淮南市及周边人群遗体与器官捐献现状调查

遗体及器官捐献是当今社会的热点话题,也是难点问题。而遗体通过制作人体标本用于教学、科研,是医学院校的必备,其来源的短缺一定程度上影响了医学的发展。随着现代医学技术的飞速发展,器官移植技术日益成熟,但器官供体的短缺成为了制约器官移植技术发展的重要因素。通过对淮南市及周边地区的问卷调查,了解到关于该地区遗体及器官捐赠的现状,呼吁广大人民群众积极支持遗体及器官捐献,共同努力促进遗体及器官捐献事业的健康发展,为社会医疗卫生事业和医学教育事业做出贡献。     

成都市大学生遗体捐献意愿调查及影响原因分析

目的 旨在了解成都市大学生对于遗体捐献意愿的现状及其影响捐献意愿的主要原因.方法 采用随机抽样方法,选取成都医学院,西南石油大学、四川农业大学、成都理工大学、成都中医药大学这五所高校716名大学生作为调查对象,应用自制问卷调查表进行调查与分析.结果 结果显示,在调查者中99.1％的成都市大学生对遗体捐献有不同程度的了解,但仅有39.9％的成都市大学生知道遗体捐献机构及12％知道遗体捐献流程.其次,87.9％的成都市大学生赞同遗体捐献,在不赞同遗体捐献中排首要原因的是担心遗体遭受不尊重.并且54.7％的成都市大学生认为遗体捐献应该有一定补偿,愿意接受的补偿方式中排首位的是本人或亲属享受移植器官时的优先治疗权.结论 相关部门应拓展大学生对于遗体捐献机构、遗体捐献流程等的了解,出台相应政策法规以及和各级医疗部门沟通合作,提高遗体捐献率.     

基于医学背景下内蒙古医科大学师生对遗体和 器官捐献的认知及意愿调查*

遗体捐献是指自然人在死亡后,由执行人依照其意愿或者由直系亲属将遗体的全部或部分捐献给医学科学事业的行为;。遗体捐献是社会文明进步的体现,也是爱和生命的延续。此外,遗体和器官捐献在医学教育、科研发展及医疗救治等领域有着至关重要的作用,医学生尊称遗体捐献者为"无言良师"或"大体老师"。     

浅析我国的遗体捐献立法

遗体捐献一般是指自然人生前自愿表示在死亡后,由其执行人将遗体的全部或部分捐献给医学事业的行为,以及生前未表示是否捐献意愿的自然人死亡后,由其近亲属将遗体的全部或部分捐献给医学科学事业的行为[1].遗体捐献对推动社会与医疗卫生事业的发展有重要作用.特别是对医学院校而言,遗体捐献是学校尸体标本的主要来源,而医学院校可供使用的标本数量远不能满足教学和科研的需要[2].法律具有规范作用和社会作用,完善的遗体捐献立法体系可以有效推动遗体捐献的发展.本文通过阅读分析相关文献以及现有的法律法规,分析我国遗体捐献立法的现状以及问题,希望在法律层面对我国遗体捐献提出建议,推动我国遗体捐献立法的完善和遗体捐献事业的发展.     

拓展遗体捐献工作,促进解剖学教学

尸体解剖在医学生培养过程中具有举足轻重的作用,遗体捐献为解剖学发展的前提,而目前我国的遗体捐献现状并不乐观,严重制约的医学教学的发展。本校通过成立遗体捐献接收站,完善接收程序等措施,提高了当地的遗体捐献率,取得了一定成效,并就存在的问题进行了探讨。     

