Donation

捐赠
  • 文章类型: Journal Article
    最大限度地利用循环性死亡(DCD)捐献者捐赠的器官,可以帮助解决器官供应的一些短缺,但这是一个重大挑战,特别是随着器官捐献者和移植接受者随着时间的推移变得越来越老,医学上也越来越复杂。成功取决于建立共同的做法和公认的协议,以允许安全共享DCD器官并最大限度地利用DCD捐赠库。英国移植学会“循环性死亡后已故供体移植指南”最近已更新。本手稿总结了与心胸器官移植相关的章节的相关建议。
    Maximising organ utilisation from donation after circulatory death (DCD) donors could help meet some of the shortfall in organ supply, but it represents a major challenge, particularly as organ donors and transplant recipients become older and more medically complex over time. Success is dependent upon establishing common practices and accepted protocols that allow the safe sharing of DCD organs and maximise the use of the DCD donor pool. The British Transplantation Society \'Guideline on transplantation from deceased donors after circulatory death\' has recently been updated. This manuscript summarises the relevant recommendations from chapters specifically related to transplantation of cardiothoracic organs.
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  • 文章类型: Journal Article
    使用循环性死亡(DCD)供体捐赠的器官移植后的受体结果可以比较有利,甚至可以将移植后的受体结果与脑死亡供体捐赠的器官相匹配。成功取决于建立共同的做法和公认的协议,以允许安全共享DCD器官并最大限度地利用DCD捐赠库。英国移植学会“循环性死亡后已故供体移植指南”最近已更新。本手稿总结了与器官捐赠特别相关的章节的相关建议。
    Recipient outcomes after transplantation with organs from donation after circulatory death (DCD) donors can compare favourably and even match recipient outcomes after transplantation with organs from donation after brain death donors. Success is dependent upon establishing common practices and accepted protocols that allow the safe sharing of DCD organs and maximise the use of the DCD donor pool. The British Transplantation Society \'Guideline on transplantation from deceased donors after circulatory death\' has recently been updated. This manuscript summarises the relevant recommendations from chapters specifically related to organ donation.
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  • 文章类型: Journal Article
    受体从实体器官移植中接受的免疫抑制治疗阻碍了对感染的防御反应。如果不采取适当的预防措施,其从供体的传播会导致移植物功能障碍或丧失,甚至导致接受者死亡。应彻底评估这种潜在风险,以最大程度地减少从供体到受体的感染传播风险。特别是来自感染供体的器官移植,而不会增加移植物功能障碍和受体的发病率和死亡率。本文件旨在回顾有关潜在供体感染筛查的最新知识,并根据现有的科学证据提供有关感染供体器官使用的临床和微生物学建议。
    The immunosuppressive treatment that recipients receive from a solid organ transplantation hinders the defensive response to infection. Its transmission from the donor can cause dysfunction or loss of the graft and even death of the recipient if proper preventive measures are not established. This potential risk should be thoroughly evaluated to minimise the risk of infection transmission from donor to recipient, especially with organ transplantation from donors with infections, without increasing graft dysfunction and morbidity and mortality in the recipient. This document aims to review current knowledge about infection screening in potential donors and offer clinical and microbiological recommendations about the use of organs from donors with infection based on available scientific evidence.
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  • 文章类型: Journal Article
    最近在医学院发表的有关解剖解剖的故事表明,有必要更多地关注解剖教育的道德和政策方面。虽然到目前为止,对这些问题的大部分关注都集中在解剖前后的程序上,从医学生的角度来看,在解剖过程中,有重要的考虑因素。该建议是由两名三年级医学生通过对相关已发表文献的回顾而提出的,反思他们在两个独立机构的解剖学课程中的个人经历,并与同行非正式讨论这些主题。建议是,应建立基本的道德准则,并由负责审查这些准则的独立委员会进行监督。建议的指导方针包括:第一,对学生在解剖学知识和解剖技术方面的预期学习有一套明确的期望;第二,学校或国家机构在尊重捐赠机构的行为方面制定最低道德标准,并将这些标准传达给参与教育解剖的教师和学生;第三,使用鼓励学生尊重他们的捐赠者并确保他们得到适当待遇的材料;第四,建立一个由学生组成的监督小组(在每个医学院和国家一级),教员,社区成员,和工作人员,他们将定期审查解剖学教育计划,并酌情更新这些道德准则。虽然许多这些建议已经在一些解剖学部门实施,在国家和学校层面建立明确的指导方针将允许学生充分参与教育的自由,知道他们已经达到了最高的道德标准,因为他们准备职业生涯作为一个人性化的医生。
    The recent publication of a story regarding anatomical dissection in a medical school has revealed the need for increased attention to the ethical and policy aspects of anatomical education. While most of the attention devoted to these questions thus far has been focused on procedures before and after dissection, from the perspective of medical students, there are important considerations during the process of dissection itself. This proposal was developed by two third-year medical students through a review of the relevant published literature, reflection upon their personal experiences in anatomy courses in two separate institutions, and informal discussion of these topics with peers. The proposal is that basic ethical guidelines should be established and monitored by an independent committee tasked with reviewing them. The proposed guidelines include: First, a clear set of expectations about what the student is expected to learn with respect to anatomical knowledge and dissection technique; second, the establishment by schools or national bodies of minimal ethical standards regarding respectful behavior toward the donor bodies, and the communication of these standards to teachers and students involved in educational dissections; third, the use of materials that encourage students to view their donors with respect and ensure proper treatment of them; and fourth, the establishment of an oversight group (at each medical school and at national level) comprising students, faculty, community members, and staff, who will regularly review the anatomical education program and update these ethical guidelines as appropriate. While many of these proposals are already implemented in some anatomy departments, the establishment of clear guidelines at a national as well as a school-by-school level will permit students the freedom to participate fully in their education, knowing they have met the highest ethical standards as they prepare for a career as a humanistic physician.
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