随着印度的肝移植之旅达到了相当数量,并提出了高质量的技术专长,现在是冷静看待大局的时候了,发现问题,并考虑未来的纠正措施。若干特征表征当前场景。虽然死者肝脏移植的比例在增加,除了主要的区域失衡,这项活动大量支持私营部门和活体捐赠者移植。该程序的高成本,公立医院参与度低,缺乏国家注册,成果报告是值得关注的问题。当前基于时间顺序或机构轮换的器官共享协议需要转向更可由法院审理的基于严重性的系统。一些措施可以扩大死者的捐赠者池。活着的捐赠者的安全仍然需要密切审查和关注。印度局势特有的多种医疗挑战也被抛出。尽管许多赤字需要国家干预和政策改变,但移植社区需要注意并强调它们。印度肝移植的未来应该朝着更加负责任的方向发展,公平,和可访问的形式。我们应归功于我们的公民,他们通过自愿成为活着的捐助者并同意死者的捐赠,对我们表现出极大的信心。
As the liver transplant journey in India reaches substantial numbers and suggests quality technical expertise, it is time to dispassionately look at the big picture, identify problems, and consider corrective measures for the future. Several features characterize the current scenario. Although the proportion of deceased donor liver transplants is increasing, besides major regional imbalances, the activity is heavily loaded in favor of the private sector and live donor transplants. The high costs of the procedure, the poor participation of public hospitals, the lack of a national registry, and outcomes reporting are issues of concern. Organ sharing protocols currently based on chronology or institutional rotation need to move to a more justiciable severity-based system. Several measures can expand the deceased donor pool. The safety of the living donor continues to need close scrutiny and focus. Multiple medical challenges unique to the Indian situation are also being thrown up. Although many of the deficits demand state intervention and policy changes the transplant community needs to take notice and highlight them. The future of liver transplantation in India should move toward a more accountable, equitable, and accessible form. We owe this to our citizens who have shown tremendous faith in us by volunteering to be living donors as well as consenting for deceased donation.