在校医学生器官移植与捐献态度及认知的调查

背景：在校医学生对器官移植的认知与态度影响着整个社会对器官移植和捐献的认知,进而影响中国器官捐献移植工作的进程。 目的：调查在校医学生对人体器官移植与捐献的态度与认知。 方法：选择济宁医学院400名学生为被试进行问卷调查。内容主要包括：①对器官移植、器官(遗体)捐献知识的掌握程度。②器官移植、器官(遗体)捐献知识的来源。③对捐献器官(遗体) 所持态度。 结果与结论：69.8%在校医学生了解器官移植捐献概念,44.6%赞成捐献自己身后器官。说明在校医学生能较好认同器官移植作为治疗终末期器官功能衰竭的有效手段,但对器官捐献所持态度不很乐观,影响其捐献态度的主要因素为家属情感和捐献程序和传统观念。一年级赞同率最低,为26.6%,五年级最高,为61.4%,赞同率随着年级的升高而增加,55.6%的在校医学生认为应该给予器官捐献者一定的奖励或补偿。     

中国遗体捐献的过去、现在与未来

解剖实验课程的顺利进行离不开遗体,遗体捐献是国内大体标本的主要来源。自20世纪70年代起,志愿遗体捐献在国内逐步推广,为解剖教学的开展和医学生的培养提供了重要支持。本文从早期起步、伦理与法律、资料统计与问卷调查、人文关怀与人文教育、问题与对策5个方面,对中国遗体捐献的实施与研究情况进行了文献回顾,为国内遗体捐献事业的发展提供参考与借鉴。     

中国传统文化和观念对器官捐献意愿的影响分析

背景：中国需要接受器官移植的患者数量还以每年超过10%的增量扩大,由于缺乏公民自愿捐献,中国较世界其他国家面临着更为严峻的供体短缺问题。导致目前中国器官供体短缺的具体原因是什么？中国公民究竟如何看待遗体器官捐献,他们对遗体器官捐献的态度如何？是哪些因素影响了中国公民遗体器官捐献行为的实施？目的：了解中国传统观念对中国公民逝世后器官捐献意愿的影响程度。方法：采用随机整群抽样法,选取来自不同社会阶层的900名接受问卷调查者为研究对象,应用自制的公众对人体器官捐献的认知、态度和行为调查表进行问卷调查。结果与结论：①有55.16%的民众认为进行器官捐献的主要目的是想帮助他人,有24.22%的民众认为进行器官捐献的主要目的是一种社会公德的体现,11.94%的民众认为进行器官捐献其实是自己生命的延续。②有70.00%的民众认为捐献的器官应该用于器官移植事业,以便挽救更多患者的生命,其平均得分为 2.53 分;而建议将捐献器官应用于医学教学用和病理解剖用的比较接近,平均得分依次为 1.72 和 1.75。③有65.01%的民众支持采取心肺死亡的标准来判断人死亡,24.33%的民众支持采取脑死亡的标准判断人死亡,还有10.66%的民众认为不清楚采取什么方式。④有50.52%的民众认为影响器官捐献的主要因素是中国传统文化和观念的影响,其次是捐献程序和家属感情。调查结果发现,中国传统文化和观念是影响民众进行器官捐献的主要因素,大部分民众认为以心肺死亡的标准来判断人死亡为最佳方法,认为捐献器官的主要目的是想帮助别人,捐献的器官应首先应用于器官移植,以便挽救更多的生命。 中国组织工程研究杂志出版内容重点：肾移植;肝移植;移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植;组织工程全文链接：     

风雨兼程20载:北京志愿遗体捐献总结与展望

遗体是解剖实验课程顺利开展的必要条件,遗体捐献项目是中国教学用遗体的重要来源。1999年,北京协和医学院、首都医科大学、北京大学医学部三家遗体捐献站成立,开启了北京市遗体捐献的新纪元。本文对20年来北京市志愿遗体捐献进行总结与展望,为中国遗体捐献的运行与发展提供参考。     

