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1.
Public awareness of organ donation.   总被引:2,自引:1,他引:1       下载免费PDF全文
A telephone survey of public attitudes toward organ donation and transplantation was conducted in a community in southwestern Ontario. The subjects were selected at random; the response rate was 57%. Of the 50 respondents 62% stated that they had signed the organ donor card accompanying their driver's licence. These respondents were more likely than those who did not sign it to have discussed organ donation with their families. At least 80% of the respondents said they would agree to donate their organs and those of their next-of-kin, and 80% said that the organ donor card should be considered a legal document. Organ transplantation was regarded by all but one respondent as an acceptable medical procedure. Also discussed were concerns about organ donation and possible strategies to improve the availability of organs for transplantation.  相似文献   

2.
Background  Organ transplantation represents an important advance in modern medical science, and it has benefited many patients with organ failure; however, the severe deficiency of organ sources has been a bottleneck that has limited the benefits this technology can bring. The aim of this study was to show the results of a survey on Chinese people’s awareness and attitudes toward organ donation.
Methods  We designed a questionnaire regarding organ donation consisting of 20 short questions, which were distributed to 10 groups. Most of the questions were multiple-choice; the core question related to people’s attitudes to organ donation and the development of organ donation. The survey was held in the outpatient hall of Beijing Chao-Yang Hospital, a commercial district, and four professional colleges. Participants were randomly selected, and answered questions about gender, age, educational background, profession, and study major.
Results  In all, 2930 valid responses were received. Male:female ratio was nearly 1:1.2 (mean age 38 years). Over 90.0% of participants knew about organ transplantation and which organs could be transplanted; more than 95.0% knew about organ donation, but the time they had been aware of it varied. Nearly 90.0% of the participants approved of deceased organ donation; 73.0% indicated they would like to donate their organs post mortem. Participants who knew more about organ failure and organ transplantation were more likely to support organ donation. College students were very positive about organ donation, though as they gain professional knowledge their attitudes may change. Altogether, 65.3% of participants approved of living organ donation, which was obviously lower than the figure for deceased organ donation (P <0.05). In all, 85.7% of participants approved of compensation to the deceased donor’s family. To promote organ donation in China, 62.9% of participants indicated that the public’s knowledge about organ donation should be increased via the media and various kinds of education. Only 20.0% of the participants believed that legislation was required.
Conclusions  We conclude that at present the Chinese public has a basic understanding about organ transplantation and donation. The majority respondents were in favor of deceased organ donation and were willing to donate their own organs after death.
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3.
Questionnaires were administered to 108 university psychology students to investigate attitudes and behaviour related to organ donation. Three groups (committed, uncommitted and opposed) were identified. A multivariate analysis of variance showed that, compared with uncommitted donors, committed donors felt better informed about organ donation, had discussed donation more often with family members and knew more people who had signed donor cards. The subjects in the opposed group and those in the uncommitted group cited different reasons for not signing a donor card. Empathy, religious beliefs and attitudes about death did not affect willingness to donate. Analyses of the interaction between willingness to donate one's own organs and willingness to donate those of a family member revealed a monotonic increase in willingness to donate the organs of a family member as the type of recipient became more personally relevant. Our findings indicate that when health care professionals request donor organs the potential recipients must be presented to the potential donors in a personally relevant manner. Educational programs must be developed to train medical personnel in how to effectively ask for organs without coercing the potential donor or invading the privacy of the potential recipient.  相似文献   

4.
BACKGROUND: Shortage of donor organs is one of the major problems for liver transplant programmes. Living liver donation is a possible alternative, which could increase the amount of donor organs available in the short term. OBJECTIVE: To assess the attitude towards living organ donation in the general population to have an overview of the overall attitude within Germany. METHODS: A representative quota of people was evaluated by a mail questionnaire (n = 250). This questionnaire had 24 questions assessing the willingness to be a living liver donor for different potential recipients. Factors for and against living liver donation were assessed. RESULTS: Donating a part of the liver was almost as accepted as donating a kidney. The readiness to donate was highest when participants were asked to donate for children. In an urgent life-threatening situation the will to donate was especially high, whereas it was lower in the case of recipient substance misuse. More women than men expressed a higher disposition to donate for their children. Sex, religion, state of health and age of the donor, however, did not influence other questions on the readiness to consider living organ donation. The will for postmortem organ donation positively correlated with the will to be a living organ donor. CONCLUSIONS: The motivation in different demographic subgroups to participate in living liver transplantation is described. Differences in donation readiness resulting from the situation of every donor and recipient are thoroughly outlined. The acceptance for a living liver donation was found to be high - and comparable to that of living kidney donation.  相似文献   

