美国计划全面改革器官移植系统(下)

There is the issue of the wait-list as well. And we should note there have been previous attempts to fix the system.

还有一个候补名单的问题。我们应该注意到，以前曾有过修复这一系统的尝试。

HHS back in 2021 pointed out that Black people were four times more likely and Latinos were almost one-and-a-half times more likely than white people to have kidney failure, but are less likely to be on those transplant wait-lists and less likely to have transplants.

早在2021年，美国卫生与公众服务部就指出，黑人患肾衰竭的可能性是白人的4倍，拉丁裔患肾衰竭的可能性几乎是白人的1.5倍，但他们出现在移植等待名单上的可能性很小，接受器官移植的可能性也很小。

Why is that? Why is it so hard to even get on the wait-list in the first place?

为什么呢? 为什么起初进入等候名单就这么难?

It's a great question. Well, quite frankly, simply put, you have to have resources to be able to complete your evaluation and your workup to make it to the waiting list.

这是个好问题。嗯，坦率地说，简而言之，你必须有资源完成进入等候名单的评估和检查。

So, if you look, there are about 700,000 Americans that have kidney failure.

如果你仔细观察，大约有70万美国人患有肾衰竭。

Fewer than 100,000 are currently wait-listed for transplant.

目前只有不到10万人在等待移植的名单上。

So we know not all patients who would benefit from transplant ever make it to the waiting list.

我们知道，并非所有能从移植手术得益的患者都能进入等待名单。

And that certainly disproportionately impacts people who self-identify as African American or Black.

从比例上讲，这对那些非裔美国人或黑人的影响尤其大。

And, certainly, social determinants of health drive a large proportion of this.

当然，健康问题社会决定因素使这一比例加大。

So, you see individuals who are from areas of high social vulnerability struggle to a much larger extent to make it to the waiting list and to achieve transplant.

你可以看到，社会高度脆弱地区的人基本上很难进入等待名单并实现移植。

Dr. Locke, you -- you're on the front lines of this every day.

洛克医生，你每天都在第一线。

I have to ask, when you look at this plan, do you believe a competitive process, the proposal, as they have put it forward, that this can help to fix the system?

我不得不问，当你看到这个计划时，你是否相信他们提案中提出的竞争过程可以帮助修复这个系统?

I think it certainly can. And it certainly can't hurt.

我认为当然可以。这当然不会有什么坏处。

There's nothing worse than going into clinic and evaluating patients, and knowing that even those patients who qualify for wait-listing, many of them are going to die before we ever have an opportunity to offer them a transplant.

没有什么比走进门诊部评估病人更糟糕的了，要知道，即使是那些符合等待名单条件的病人，他们中的许多人在我们有机会为他们提供移植之前就已经去世了。

And we know that transplants are lifesaving, life-giving. They are associated with a substantial survival benefit.

我们知道移植可以挽救生命，赋予生命，与重大的生存相关。

And what is just so disheartening is to know that, in many cases, organs are being discarded simply from logistical challenges, from not getting the organs where they need to go fast enough.

令人沮丧的是，在许多情况下，器官被丢弃仅仅是因为物流挑战，因为没有快速地将器官运送到需要的地方。

Organs have a shelf life. They can only be out of the body for so long, they can only be on ice for so long before they're no longer good enough to transplant.

器官是有保质期的。器官无法在体外待很长时间，在它们不再适合移植之前，只能在冰上保存一段时间。

So, no matter how good an OPO is at finding an organ, or how good a transplant center is at accepting those and doing the transplant, if they don't get where they're needed quickly enough, then it -- the game is over.

不管器官获取组织有多擅长寻找器官，也不管移植中心有多擅长接收器官进行移植，如果它们不能快速到达需要的地方，那么万事俱休。

And so I think anything that can help our system get better, to be more efficient, so that we can help those individuals waiting, that's a win.

我认为做一些任何能帮助我们的系统变得更好，更有效率的事情，以便能帮助那些等待移植的患者，这就是胜利。

Meanwhile, as we mentioned, there are more than 100,000 people currently on that wait-list.

与此同时，正如我们提到的，目前有超过10万人在等待名单上。

What does this proposal mean for them?

这个提议对他们来说意味着什么?

Well, my hope is that it means that they have a new, renewed hope for the opportunity to achieve the gift of life in the form of a transplant.

我的希望是，这代表他们有了新希望，有机会通过移植来实现生命的赠与。

My hope is that it gives them a voice.

我希望这能给他们一个发声的机会。

I think this is the Biden administration, along with the Senate and the House, which has had bipartisan support, saying we need to do better.

我认为拜登政府、以及参议院和众议院得到了两党的支持，他们在表达他们需要做得更好。

We need to do more for these individuals who have been waiting, and to let them know that they're not forgotten, and that we need to do better collectively to help them achieve this extraordinary gift of life.

我们需要为这些一直在等待的人做更多的事情，让他们知道他们没有被遗忘，我们需要一起做得更好，帮助他们获得非凡的生命赠与。

That is Dr. Jayme Locke joining us from the University of Alabama at Birmingham.

这是来自阿拉巴马大学伯明翰分校的杰米·洛克医生。

Thank you for your time, Doctor.

谢谢你能抽出时间，医生。

Thank you.

谢谢你！