构建中国人体器官捐献社会宣教系统的策略

背景：分析中国目前人体器官移植所面临的困境及导致器官移植供体短缺的社会影响因素,发现民众对器官移植及捐献流程相关知识普遍缺乏。 目的：从器官捐献宣教系统构建的重大意义、现状总结、应遵循的伦理原则以及建议对策等4个方面进行了尝试性探索,为科学地进行器官捐献的宣传教育提供建议与参考。 方法：在CNKI和PubMed通过关键词“器官捐献、器官移植、伦理学原则、宣传教育”查阅相关文献,对来源于核心期刊的文章进行综合分析。以“器官捐献,器官移植,伦理原则,供体短缺,遗体捐献,宣传教育”为中文捡索词,以“organ donation,organ transplantation,shortage of donor,body donation,education system”为英文检索词,检索维普和中国知网(CNKI)期刊全文数据库万方、Pubmed,Medline,2005年1月至2014年11月有关器官捐献报告中主要涉及器官捐献宣传教育及协调员的相关报道。通过对文献归纳,总结分析目前中国器官捐献宣教的现况,提出构建器官捐献宣教系统的对策。 结果与结论：详细阐述了器官捐献宣教系统的必要性,系统分析了国内目前器官捐献宣传教育存在的问题及应该遵循的伦理原则,探索了国内器官捐献宣教系统建设应采取的路径和方法。缓解器官移植供体紧张,扩大供体来源,必须要赢得公民的广泛支持与理解,才能保证器官捐献工作的可持续发展。因此构建人体器官捐献社会宣教体系具有重要意义。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

Minority donation in the United States

Background and Objective  In the United States, approximately 15 million whole blood products are collected each year from 10 million volunteer donors. African Americans are underrepresented in the donor pool. In 2008, 7% of white versus 4% of African American and Hispanics adults donated in the previous year. The donor rates vary by region in the United States: 77–93% for whites, 1–16% for African Americans and 1–13% for Hispanics. In the Atlanta metropolitan area whose donor pool is 77% white, 16% African American and 4% Hispanic, the blood donor rate (number of blood donors per population) was 11/1000 population for whites, 6/1000 for African Americans and 3/1000 population for Hispanics; and the blood donation rate (number of units donated by population over the total population) was 77 donations/1000 population for whites, 22/1000 population for African Americans and 10/1000 population for Hispanics. Thus, African Americans and Hispanics represent half of the donors as whites when adjusted for their percentage of the population and more strikingly donate a significantly fewer number of units per each donor. Materials and Methods  Literature on reasons for racial/ethnic differences in donation rates and methods to address these differences was reviewed. Results  The reasons for these differences are multifactorial. First, although 41% of the total US population is estimated to be eligible to donate, African Americans and Hispanics have lower eligibility rates (whites 46%, African Americans 36%, and Hispanics 41%). Second, donor deferral rates are higher for minorities: whites 11%, African Americans 18%, Hispanics 14% and Asians 16%. Deferral is most commonly secondary to temporary deferral reasons such as low hemoglobin level, yet donors are less likely to return once deferred, and thus deferral affects donor and donation rates. Third, minorities may have different motivators and barriers. The most cited motivators to blood donation are more convenient place and times, and being asked; and the most cited barriers are fear of catching a disease and feeling faint/dizzy, and not have time or knowing where to donate. Racial differences in motivating factors identified include African Americans are more likely than whites to donate to receive an item/gift and be tested for infectious disease, and if assured that donating is safe. Notably, these motivators are not the primary cited motivators. African Americans compared with whites more commonly cite fear, difficulty finding veins and not knowing where to donate as deterrents. In addition, African Americans have distrust in the healthcare system, which is correlated with lower donation rates. Fourth, different racial/ethnic groups may have different preferred marketing strategies, including methods of contact, as well as culturally specific motivators for behavioural change. Conclusion  Thus, with an improved understanding of these differences as well as accurate tools to measure the outcomes, culturally targeted recruitment programs can be developed to increase donation rates.     