5.
CONTEXT: Transplantation has become the therapy of choice for patients with organ failure. However, the low rate of consent by families of donor-eligible patients is a major limiting factor in the success of organ transplantation. OBJECTIVE: To explore factors associated with the decision to donate among families of potential solid organ donors. DESIGN AND SETTING: Data collection via chart reviews, telephone interviews with health care practitioners (HCPs) or organ procurement organization (OPO) staff, and face-to-face interviews with family for all donor-eligible deaths at 9 trauma hospitals in southwestern Pennsylvania and northeastern Ohio from 1994 to 1999. PARTICIPANTS: Family members, HCPs, and OPO staff involved in the donation decision for 420 donor-eligible patients. MAIN OUTCOME MEASURE: Factors associated with family decision to donate or not donate organs for transplantation. RESULTS: A total of 238 of the 420 cases led to organ donation; 182 did not. Univariate analysis revealed numerous factors associated with the donation decision. Multivariable analysis of associated variables revealed that family and patient sociodemographics (ethnicity, patient's age and cause of death) and prior knowledge of the patients' wishes were significantly associated with willingness to donate (adjusted odds ratio [OR], 7.68; 95% confidence interval [CI], 6.55-9.01). Families who discussed more topics and had more conversations about organ donation were more likely to donate (adjusted OR, 5.22; 95% CI, 4.32-6.30), as were families with more contact with OPO staff (adjusted OR, 3.08; 95% CI, 2.63-3.60) and those who experienced an optimal request pattern (adjusted OR, 2.96; 95% CI, 2.58-3.40). Socioemotional and communication variables acted as intervening variables. CONCLUSIONS: Public education is needed to modify attitudes about organ donation prior to a donation opportunity. Specific steps can be taken by HCPs and OPO staff to maximize the opportunity to persuade families to donate their relatives' organs.  相似文献   

6.

Background

Organ shortage remains a major challenge in transplantation medicine. The aim of this study was to analyze the public’s willingness to donate organs and to observe whether increased knowledge about organ donation has an effect on the attitude toward organ donation. The study in particular tested the efficacy of using electronic communication as a means to distribute information.

Methods

In 2011, an Email invitation to participate in a survey was sent to the employees of the University Duisburg-Essen. The survey consisted of a two-piece questionnaire with an informational intervention on organ donation between the questionnaires. The technical design ensured that interviewees remained anonymous and could participate only once.

Results

In total, 1,818 interviewees completed the questionnaire. Of the respondents, 42% were organ-donor card holders (which was consistent among genders and age groups), whereas 87% of the interviewees would support an organ donation for themselves. Of the interviewees who did not possess an organ-donor card, 67% were positively inclined toward holding one in future after reading the interventional information.

Conclusions

The considerable improvement in attitude toward carrying an organ-donor card after reading the information illustrates the effectiveness of distributing concise information on organ donation. To increase the willingness to donate organs, it is of great importance to inform the public and facilitate the documentation of a decision to donate. The present study has proven the use of Email communication to be an important asset to this process.  相似文献   

7.
刘博君  李宁 《北京医学》2017,(12):1194-1200
目的 了解医务人员器官捐献意愿及其影响因素.方法 以北京市一级、二级、三级医院医务人员为研究对象,采用调查问卷方法,分别调查7所医院医护人员的基本资料,及其对器官捐献认知、态度及意愿,并对影响因素进行分析.结果 共调查男性149人(20%),女性596人(80%),受访者平均年龄为(34.6±8.8)岁,75.8%的受访者已婚,98.4%的受访者具有专科以上学历,65.9%的受访者收入在5 000元以上,76.1%的受访者来自三级医疗机构,77.7%的受访者来自内科,54.6%的受访者为医师.影响因素分析结果显示,文化程度、对脑死亡了解程度、对遗体器官捐献态度、是否担心同意捐献后医生为获得器官不尽力医治成为影响捐献意愿的主要因素.结论 应加强器官捐献的宣传工作,提高医务人员对器官捐献的认识.  相似文献   

