美国计划全面改革器官移植系统(上)

The Biden administration announced plans today to overhaul the network that's run the nation's organ transplant system for nearly four decades.

拜登政府今天宣布计划对运行了近40年的国家器官移植系统网络进行全面改革。

The United Network for Organ Sharing, known as UNOS, has faced criticism for inadequately managing the process.

器官共享联合网络(简称UNOS)因管理不当而受到批评。

In 2022, doctors performed more than 42,000 transplants in the U.S.,

2022年，美国医生进行了42000多例移植手术，

but there are still 104,234 men, women and children currently on the organ transplant wait-list,

但目前仍有104234名男性、女性与儿童在等待器官移植，

and, every 10 minutes, another person is added to that list; 17 people die every day waiting for an organ transplant.

并且，每10分钟就会增加一个人等待器官移植; 每天有17人因等不到器官移植而丧命。

The proposal would open up a competitive bidding process for other organizations to possibly take over the network, with a goal of shortening wait times and saving lives.

该提案将为其他组织可能接管该网络打开一个竞争性招标过程，目的是缩短等待时间，拯救生命。

To help us understand why this overhaul is crucial, I'm joined by Dr. Jayme Locke, director of the Division of Transplantation at the Heersink School of Medicine for the University of Alabama in Birmingham.

为了帮助我们理解这一改革至关重要的原因，我邀请到了伯明翰阿拉巴马大学希尔辛克医学院移植部门主任杰米·洛克医生。

Dr. Locke, welcome and thanks for joining us.

洛克医生，欢迎欢迎，感谢加入我们节目。

There's a lot the administration's plan seeks to do.

拜登政府有很多计划要实施。

At the heart of it, though, is breaking up this network that's basically operated like a monopoly for almost 40 years.

而核心是打破这个基本上垄断了近40年的网络。

Help us understand, how did it come to be that way in the first place?

为了帮助我们理解，事情最初是如何变成这样的?

Yes, thank you so much.

非常感谢邀请我参加节目。

I think, in many ways, it's been that way because sort of there's been a lot of inertia to overcome.

考虑到方方面面，我认为变成这样，是因为需要克服很多一贯做法。

In part, it reflects how the National Organ Transplant Act was written, and sort of some of the requirements that HRSA has in terms of administering that contract.

一部分，这反映了《国家器官移植法案》的制定过程，以及卫生资源和服务管理局(HRSA)在管理合同方面的一些要求。

But it's great to see a desire to reflect on where we are and how we can get a lot better, so that we can help our patients.

不过，还是很高兴看到，人们希望反思我们的现状以及改进方法，以便能帮助我们的病人。

So, that UNOS system relies basically on a network of more than 50 local organizations to both procure the organs and also help to manage the transplant process.

器官共享联合网络主要依靠一个由50多个当地组织组成的网络，这些组织既能获取器官，又能帮助管理移植过程。

And we should note that network is responsible for increasing the number of transplants performed over the years, but critics say that system has led to vast regional inequities.

我们应该注意到，该网络使近年来移植手术数量得以增加，但批评者则表示，该网络导致了较高的地区不平等。

Where have you seen that shown up?

表现在哪些区域?

Well, I think for us, in particular, in the southeastern United States, particularly when you look at things like kidney disease, there's no question that, recently, we have seen an increase in the number of transplants,

嗯，我想，特别是当你看到美国东南部地区肾脏等疾病的情况时，毫无疑问，我们也相应地看到了近期器官移植数量的增加，

but that really reflects, sadly, an opioid crisis that's really increased the number of deceased donors as a result of that.

不过，悲哀的是，这确实反映了阿片类药物危机，而这一危机确实造成遗体捐献者数量的增加。

But what those numbers don't reflect is the increase in discards that we have seen as a result of some of the new allocation systems.

但这些数字并没有反映出，我们看到的因新的分配系统而造成的器官丢弃的增加。

And, currently, due to inefficiencies with our allocation systems, as well as logistics, one in four kidneys are actually discarded in the United States, are not transplanted.

目前，由于我们的分配系统与组织工作效率低下，美国四分之一的肾脏实际上没有被移植，而是被丢弃了。

That's one in four. That's 25 percent. And those are really lives that could have been saved if we could have utilized those organs.

那是四分之一。也就是25%。如果我们能利用这些器官，可以挽救25%的生命。