Elinluovutus kuoleman jälkeen
Koivusalo, Anna-Maria; Nordin, Arno; Lempinen, Marko; Ulander, Veli-Matti; Ala-Kokko, Tero (2021-10-08)
Koivusalo, Anna-Maria; Nordin, Arno; Lempinen, Marko; Ulander, Veli-Matti; Ala-Kokko, Tero (2021) Elinluovutus kuoleman jälkeen. Lääkärilehti 76(40), 2227-2230. https://www.laakarilehti.fi/pdf/2021/SLL402021-2227.pdf
© Lääkärilehti 2021.
https://rightsstatements.org/vocab/InC/1.0/
https://urn.fi/URN:NBN:fi-fe202201111833
Tiivistelmä
Tiivistelmä
Elinsiirrot ovat kustannustehokasta hoitoa. Niitä rajoittaa elinluovuttajien määrä ja siirrännäisten puute. Elinsiirto- ja -luovutustoimintaa säädellään ja valvotaan tarkkaan lailla. Luovuttajien määrää on yritetty lisätä lainsäädännöllä ja toimintaa koordinoimalla. Kuolleet elinluovuttajat Suomessa ovat olleet aivokuolleita. Monissa maissa on käytössä elinluovutus verenkierron pysähtymisen ja kuoleman toteamisen jälkeen -toiminta. Se mahdollistaa elinluovutuksen potilaalta, jolla on palautumaton aivovaurio mutta tila ei etene aivokuolemaan. Tämä toiminta on tarkoitus aloittaa myös Suomessa.
Summary
Organ transplantation is the best, and in many cases the only available treatment for end-stage organ failure. In the case of kidney failure, transplantation is also the most cost-effective treatment. The greatest problem affecting organ transplantation is a continuous shortage of suitable transplants. Currently, there are more than 550 people on the waiting list in Finland and 10% of patients die while waiting for an organ. The main objective of the Finnish National Action Plan is to ensure that all patients in need of organ transplantation on medical grounds have timely and equitable access to a transplant. Organ donation and transplantation is strictly regulated by law; the purpose is to ensure safety, traceability and high quality of organs, to provide guidance and supervision and to prevent trafficking. Regular inspections are carried out by a government agency in donor hospitals and transplant centres. A national steering group and coordinator for organ donation, which are separate from the transplantation centre, are established in Helsinki University Hospital to develop, guide and monitor the organ donation process. All central hospitals are procurement hospitals and they all have donor coordination teams in charge of steering, education, follow-up and auditing. Much has been done to increase donor numbers. We have presumed consent in our Tissue Act, also living donation is made easier by the law. “Potential organ donor” is an indication for intensive care treatment. Education, guidance and support has improved so that we would not miss a single organ donor. More marginal donors have also been accepted. But still we need more donors. We have made a protocol to begin a donation after circulatory determination of death (DCDD) programme which is piloting next year; there are no legal barriers and it is also ethically approved. Organ donation is a part of normal activity in hospitals. It is a way to honour patients’ wish to donate organs after death and a part of good and respectful end-of-life care.
Kokoelmat
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