8.
目的:了解四川省在校大学生对器官移植的态度及捐献意愿,探讨阻碍器官移植事业发展的可能原因。方法以问卷形式,对四川省内8所在校大学生进行调查研究。结果大学生从媒体宣传中获得器官移植相关知识的人数占39.16%;医学专业学生愿意捐献的人数占41.63%,非医学专业学生愿意捐献的人数占22.35%,医学专业学生的捐献意愿更高;影响大学生器官捐献态度的因素主要是家属意见(52.05%)和对相关机构的不信任(53.79%)。结论大学生器官捐献意愿度低;捐献意识有待提高;非医学院校有必要开展器官移植相关课程;有关政府部门应加大宣传力度,设立合理补偿机制,完善现有体制。  相似文献   

9.
Prevalence of organ failure is high through out the world. Organ transplantation, the definitive treatment option of organ failure keeps very low due to scarcity of organ. Most of the people are not aware about organ donation. Adolescent girls will be the mother of future nation and they can motivate family members for organ donation. This study was carried out to see attitudes towards organ donation and determine the negative factors of organ donation prevailing among school girls. One hundred sixty eight girls from class VIII to class X of a higher secondary school were participated. A structured questionnaire was filled up by the girls. The data were processed from questionnaire and analyzed. Among study population, most of them (64%) had no idea about on going organ donation and transplantation. The positive attitude of the girls towards organ donation was low when they are live (16%) and their attitudes also kept low even after their death (14%). The girls who did not agree to donate organ were further asked to mention the reasons. The reasons of negative attitude were religious belief, fear of illness and social and familial reservation. The result of this study suggests that among girls, awareness and attitudes about organ donation is poor. There were several reasons identified for low consent rates. Multidisciplinary actions should be taken to improve the awareness of the people about organ donation and motivate them for donation.  相似文献   

10.
INTRODUCTIONHealthcare professionals (HCPs) working in critical care areas play an important role in the organ donation (OD) process. We studied HCPs’ own willingness to be organ donors and its association with sociodemographic factors as well as their knowledge and attitudes about OD and transplantation.METHODSA cross-sectional survey of HCPs working in four critical care units in a major transplant centre in Malaysia was undertaken using a validated structured questionnaire. Responses were analysed using multivariable analysis with willingness to donate as the dependent variable.RESULTSOf the 412 respondents (response rate 98.1%), the majority were nurses (60.4%), Malay (71.1%) and female (77.2%). Overall, 68.0% were willing to donate. The independent predictors of willingness to donate were profession (p < 0.001) and the Hindu religion (p = 0.001). Ethnicity (p = 0.003), religious belief (p < 0.001), knowledge (p = 0.016), belief in brain death (p = 0.018) and confidence in transplantation (p < 0.001) also independently correlated with willingness to donate, while attitudes to OD did not. Of those willing to donate, only 37.3% were carrying a donor card and only 63.1% had informed their family of their intention to donate.CONCLUSIONAlthough willingness to donate was higher in critical care HCPs than HCPs in general, significant knowledge gaps as well as certain beliefs and perceptions that could pose a barrier to OD were identified in this group. Measures to improve OD rates in Malaysia should include targeted educational programmes for HCPs working in critical care areas.  相似文献   

11.
Organ transplantation was enacted by a law "Transplantation of Human Organ Act" in 1994 but still, getting the consent from the relatives of brain dead person is a very difficult task and hence cadaveric transplant accounts for a minimum number. In India, most of the transplantations carried out are related to living donor and very few are cadaveric. The poor status of cadaver transplantation may be attributed to the moral, emotional and religious beliefs and taboos that inhibit the relatives of the deceased to come forward to donate organ(s) of a brain dead person.Non-existence of a trained transplant co-ordinator who is the backbone of any successful transplant programme is another reason for poor response in cadaver transplantation. The great task is to motivate and prepare the relatives for organ donation of their near and dear ones. Transplant co-ordinators are being prepared for motivating individuals or relatives for donation. To promote human organ transplantation government's initiative is very important. Mass media supported by the government can develop better awareness among the people. Non-government organisations (NGOs) can help in the similar ways. All hospitals are not authorised for the procedure of human organ transplantation. Other hospitals can help the process by informing the authorised hospitals about recent admission of potential donor (brainstem death). Role of transplant coordinator is crucial. He/she is the real inspiration to make agree the relatives for organ donation. Overall success of transplant programme is based on co-ordinated activity. Involvement of all agencies to motivate the person to pledge for organ donation during his/her life time is the first and the foremost requirement for successful planning and programme of organ transplantation.  相似文献   