Perceptions of the living dead: An assessment of knowledge and opinions about whole body donation,its process,and willingness to become cadaveric donors in Pennsylvania

Despite the many important uses for human cadavers, there is a relative shortage of bodies donated to the scientific community in the United States of America. The purpose of this study was to determine the community's perceptions regarding whole body donation and their willingness to become donors. Moreover, we aimed to investigate people's understanding of the process of whole body donation, and examine their opinions regarding its importance. Individuals in Erie, Pennsylvania were surveyed. Data were collected via a questionnaire, which was offered to friends and family members of patients in the waiting area of the UPMC Hamot Surgery Center. All participants were residents of Erie County. The questionnaire was designed to evaluate knowledge and opinions about whole body donation. A total of 123 people completed the survey. We found people were willing to become whole body donors and understood the importance of this giving act, but lacked understanding about the registration process and the use of donated bodies. Participants revealed the belief that they have the right to decide what is to be done with their bodies after death, but did not indicate specific negative repercussions of becoming whole body donors. In conclusion, our findings indicate that the shortage of cadaveric donors could be due to lack of understanding about whole body donation and the registration process. Clin. Anat. 28:442–448, 2015. © 2015 Wiley Periodicals, Inc.     

The acceptability of posthumous human ovarian tissue donation in Utah

BACKGROUND: Infertility due to accelerated loss of ovarian follicles/oocytes may occur through numerous mechanisms. As a result, posthumous human oocyte donation, banking and maturation protocols for research and fertility restoration are current interests in reproductive medicine. METHODS: A computer-generated sample of Utah residents (n = 704) were surveyed regarding demographics, willingness to donate organs, IVF acceptability and posthumous follicle/oocyte donation for: research, fertilization with monitoring to the preembryo stage (eight cells), and fertilization and subsequent transfer of embryos derived from themselves, their partner or non-spousal relative for whom they act as guardian. RESULTS: Ovarian tissue donation for follicle/oocyte retrieval, maturation and scientific investigation without fertilization was acceptable (>or=70%) to a majority of the Utah population. However, fertilization of oocytes or fertilization and transfer of resulting preembyos derived from such donations to cause a pregnancy was less acceptable (58.3% and 57.4%, respectively) in the population responding for their own or partner's oocytes, and more so when the donation was guardian-directed (54.8% and 52.1%, respectively). Similar declines in the level of acceptance were noted when those who had an express interest in such donations (ovarian failure or surgical castration) were surveyed (n = 50). CONCLUSIONS: This study substantiates the ethical recommendation that explicit prior written consent of the donor be obtained when ovarian tissue donations are procured for fertilization, or transfer of a preembryo to cause a pregnancy. In light of the rapid technological advancements in ovarian follicle/oocyte cryopreservation and maturation, the time may have come to provide potential organ donors the opportunity to specify their desires regarding ovarian tissues when registering for organ donation.     

Oocyte and semen donation: a survey of UK licensed centres

In view of the difficulties encountered by licensed clinics in the recruitment of oocyte and semen donors, the present survey was commissioned by the National Gamete Donation Trust (NGDT) to provide systematic information on current practice as a basis for planning future recruitment strategies. Sixty-four clinics agreed to participate in the survey, of which 55 recruited oocyte donors, 30 recruited semen donors, and 24 recruited both oocyte and semen donors. Almost all of the clinics had experienced difficulty in obtaining a sufficient supply of donated oocytes, and many patients requiring treatment with donated oocytes were placed on a waiting list for more than one year. Three-quarters of potential donors changed their mind about donating after receiving information on the procedures involved. The difficulties in recruiting semen donors were generally less acute. In this case, the greatest problem was the high proportion of potential semen donors who were deemed unsuitable after completing the screening process. Clinics also reported a shortage of both oocyte and semen donors from specific ethnic groups.     

