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Organ: System must be carried out 'gradually and cautiously' "With matching recipients, the hospital that procures organ donations should at least have one organ harvested and transplanted for its own patient," he said. The other organs donated are allocated first in the city and then the province. But Gao stressed that putting all organ donations through the allocation system will become standard procedure. "That should be regulated by the health authority and requires a matching mechanism to facilitate supervision by the Red Cross," Gao urged. He was concerned whether the coming mandate would hurt hospitals' enthusiasm, as they might fear that the organ donations they procure could be used by other hospitals. "More time and caution is needed for related issue planning and implementation," he said, pointing out that China's organ donation system was just getting off the ground and scaled up nationwide after a three-year trial in various regions. Regarding the inconsistency between local practice and national policy, Wang Haibo said the policy should not simply be altered based on individual preference. The suggestion for policy revision should be subjected to review and approval by the China national organ donation expert committee. Men Tongyi, a leading kidney transplant surgeon at Qiaofoshan Hospital in Jinan, Shandong province, agreed, adding that step-by-step progress is more practical. He conceded that they had not yet turned to the system for allocation. "The provincial Red Cross is now in charge of the allocation and sharing of organ donations within Shandong," he said. Of the nearly 100 kidney transplants performed in the hospital last year, 13 were deceased public organ donations, procured by the hospital and others. Li Peng, a doctor at the procurement center of the General Hospital of Guangzhou Military Command of the PLA, thought otherwise. "We've long been waiting for such a regulation," he said. Without the system, "how can we ensure fair allocation and bolster public willingness to donate", he noted. When asked by donor families if the organs only go to the rich and powerful, "I can firmly say 'no' and show them the system", he said. The first to use the system, the hospital has performed nearly 40 public deceased organ donations since 2011 involving about 100 organs, he revealed. Nearly half went to other hospitals and some even went outside Guangdong via the system. However, "we never received one from others", he complained. He urged quick introduction of the regulation to address the problem, which he said is caused primarily by poor awareness and hospital-based organ allocation.
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目前，為了鼓勵(lì)器官捐獻(xiàn)和移植醫(yī)院，獲取器官的醫(yī)院在該器官分配中享有優(yōu)先權(quán)。且在有匹配的器官接受病人的情況下，至少獲得一個(gè)器官在本院內(nèi)進(jìn)行移植手術(shù)，高介紹說。 “其余的器官將首先在市內(nèi)，然后在省內(nèi)按照遠(yuǎn)近，病人情況和病人等待時(shí)間等因素綜合進(jìn)行分配，”高說。 但統(tǒng)一進(jìn)入系統(tǒng)進(jìn)行分配，將是未來的趨勢，他說。 “其實(shí)現(xiàn)必須由衛(wèi)生行政部門來進(jìn)行規(guī)定，且需要紅十字會(huì)的監(jiān)督”，他對媒體表示。 但對此新規(guī)，高也表示擔(dān)憂，它是否會(huì)影響醫(yī)院對于器官捐獻(xiàn)的積極性。 “醫(yī)院可能會(huì)擔(dān)心自己費(fèi)力獲取的器官卻被分配到別的醫(yī)院進(jìn)行使用，”他解釋道。 解決他們的顧慮，需要更多的時(shí)間和教育，他補(bǔ)充道。 “畢竟我們的器官捐獻(xiàn)事業(yè)才只進(jìn)行了三年的試點(diǎn)，剛剛鋪開全國，”他說。 山東省千佛山醫(yī)院腎移植科主任門同義也表示，這一規(guī)定的實(shí)施應(yīng)該循序漸進(jìn)，不可一蹴而就。 門同義所在的醫(yī)院從未使用系統(tǒng)進(jìn)行過捐獻(xiàn)器官的分配。 據(jù)他介紹，目前山東省內(nèi)的捐獻(xiàn)器官是由省紅會(huì)同意分配的。 去年，千佛山醫(yī)院共實(shí)施100多例腎臟移植，包括13例來自公民捐獻(xiàn)。這其中有本院獲取的，也有外醫(yī)院獲取而被分配到該院的。 廣州軍區(qū)廣州總醫(yī)院醫(yī)生李鵬則認(rèn)為，這一規(guī)定早就應(yīng)該實(shí)施了。 據(jù)了解，廣州軍區(qū)廣州總醫(yī)院早在2005年就開始開展公民逝世后器官捐贈(zèng)工作，并于2006年初實(shí)施了該院首例公民逝世后器官捐贈(zèng)，2011年六月國內(nèi)首家器官獲取組織在廣州軍區(qū)廣州總醫(yī)院宣告成立。標(biāo)志著我國器官捐獻(xiàn)過程中器官獲取工作開始逐步走向科學(xué)和規(guī)范。 作為該院器官獲取組織的成員，李鵬認(rèn)為不使用系統(tǒng)分配器官，難以保證分配的公平，不易于公眾的信任建立，影響其捐獻(xiàn)的意愿。 有了系統(tǒng)，每每有捐獻(xiàn)者家屬詢問我是否將捐獻(xiàn)了的器官都給了有權(quán)有錢的人時(shí)，“我就會(huì)說不，并且給他們講國家的分配系統(tǒng)，”他說。 不過他也坦言，到目前為止使用這一系統(tǒng)的醫(yī)院仍不多。 作為中國首家使用這一系統(tǒng)進(jìn)行器官分配的醫(yī)院，從2011年起，廣州軍區(qū)總醫(yī)院已經(jīng)累計(jì)實(shí)施了40多例公民身后器官捐獻(xiàn)，包括100多個(gè)器官。 這其中，有近一半經(jīng)由系統(tǒng)分配到別的醫(yī)院進(jìn)行移植，李醫(yī)生介紹說。 “這里還有外省的醫(yī)院，”他說。但是，李所在的醫(yī)院卻從未接收過系統(tǒng)分配來的，別的醫(yī)院獲取的器官。 究其原因，李鵬表示，還是使用系統(tǒng)的醫(yī)院不夠多。 他敦促衛(wèi)生行政部門盡快實(shí)施這一規(guī)定，以確保系統(tǒng)的廣泛，充分使用。 他表示，長期以來的以醫(yī)院為中心的器官分配的方式和觀念阻礙了系統(tǒng)的推廣和廣泛使用。 黃潔夫認(rèn)同其觀點(diǎn)，表示未來將加強(qiáng)相關(guān)的醫(yī)療人員的培訓(xùn)。 “沒有醫(yī)院和醫(yī)務(wù)人員的理解和支持，器官捐獻(xiàn)和分配也難以推進(jìn)?！秉S潔夫說。 （中國日報(bào)記者 單娟） （本文為編譯，英文刊發(fā)于4月12日版《中國日報(bào)》） |
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