大愛器官指定捐贈腎臟移植之倫理情境

The Ethical Context of Designated Transplants of Cadaveric Kidneys

賴麗芳(Li-Fang Lai) ； 黃智英(Chih-Ying Huang)

《彰化護理》 27卷4期 (2020/12) Pp. 20-23

https://doi.org/10.6647/CN.202012_27(4).0004

摘要

末期腎臟病人接受透析替代療法，可藉由移植一顆正常的腎臟，脫離透析重新回歸正常生活。腎臟的來源分為大愛捐贈與活體親屬捐贈，依據財團法人器官捐贈移植中心人體器官移植分配及管理辦法，接受大愛捐贈器官病人需以配對排序名單獲得一顆腎臟器官，若大愛捐贈者與受贈者是五親等以內之血親、姻親或配偶可以指定捐贈器官移植給受贈者。本文藉由收集資料經移植醫療團隊合作模式與專業臨床判斷進行病人與家屬對大愛（屍體）器官指定捐贈移植流程之倫理情境探討，來提供最有益於個案及家屬之醫療照護抉擇。

並列摘要

Patients with end-stage renal disease receiving dialysis therapy can return to a normal life after undergoing renal transplantation. The source of kidneys is divided as cadaveric (Da- Ai) organ donation and living relatives' donation. Taiwan organ registry and sharing center stipulates the regulations for organ allocation and management. The priority of cadaveric organ transplantation is determined by the matching score between the donor and the patient on the waiting list. However, if the donor and the person to be transplanted are among the fifth-degree relatives or spouses, a designated transplant can be performed. This article collects data and discusses the ethical context in the process of designated donation of cadaver organs through the cooperation model of the transplant medical team and professional clinical judgments, so as to provide the most beneficial medical care choices for the patients and family members.

並列關鍵字

designated organ donation ； medical choice ； donation after circulatory death

參考文獻

杜明勳、黃資雅、陳如意、曾馨慧、鍾瑞美、林璊鸚(2016）．末期病人撤除維生醫療-某醫學中心之經驗．安寧療護雜誌，21（3），289-303。https://doi.org/10.6537/TJHPC.2016.21(3).4

黃馨保、蔡甫昌(2019)．循環停止死亡後器官捐贈之倫理與法律議題．台灣醫學，23(4)，413-424。https://doi.org/10.6320/FJM.201907_23(4).0001

蘇思憓、吳麗敏（2018）．重症病患決策代理人之醫療決策行為意向及其相關因素探討．護理雜誌，65（2），32-42。 https://doi.org/10.6224/JN.201804_65(2).06

Kok, V. C. (2015). Compassionate extubation for a peaceful death in the setting of a community hospital: a case-series study.Clinical Interventions in Aging, 10, 679-685. https://doi.org/10.2147/CIA.S82760

財團法人器官捐贈移植登錄中心(2015，7月1日)．人體器官移植條例。 https://www.torsc.org.tw/docDetail.jsp?uid=25&pid=8&doc_id=984&rn=934473224