referring to another transplant center, considering novel treatment options, and investigating how the infection\'s virulence factors stratify that patient\'s risk for poor transplant outcomes.
摘要：
伯克霍尔德氏菌（Bcinocepacia）是一种革兰氏阴性菌，与肺移植后的高发病率和死亡率相关。大多数美国移植计划认为Bcinocacia定植是移植的绝对禁忌症。本文认为,如果临床医生有很好的临床理由预计Bcenocapacia患者的预后不佳，那么无论如何提供移植是对临床医生信托职责的废除。本文还讨论了移植计划可能对B患者的其他信托义务，比如提到另一个移植中心，考虑到新的治疗选择，并调查感染的毒力因子如何对患者移植结果不佳的风险进行分层。
