CAJ | 학술논문

活体肝移植术虽部分解决了供肝短缺问题，但需从活的供体身上切取部分肝脏，使其承担手术创伤甚至死亡的风险，故存在诸多伦理问题。本文应用质性研究，对7名与活体肝移植相关的不同领域专家及6名手术相关者进行访谈，采用 Nvivo9．0软件辅助对访谈资料进行了分析。探讨活体肝移植的伦理审查、供体选择及心理评估的相关伦理问题。结果显示，尽管活体肝移植手术仍在全国多家医院进行，目前政府对活体肝移植伦理审查和监管更加严格，伦理审查缺少对供体、受体的心理综合评估。因此，建议建立健全并推广死亡器官捐赠注册系统以增加肝源，减少活体肝移植对供体带来的健康风险，并开发适用的心理综合评估工具，评估结果应列入伦理审查范围。
활체간이식술수부분해결료공간단결문제，단수종활적공체신상절취부분간장，사기승담수술창상심지사망적풍험，고존재제다윤리문제。본문응용질성연구，대7명여활체간이식상관적불동영역전가급6명수술상관자진행방담，채용 Nvivo9．0연건보조대방담자료진행료분석。탐토활체간이식적윤리심사、공체선택급심리평고적상관윤리문제。결과현시，진관활체간이식수술잉재전국다가의원진행，목전정부대활체간이식윤리심사화감관경가엄격，윤리심사결소대공체、수체적심리종합평고。인차，건의건립건전병추엄사망기관연증주책계통이증가간원，감소활체간이식대공체대래적건강풍험，병개발괄용적심리종합평고공구，평고결과응렬입윤리심사범위。
Living donor liver transplantation (LDLT ) technology solves the shortage of donated liver partially and saves the lives of patients ;however ,living donors are faced with risks and /or complications after the surgery .How to protect the health of living donor is an important issue in application of LDLT .A qualitative study was designed and conducted to explore the ethical concerns in LDLT process , including IRB review , selection of living donor , and comprehensive psychological evaluation for donors .Six individuals (2 donors ,2 former recipients and 2 family members of donors) ,and 7 experts (IRB , psychology and transplant surgeon ) were interviewed by researchers in the Peking University Clinical Research Institute .Nvivo9 .0 software was used to analyze the data .From the interview ,we found that the psychological evaluation for donors and recipients before surgery is necessary but absent currently .Applicable psychological evaluation tools should be developed ,and the evaluation results should be included in IRB review .Organ donation registry system is recommended to add more available liver to reduce health risk from LDLT .It is very clear that the trend of government regulation and IRB review to LDLT is getting strict ,pointed by experts .