活體腎臟移植評估成敗與捐受贈者壓力相關因素之探討-以台中榮民總醫院為例

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题名:	活體腎臟移植評估成敗與捐受贈者壓力相關因素之探討-以台中榮民總醫院為例
其它题名:	A Study of Factors Related to Living Donor Kidney Transplant – Taichung Veterans General Hospital Experiences
作者:	林依頻 Lin, YiPin
贡献者:	潘忠煜 Pan, ChungYu 東海大學工業工程與經營資訊學系
关键词:	活體腎臟移植;活體移植評估;親等關係 Living Donor Kidney transplantation;Living donor assessment;Family relationship
日期:	2012
上传时间:	2013-01-03T05:57:46Z (UTC)
摘要:	愈來愈多末期腎病透析患者在等待腎臟移植，由於器官來源的短缺，更顯出活體腎臟移植是一個值得關切的議題。在歐美國家活體腎臟移植的風氣愈來愈普遍下，我國亦開始推動活體腎臟移植以解決器官來源不足的問題並節省健保在透析項目的支出。既有研究中，針對活體腎臟移植的捐、受贈者評估時及手術後之壓力等相關因素甚少被探討，本研究基於器官移植條例五親等之限制及民族風情的差異，試著分析活體腎臟移植之捐、受贈者親等關係差異並探討相關壓力源。本研究包含台中榮總於2006年至2010年間，共127對進行活體腎臟移植評估案例之親等關係差異性及未能通過評估進行移植手術之原因分析，並針對正進行移植前後所評估之16對捐、受贈者進行深度訪談。本研究發現，不同親等關係之捐贈移植(父母捐子女、子女捐父母、手足間、夫妻)進行評估與接受移植手術，統計上並無顯著性差異。然而深度訪談中，不同的捐贈親等關係存在著不同的考量，家庭因素及相關支持系統占大部分影響。一支完整專業且有經驗的醫療團隊，團隊成員各司其職才能使移植更加圓滿，精神科心理師、社工師及早介入評估並尋求相關資源，確認捐贈動機、壓力源及其家庭支持系統，可避免後續進行侵入性檢查及醫療資源的浪費。 The number of patients who have reached at end stage of renal disease and are waiting for kidney donation increase stably. Due to organ shortage, living kidney donation becomes an important issue. In Europe and United States, the proportion of living organ donation has increased gradually. In Taiwan, government promotes living donor kidney transplantation to overcome organ shortage and reduce health care budget on dialysis. There is a few researches focus on the stress on donors and recipients during donation evaluation and post operative period.From 2006 to 2010 at Taichung Veterans General Hospital, 127 pairs of living kidney donor & recipient have been receive pre-transplant evaluation. We analyzed the reason of failure to proceed, and found that there was no significant differences among relative relationship those were parents to children, and vise versa, sibling, and couple. In addition, when we deep interview 16 pairs of living kidney donor & recipient who are undergoing evaluation process and find that different relative relationship posses various considerations. Family issue plays major role.A complete and experienced medical team with the psychologist and social worker perform early intervention into the evaluation process. To confirm the motivation, source of pressure and family support system can help early differentiation of possible donation and prevent the waste of medical fee of subsequent interventional examination.
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