活體肝臟移植的決策經驗

Living Donor Liver Transplantation: The Decision Experience

活體肝臟移植手術是因應器官捐贈短缺，而需要解救末期肝病病人生命的一個選擇，而決定採用活體移植的方式可能是整個家庭成員之間互動的結果，從本文的案例發現，由於是自己的親人需要新的器官，捐贈者是義無反顧，有捨我其誰的情操，會經歷掙扎、不捨、害怕與猶豫等天人交戰的時刻，透過對醫護人員的信任、評價自己的情況與風險使決心更加確定。另外，此手術將同時影響捐贈者、受贈者及主要家屬的健康，因此醫護人員必須深入了解他們的經驗與感受，以作為臨床照護的實證基礎。

Living donor liver transplantation is a treatment choice for end-stage liver disease patients who face a shortage of currently available donated livers. The decision process involved in living donor organ donation has been described as a complicate process within the family of the patient. Donors have expressed willingness to donate a part of their own living liver in order to ensure the health of a loved one or relative when such a proposition was raised by the attending physician. Such decisions were taken even in the face of certain struggle, fear and ambiguous feelings. Donation decisions may be reinforced through feelings of confidence and trust in the physician and positive evaluations of the risk to donor health of making a 'living' donation. Necessary surgery will impact not only the recipient and donor but also family members. Staff on the transplantation team should make greater efforts to explore perceptions and concerns within families of living donors in order to deliver effective evidence-based care.