12.
A sample of 195 physicians and nurses likely to be involved in organ procurement for transplantation was interviewed about knowledge, personal concepts, and attitudes concerning "brain death" and organ donation. Only 68 respondents (35%) correctly identified the legal and medical criteria for determining death. Personal concepts of death varied widely. Most respondents (58%) did not use a coherent concept of death consistently; others (19%) had a concept of death that was logically consistent with changing the whole-brain standard to classify anencephalics and patients in a persistent vegetative state as dead. The findings demonstrate confusion about correct criteria for determining death and differences in concepts of death that might prove troublesome to the transplantation enterprise. We conclude that health professionals should do more to resolve the clinical and conceptual issues in the definition and determination of death before policies concerning organ retrieval are changed.  相似文献   

13.
We conducted a telephone survey of parents in the National Capital Region to assess their intention to donate their child's organs and to provide physicians with information that could help alleviate their concerns about approaching parents for consent. Of 339 parents who agreed to answer questions after being given details of their child's "death" 288 (85%) said that they would be willing to donate their child's organs. The degree of willingness was associated with the certainty of death, altruism and empathy toward children in need of an organ, previous discussion of organ donation with a family member and knowledge of an adolescent or adult child's attitude toward donation. Factors that inhibited the intention to donate included uncertainty of death, insufficient information from medical professionals and fear of multilation. The child's age was not significantly associated with intention to donate. Concordance between the results and actual donation rates in Canada and the United States supports the generalizability of the survey findings.  相似文献   

14.
目的 探讨适合临床的公民死亡器官捐献(DCD)潜在供体转运通道及供体重症监护室供体维护机制.方法 首都医科大学附属北京佑安医院自2012年1月开通转运通道,至2016年6月,器官获取组织(Organ Procurement Organization,OPO)共接到DCD相关信息152例,评估152例.临床判定为潜在捐献者合格84例,访谈84例,41例潜在供体家属同意捐献.建立DCD潜在供体转运通道,一般流程下直接转运潜在供体入供体重症监护室(DI-CU),并立即进行各重要器官的评估及维护.当潜在供体在转运过程中出现生命体征的恶化,紧急情况下启动应急流程.评价潜在供者进入DICU时和捐献前各项实验室检查指标的变化.结果 自2012年首都医科大学附属北京佑安医院共接收潜在供体41例,其中男29例,女12例;年龄(35.17±19.51)岁.1例(2.4%)转运过程中出现呼吸心跳停止,3例(7.3%)因家属意愿改变而中止捐献,37例(90.2%)顺利完成器官捐献.按中国心脏死亡器官捐献分类标准进行分类,此37例中国际标准化脑死亡供体28例(75.7%),国际标准化心脏死亡供体3例(8.1%),国际标准化心脑死亡供体6例(16.2%).其中31例供体捐献器官用于移植,6例供体的器官捐献后因损伤超出标准被弃用.潜在供体入DICU时和捐献前各项化验指标变化,AST、T-BIL、D-BIL、BUN的差异有统计学意义(P<0.05).结论 建立适合临床工作的公民死亡器官捐献潜在供体转运通道及供体重症监护室以维护器官功能、提高捐献成功率非常重要,保证了供体器官的数量及质量.  相似文献   

15.

Background

Shortage of donor organs is one of the major problems for liver transplant programmes. Living liver donation is a possible alternative, which could increase the amount of donor organs available in the short term.

Objective

To assess the attitude towards living organ donation in the general population to have an overview of the overall attitude within Germany.

Methods

A representative quota of people was evaluated by a mail questionnaire (n = 250). This questionnaire had 24 questions assessing the willingness to be a living liver donor for different potential recipients. Factors for and against living liver donation were assessed.

