器官捐贈勸募之探討

A Study of Organ Donation and Procurement

本文主要在探討腦死病患在器官捐贈勸募經驗。於西元2001 年1 月至2008 年12 月，期間共計八年時間，經彰化基督教醫院器官捐贈小組對166 人介入進行器官勸募，男性為122 人及女性為44 人，器官捐贈成功為34 人，而器官捐贈失敗為132 人。收案疾病區分為頭部外傷為108 人、腦血管疾病為48 人、缺氧性腦病變為8 人及腦瘤為2 人。家屬拒絕器官捐贈之常見原因歸納為五大因素，包括：（1）風俗習慣為48 人；（2）家庭因素為36 人；（3）疾病認知不同為22 人；（4）醫學評估不適合為18 人；（5）其他因素共8人。成功勸募34 人，共募得器官為心臟22 個、肝臟27 個、腎臟66 個、及肺臟2 個，使得117 位受贈者受益。統計這34 位患者，經由介入至成功器官捐贈，統計需時間為一到十二天，平均為2.3 天時間。由入加護病房至開刀房摘取器官總住院天數為一到十六天，平均住院天數為5.9 天。本文藉由器官勸募之經驗，了解彰化地區民眾對於器官捐贈議題的接受程度，並從中探究失敗的因素及成功經驗，期待能建立正確的勸募模式，提供加護病房單位勸募的參考。

This paper is to study the experience procuring organ donation. The Organ Donation Crew of Changhua Christian Hospital between January 2001 and December 2008 with a period of 8 years, including 122 males and 44 females, has persuaded one hundred and sixty-six patients into organ procurement. Among them 34 donors had successfully donated their organs, while the other 132 donors were failed. These donations were divided to the following groups: 108 head injury patients; 48 cerebrovascular disease patients; 8 hypoxic encephalopathy patients and 2 brain tumor patients. Five factors are associated with high failure rate of organ donation: (1) Cultural traditions: 48 cases; (2) lack of knowledge of illness: 22 cases; (3)Family’s decision: 36 cases; (4) Unsuitable organ after the medical evaluation: 18 cases; (5) Others, 8 cases, such as- patients were involved in criminal case investigations; patient’s condition got worse after the first judge of brain death; patients had discussed organ donation with family members and refused the idea; cases involved medical treatment dispute; case had diplomatic and administrative concerns of foreign patients. There were a total of 34 successful donors, who donated 22 hearts, 27 livers , 66 kidneys, and 2 lungs-which brought second lives to 117 recipients. For these 34 donors, it usually took 1 to 12 days from persuading organ donation to donating successfully, and the average waiting time was 2.3 days. For a brain death patient, the period from admission to Intensive Care Unit to Operation Room ranges between 1 and 16 days, with an average time of 5.9 days. This paper is to understand the extent of accepting organ donation for people in Changhua area through the experiences procuring organ donation, and to research into the causes of failure and the successful experiences. Hopefully this paper can help to establish the proper mode of procuring organ donation, and be used as a reference for all the Intensive Care Units to procure organ donation.