Termination of pregnancy after conception with donor oocytes and donor spermatozoa: case report

Two couples, each suffering from longstanding primary subfertility due to severe oligoasthenoteratozoospermia in the male partner and perimenopause in the female, were referred to Bourn Hall Clinic for assisted conception treatment. Both couples received independent counselling prior to being accepted onto our programme. Both women conceived following embryo transfer. The embryos were created from (separate) donor oocytes and donor spermatozoa, and three and two embryos were transferred respectively. The first recipient conceived a triplet pregnancy, while the second conceived a twin pregnancy. Both felt unable to cope with their multiple pregnancies and declined further counselling. Both were offered elective fetal reduction; however, both declined and both decided to terminate their pregnancies. Both patients underwent termination of pregnancy, despite being advised against it. The reasons couples may opt for termination of their much-wanted pregnancies, after a protracted period of infertility, intensive and expensive infertility treatment and despite the counselling they receive before, during and after their treatment, are discussed.     

Semen donor recruitment in an oocyte donation programme

The article presents a new system for the recruitment of gamete donors. The system is a partial application of the mirror exchange system: the male partner of a couple donates sperm, and in return, he receives the guarantee that his partner benefits from a greatly reduced waiting time for donor oocytes. More specifically, the woman will obtain donor oocytes within a period of 8 months. The procedure was very successful in recruiting sperm donors while avoiding the ethical objections raised against other incentives to attract donors. The data indicate that the system would also work to encourage IVF patients to share their oocytes.     

两种献血目的人群的免疫四项结果对比分析

目的 回顾性分析我院互助献血与无偿献血的血液免疫四项(HBsAg、Anti-HCV、Anti-TP、Anti-HIV)情况,为进一步评价不同献血目的人群的血液传播疾病风险提供依据.方法 对我院2015年1月至11月所采集的29935例献血者的免疫四项检测结果进行回顾性分析,根据献血者种类将献血者分为无偿献血组与互助献血组,对两组献血者的免疫四项结果的阴阳性分别进行统计分析.结果 互助献血组14940例,免疫四项结果不合格628例,在同组人数中占比4.20％.其中,HBsAg、Anti-HCV、Anti-TP、Anti-HIV不合格率分别为2.23％、0.72％、1.14％、0.10％.无偿献血组14995例,免疫四项结果不合格154例,在同组人数中占比1.03％.其中,HBsAg、Anti-HCV、Anti-TP、Anti-HIV不合格率分别为0.23％、0.42％、0.35％、0.02％.互助献血组与无偿献血组的总不合格率、HBsAg不合格率以及Anti-TP不合格率差异均具有统计学意义.结论 互助献血来源的血液安全性远低于无偿献血来源的血液.     

赠卵技术实施中的伦理问题

赠卵技术的出现和发展为一部分本无生育希望的不孕患者带来了福音,同时由其引发的伦理争论也一直在继续。本文对赠卵技术实施中相应环节的伦理问题进行了分析,并认为在赠卵技术实施的过程中,既要作到供卵者和受卵者的充分知情同意,又要确保他们之间的互盲,同时严防此项技术的商业化,当务之急是如何规范赠卵的医疗行为和个人行为。使之尽可能符合我们现有的道德伦理法律标准。     

Ethics and society: A survey of semen donation: phase II -- the view of the donors

This report presents the findings of phase II of the surveyof semen donation commissioned by the Human Fertilization andEmbryology Authority (HFEA), the purpose of which was to obtaininformation about the motivations and attitudes of semen donorsin comparison with a matched group of non-donors. A total of14 centres licensed by the HFEA to conduct donor inseminationparticipated in the investigation. At each centre, all men whoattended for their first or second appointment between 1st November1993 and 31st January 1994 were asked to complete a questionnaireabout the factors which prompted them to attend the centre andabout their knowledge of, and attitudes towards, semen donation.In spite of the recommendation by the HFEA that attempts shouldbe made to recruit as semen donors older men in stable relationshipswho already have children of their own and who wish to donatefor altruistic reasons, it remains the case that the large majorityof men in the UK who donate semen are young single studentswho are largely motivated by payment. Views on oocyte donationof women who had never donated oocytes were also obtained, andcompared with views on semen donation of a matched group ofmen who had never donated semen.