Results

Donating a part of the liver was almost as accepted as donating a kidney. The readiness to donate was highest when participants were asked to donate for children. In an urgent life‐threatening situation the will to donate was especially high, whereas it was lower in the case of recipient substance misuse. More women than men expressed a higher disposition to donate for their children. Sex, religion, state of health and age of the donor, however, did not influence other questions on the readiness to consider living organ donation. The will for postmortem organ donation positively correlated with the will to be a living organ donor.

Conclusions

The motivation in different demographic subgroups to participate in living liver transplantation is described. Differences in donation readiness resulting from the situation of every donor and recipient are thoroughly outlined. The acceptance for a living liver donation was found to be high – and comparable to that of living kidney donation.The shortage of donor organs is one of the key problems in solid organ transplantation. Many patients with clear indications for transplantation have to wait for several months (lung, heart or liver) or even years (kidney) in a declining state of health and with a decreasing quality of life.1 In some cases, patients requiring transplant die while on the waiting lists. To overcome the gap between organs needed for transplantation and those available, various strategies have been considered.The first studies on xenotransplantation were started in the 1960s using non‐human primates, pigs and other animals as potential donor. Although some of the immunological and infectious obstacles have been overcome during the past two decades, xenotransplantation is still far from being introduced into clinical practice.2 Replacing organ function by artificial devices is a standard procedure in cases of progressive kidney failure. Although long‐term dialysis can keep patients alive with an acceptable state of health, kidney transplantation is considered to be the better alternative in most cases, increasing the patients'' life standard and decreasing the overall sociomedical costs.3,4 Distinct methods of replacing other organs with substitution devices, with or without the use of living cells (eg, intracorporal heart pumps or bioartifical liver reactors) may be of additional use in the future. The first preclinical trials utilising these techniques have been initiated; the broad application of such methods, however, cannot be predicted. In addition, promising approaches for using stem‐cell‐based treatments have been described recently. Some of the new stem cell techniques may have the potential to solve the problem of organ shortage in the future. Today, their clinical application is still far away.In contrast, living organ donation can be immediately applied to compensate for the lack of donor organs without major technical problems. The first experiences with transplantation of parts of the liver were made in the early 1980s (mostly with children as recipients).5 In the late 1980s and 1990s, split liver transplantation was developed, offering the possibility to treat two recipients with only one cadaveric organ graft.6 Later, reduced size liver transplantation and split techniques formed the basis on which living related liver transplantation was introduced. The first reports of living related liver transplantation were published in the late 1980s and 1990s.7,8 Living related liver transplantation as a widely used procedure for children and adults has been reported throughout the past decade.9 Today, recipient outcome in the hands of experienced centres is at least as good as that for cadaveric donation.10,11 A certain risk for the organ donor, however, remains. Living liver donation has a donor mortality of approximately 0.2–0.6% for right liver lobe donation and less than 0.1% for left lateral lobe donation (estimated by reported donor deaths) and is associated with some typical complications, mostly affecting the biliary system.12,13 This leads to considerable ethical problems for all who are associated with the process, including the donor, the recipient and the transplant team.14,15,16This study focused on the overall motivation to become a living liver donor among the general population in Germany. Two hundred and fifty citizens, who were not directly linked to a situation of organ transplantation, were asked for their attitude towards living organ donation. Here, we detail the social circumstances and demographic factors that result in changes of the donation readiness, thereby providing important data that will allow improved communication between potential donors and their transplant centres.  相似文献   

16.
Organs available for transplantation are scarce and valuable medical resources and decisions about who is to receive them should not be made more difficult by complicated calculations of desert. Consideration of likely clinical outcome must always take priority when allocating such a precious resource otherwise there is a danger of wasting that resource. However, desert may be a relevant concern in decision-making where the clinical risk is identical between two or more potential recipients of organs. Unlikely as this scenario is, such a decision procedure makes clear the interdependence of organ recipient and organ donor and hints at potential disadvantages for those who are willing to accept but unwilling to donate organs (free-riders). A combined opting-out and preference system weakens many of the objections to opting-out systems and may make the decision to donate organs on behalf of their deceased relatives easier for families.  相似文献   

