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站在亚洲看世界:亚洲视角下脑死亡器官捐献的可持续健康发展

江文诗. 站在亚洲看世界:亚洲视角下脑死亡器官捐献的可持续健康发展[J]. 器官移植, 2022, 13(6): 697-710. doi: 10.3969/j.issn.1674-7445.2022.06.003
引用本文: 江文诗. 站在亚洲看世界:亚洲视角下脑死亡器官捐献的可持续健康发展[J]. 器官移植, 2022, 13(6): 697-710. doi: 10.3969/j.issn.1674-7445.2022.06.003
Jiang Wenshi. With a focus on Asia and a global perspective: sustainable development of donation after brain death[J]. ORGAN TRANSPLANTATION, 2022, 13(6): 697-710. doi: 10.3969/j.issn.1674-7445.2022.06.003
Citation: Jiang Wenshi. With a focus on Asia and a global perspective: sustainable development of donation after brain death[J]. ORGAN TRANSPLANTATION, 2022, 13(6): 697-710. doi: 10.3969/j.issn.1674-7445.2022.06.003

站在亚洲看世界:亚洲视角下脑死亡器官捐献的可持续健康发展

doi: 10.3969/j.issn.1674-7445.2022.06.003
基金项目: 

中欧器官捐献领导力培训与专业技术输送计划项目 573787-EPP-1-2016-ES-EPPKA2-CBHE-JP

详细信息
    通讯作者:

    江文诗,硕士,研究方向为器官与组织捐献,Email:wenshi.jiang@hotmail.com

  • 中图分类号: R617, R19

With a focus on Asia and a global perspective: sustainable development of donation after brain death

More Information
  • 摘要: 器官短缺是全球移植界面临的共同难题,世界卫生组织呼吁所有国家通过减少疾病负担和扩充符合伦理原则的有效器官来源以实现器官移植的自给自足。在全球范围内,脑死亡器官捐献(DBD)仍是移植器官的主要来源。近几年,包括中国在内的一些亚洲国家积极推动死亡器官捐献事业的发展,这些举措正逐步改变亚洲地区以活体捐献为移植器官主要来源的格局。2020年新型冠状病毒肺炎疫情的暴发放缓了全球器官捐献和移植数量近十年的增长趋势。在疾病负担和移植需求未有显著降低的前提下,我国器官捐献和移植工作在“人民至上,生命至上,坚持动态清零”的疫情防控总方针和相关政策的指引下稳步开展。这一定程度证明了在人民群众医疗诉求和移植需求的持续驱动下,我国已经形成一个有韧性的、有抗压能力的、并具运作惯性且行业赖以生存的器官捐献与移植工作体系。站在中国看亚洲,站在亚洲看世界。本文通过整理全球及亚洲器官捐献与移植相关数据,重点剖析在全球器官移植发展新潮流下亚洲器官捐献和移植整体格局的变化,并结合我国自身发展特征及实践经验,探索脑死亡器官捐献的影响因素,并提出针对性的应对策略,以期为亚洲及我国器官捐献和移植的可持续健康发展提供专业参考。

     

  • 图  1  全球各大器官移植器官来源分布

    Figure  1.  Donor source of organ transplantation in the world

    图  2  全球器官捐献发展趋势

    Figure  2.  Global trends in organ donation

    图  3  Global trends in organ donation

    Figure  3.  Proportion of living kidney transplantation and liver transplantation by continents

    图  4  亚洲肾移植和肝移植器官来源分布

    Figure  4.  Donor source of kidney transplantation and liver transplantation in Asia

    图  5  2019年和2020年亚洲各国肾移植器官来源分布

    注:国家顺序按 2020 年器官移植例数降序排列。

    Figure  5.  Donor source of kidney transplantation by Asian countries (2019 vs. 2020)

    图  6  亚洲各国活体肾移植的比例

    Figure  6.  Proportion of living donor kidney transplantation by Asian countries

    图  7  2019年和2020年亚洲各国肝移植器官来源分布

    注:国家顺序按 2020 年器官移植例数降序排列。

    Figure  7.  Donor source of liver transplantation by Asian countries (2019 vs. 2020)

    图  8  亚洲各国活体肝移植的比例

    Figure  8.  Proportion of living donor liver transplantation by Asian countries

    图  9  2020年亚洲各国DBD比例与活体肾移植和肝移植比例

    注:中国、巴基斯坦、格鲁吉亚、亚美尼亚尚未进行脑死亡立法;印度、韩国、土耳其、日本、伊朗、泰国、沙特阿拉伯、以色列、斯里兰卡、叙利亚、马来西亚、孟加拉国、菲律宾、约旦、阿联酋、新加坡、科威特、蒙古、卡塔尔已进行脑死亡立法。

    Figure  9.  Proportion of DBD vs. living donor kidney transplantation and liver transplantation by Asian countries in 2020

    图  10  2020年全球每百万人口年捐献率

    注: 红色字体的国家为亚洲国家。

    Figure  10.  Global organ donation per million population in 2020

    图  11  全球各大洲DBD比例

    Figure  11.  Proportion of DBD by continents

    图  12  亚洲各国DBD比例

    Figure  12.  Proportion of DBD by Asian countries

    图  13  全球、美国、欧洲、亚洲和中国的供者类型比例

    Figure  13.  Proportion of donor type in the world, the United States, Europe, Asia and China

    表  1  13个亚洲国家脑死亡判定实践

    Table  1.   Brain death determination practice in 13 Asian countries

    国家 捐献同意制度 是否有判定指南 是否通过立法 判定人数(人) 是否要求AT 是否要求辅助试验
    中国 选择加入 2
    伊朗 选择加入 3
    韩国 选择加入 4~6
    印度 选择加入 4
    泰国 选择加入 3
    土耳其 推定同意 4
    斯里兰卡 选择加入 2
    以色列 选择加入 2
    日本 选择加入 2
    沙特阿拉伯 选择加入 2
    马来西亚 选择加入 2
    科威特 选择加入 3
    新加坡 选择加入和选择退出 2
    注:①为自主呼吸激发试验。
    ②为1岁以下儿童需要进行2次脑电图检查。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2022-07-06
  • 网络出版日期:  2022-11-14
  • 刊出日期:  2022-11-15

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