摘要
背景：在許多西方國家，來自於癌末病患所捐贈的眼角膜已經成為眼角膜移植的重要來源。但是在台灣以及其他華人社會，癌末病患捐贈眼角膜卻很少被提及，因此吾人提出報告。 方法：從2004年4月至2007年12月，本院癌症病房的醫護人員徵詢癌末病患捐贈眼角膜的意願。當病患填立同意書之後，醫護人員便照會眼科醫師並檢測VDRL、anti-HIV、anti-HCV、HBsAg、anti-HBs及anti-HBc以排除感染性疾病的可能。當病患過世之後，眼科醫師在十二小時內摘取其眼角膜供移植用。 結果：在研究期間，有九位病患填立同意書，不過最後卻只有三位成功地捐出眼角膜。在其餘六位病患中，一例被查出是B型肝炎帶原而被排除，兩例是眼科醫師擔心癌症轉移而不願意執行手術，兩例是家屬拒絕而無法執行，一例是在死亡前撤除其原先填立的同意書。 結論：癌末病患捐贈眼角膜一事，對於病患本人、家屬和醫護人員都是一件複雜的事。根據吾人有限的經驗，要在台灣推動此一風氣，雖非不可能，但卻是困難重重，因此未來仍有極大的努力空間。
並列摘要
Background: Corneas from donors with systemic malignancies are usually accepted for transplantation and represent a major source of donor material for keratoplasty in many Western countries. Since, corneal donation from cancer patients has not been reported in Taiwan, and it is also rare in other Chinese societies, we report our limited experience. Methods: From April/2004 to Dec/2007, health care professionals (HCPs) in our cancer ward tried to approach the cancer patients there about the option of corneal donation. After obtaining patient consent, we consulted our ophthalmologist to evaluate the eligibility of corneas and checked VDRL, anti-HIV, anti-HCV, HBsAg, anti-HBs and anti-HBc to exclude infectious diseases. After the consenting patients were deceased, the ophthalmologist obtained their corneas within 12 hours. Results: During the study period, 9 terminally ill cancer patients gave their consent. However, corneal procurement succeeded in only three cases. Among the six cases of unsuccessful procurement, one case was an HBV carrier, two cases were not considered qualified by our ophthalmologist, the families of two cases refused the procurement in spite of the donors' consent, and one case withdrew consent. Conclusions: Corneal donation from cancer patients is a complex decision, not only for donors but also for their family members. According to our limited experience, it is difficult but not impossible to encourage cancer patients for corneal donation. However, there is a long way to go in Taiwan.
延伸閱讀
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