17.
Presumed consent to organ donation looks increasingly unlikely to be a palatable option for increasing organ procurement in the UK following the publication of the report into events at Alder Hey and elsewhere. Yet, given that the alternative to increasing the number of cadaveric organs available is either to accept a greater number of live donations, or accept that people will continue to die for the want of an organ, public policy makers remain obliged to consider other means of increasing the procurement rate. In this paper, we meet the main objections to mandated choice (namely that it undermines autonomy and that mandated donation is preferable). We have modified the traditional approach to mandated choice to take into account the force of the objection that mandated donation is preferable, by accepting that people can and do make bad decisions about organ donation and proposing that all accompanying public education and information about cadaveric donation should be directed in favour of donation.  相似文献   

18.
In the wake of scandals about the unauthorised retention of organs following postmortem examination, the issue of valid consent (or the lack of it) has returned to the forefront. Emphasis is put on obtaining explicit authorisation from the patient or family prior to any medical intervention, including those involving the dead. Although the controversies in the UK arose from the retention of human material for education or research rather than therapy, concern has been expressed that public mistrust could also adversely affect organ donation for transplantation. At the same time, however, the British Medical Association (BMA) continues to call for a shift to a system of presumed consent for organ transplantation. This apparent inconsistency can be justified because valid distinctions exist between the reasons requiring explicit consent for retention and the acceptability of presumed consent for transplantation. This paper argues for introducing a system of presumed consent for organ donation, given the overwhelming expressions of public support for transplantation. Ongoing legislative review in the UK provides an ideal chance to alter the default position to one where potential donors can simply acquiesce or opt out of donation. Combined with consultation with their relatives, this could be a much better method of realising individuals' wishes. It would also achieve a better balance between the duties owed to the deceased and those owed to people awaiting a transplant.  相似文献   

19.
OBJECTIVE: To determine the potential for organ donation in 12 Victorian hospitals. DESIGN AND SETTING: Prospective audit of all deaths in 12 major public hospitals in the state of Victoria between January 2002 and October 2004. MAIN OUTCOME MEASURES: Number of organ donors and potential organ donors (patients with brain death or likely to progress to brain death within 24 hours if supportive treatment continued), requests for organ donation and consents. Unrealised potential donors (organ donation not requested) were categorised by an independent panel of intensivists as category A (brain death formally diagnosed); B (brain death not formally diagnosed but criteria likely to be fulfilled); and C (potential to progress to brain death within 24 hours). RESULTS: There were 17,230 deaths, 280 potential organ donors and 220 requests for organ donation. The 60 unrealised potential organ donors were classified as category A (3), B (17) and C (40). Consent rate was 53% to 65%, depending on the definition of potential donor (categories A, B and C or category A only). Consent rate was lower when discussions about organ donation were held by trainees or registrars (21%) than when specialists were present (57%) (P = 0.004). A maximum practically achievable organ donation rate for Victoria was estimated to be 15 to 17 donors per million population (current rate, 9 per million population). CONCLUSIONS: The potential for organ donation in Victoria is limited by a small organ donor pool. There is potential to increase the number of organ donors by increasing the consent rate (lower than expected from public surveys), the identification of potential organ donors (particularly those likely to progress to brain death if supportive treatment is continued), and requests for organ donation.  相似文献   

20.
Patient attitudes to donation of embryos for research in Western Australia   总被引:1,自引:0,他引:1  
OBJECTIVE: To ascertain patients' attitudes to embryo donation for research purposes. DESIGN: Anonymous questionnaire survey. PARTICIPANTS AND SETTING: 235 couples who had embryos in storage at Concept Fertility Centre on 30 March 2003 that had been cryopreserved between 1 January 2000 and 30 June 2002. MAIN OUTCOME MEASURES: Participants' choices with regard to donating embryos to another couple, to research to improve in-vitro fertilisation (IVF) techniques or to stem-cell research, and the likelihood of couples choosing to use a range of sources to help them with their decision. RESULTS: The response rate was 57%. Twenty-nine per cent of respondents (36/126) reported they would donate their embryos to research that would improve IVF techniques and 27% (34/126) reported they would donate their embryos to stem-cell research. Fifteen per cent (19/126) would donate their embryos to another infertile couple. Willingness to donate to research was not influenced by whether the couple had previous children, or age. Women and men with moderate to strong religious beliefs were less likely to donate to research. Over 90% of respondents indicated they would seek outside help to decide the fate of their embryos. CONCLUSION: This study suggests that about 30% of couples would donate their embryos to research, and highlights the need to provide support and information to help couples through their decision-making process.  相似文献   

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