中国的器官移植，面临着从哪里来、到哪里去两大难题。正因为器官资源紧缺，才更需要公正的分配。本月10日，卫生部新闻发言人表示，《中国人体器官获取与分配管理办法(试行)》已讨论通过，将于近期印发全国。

Chinese organ transplantation,Faced with come from/Where to two big problem.Because of organ resource shortage,Just need more fair distribution.This month 10,The ministry of health news spokesman said,[China human organs obtain and distribution management measures(trial)]Has been discussed through the,In the near future will be issued by the national.

　　管理办法规定，今后有关医院如获得器官，均须通过“中国人体器官分配与共享系统”统一分配。这是一套什么样的系统？背负生命的期待，它如何能够确保公平公正？又将如何确定在众多需要器官移植的患者中，准确找到“最需要”的那个人？日前，本报记者就此专访这一系统的设计者、香港大学外科学系研究主任王海波。

Management measures,The hospital in the future such as get organs,Shall be through the"China human organs distribution and sharing system"Uniform distribution.This is a what kind of system?Bear the life's expectation,How it will be able to ensure a fair and just?And how to determine the need organ transplants in many patients,Accurately find"Most in need"the?a,Our newspaper reporter interviews the system designer/Department of surgery, university of Hong Kong research WangHaiBo director.

　　

□卫生新政 - health New Deal

　　

器官分配系统拟强制推行 Organ distribution system quasi impose

　　据王海波介绍，受国家卫生部委托，香港大学中国肝移植注册研究中心于2009年9月开始人体器官分配与共享政策研究项目，2010年完成《中国人体器官分配与共享基本原则和肝脏、肾脏分配与共享核心政策》(以下简称“核心政策”)的起草，并于当年12月正式下发执行。

According to WangHaiBo introduced,Entrusted by the state ministry of health,The university of Hong Kong Chinese liver transplantation registered research center in September 2009 began to human organs distribution and sharing policy research project,Completed in 2010[China human organs distribution and sharing basic principle and liver/Kidney distribution and sharing core policy](Hereinafter referred to as"Core policy")drafting,And in the December formally issued execution.

　　外界广泛关注的器官统一分配，具体由“中国人体器官分配与共享系统”(以下简称“分配系统”)来实现。分配系统基于核心政策而研发，去年4月6日上线试运行。

The outside world wide concern organ uniform distribution,The specific"China human organs distribution and sharing system"(Hereinafter referred to as"Distribution system")To realize.Distribution system based on the core policy and research and development,Last April 6 on-line test run.

　　王海波表示，在试运行期间，这套分配系统只是“要求使用”，待管理办法正式发布后，分配系统的使用将带有强制性。

WangHaiBo said,In the trial run period,This distribution system only"require",The measures for the administration of the stay after the official launch,The use of the distribution system will be a mandatory.

　　据介绍，这套分配系统包括两个子系统，分别是器官移植等待者预约名单系统和器官捐献者登记及器官匹配系统。

According to introducing,This distribution system including two subsystems,Respectively are waiting for organ transplants the reservation list system and organ donor registration and organs matching system.

　　移植中心需将移植等待者的病例录入前一个系统，目前它包括了肝、肾移植的等待者预约名单系统；而器官获取组织则将捐献者信息录入后一系统，最终通过后一系统触发器官匹配，自动在两个子系统之间进行交互匹配。

Transplant center should be waiting for transplantation of those cases before entering a system,It includes the liver/Renal transplantation is waiting for the appointments list system;And organs for organization will donor information recorded after a system,Finally through a system trigger organs after the match,Automatic in two subsystems interact between matching.

　　自开始试点以来，这套系统已经完成340个器官的分配。通过分配系统，如果器官获取组织辖区内没有合适的等待者，可以将器官共享给器官获取组织所在省级等待名单，乃至更大范围。这个地理分配政策可以有效减少器官浪费。

Since start since the pilot,The system has been completed 340 organ allocation.Through the distribution system,If the organ for organizations within the jurisdiction of no suitable waiting for the person,Can organ sharing to organ at the provincial level for organization in a waiting list,And even greater range.The geographic distribution policy can effectively reduce waste organs.

　　

□政策监管 - policy supervision

　　

违规分配将取消资质吊销证书 Illegal distribution will cancel the qualification certificate revoked

　　王海波介绍，这套分配系统是一个自动化计算机系统，严格遵循国家分配政策。

WangHaiBo introduced,This distribution system is an automated computer system,Strictly follow the national distribution policy.

　　根据统计，经分配系统进行分配，从录入供者信息后触发分配，到器官真正被分配到等待者身上，整个分配过程平均用时26分钟，其中匹配环节的平均时间仅为0.96秒。整个过程完全排除了人为干扰。

According to statistics,The distribution system of distribution,From entering donor information trigger distribution,To organ really was assigned to wait upon those,The whole distribution process when average 26 minutes,The matching link the average time of just 0.96 seconds.The whole process completely ruled out the human disturbance.

　　王海波说，两个子系统彼此隔离，有关人员在按键分配之前，因为全国病源状态在不断变化，根据医学需要的原则，他并不知道这个器官会去到谁身上。

WangHaiBo said,Two subsystems from each other,Relevant personnel in key distribution before,Because the pathogenic condition in the constant change,According to the principle of medical needs,He did not know this organ will go to him.

　　与此同时，每一次分配痕迹都将被永久保留在系统数据库中。如有疑义可以随时重建任一次的分配，重审案例，查看任何可疑的地方。

meanwhile,Every time distribution mark will be permanently retained in the system's database.If you have any questions at any time can rebuild the distribution of the time,Retrial case,Check any suspicious place.

　　此外，从监管的角度讲，整个分配过程受人体器官捐献工作委员会监督。每个省的卫生行政部门和国家卫生部都有这个系统的监督账户，他们可以随时登录系统，实时查看器官的分配和接受情况。

In addition,From the standpoint of supervision,The whole process of distribution by human organ donation working committee supervision.Every provincial administrative department of public health and the state ministry of health has the system to the supervision of the account,They can always login system,Real-time view organ allocation and accept the situation.

　　据业内人士透露，管理办法将对在器官分配过程中出现的违规行为，视情节轻重及危害程度，由中国人体器官捐献工作委员会、卫生部人体器官移植技术临床应用委员会和卫生行政部门分别处以取消器官分享权、取消移植资质、吊销医师执业证书等处罚。构成犯罪的，将依法追究刑事责任。

According to industry insiders revealed,The measures for the administration of the will in the organ distribution appeared in the process of illegal behavior,The seriousness of the cases and the damage degree,By the China human organ donation working committee/The ministry of health human organ transplant technology clinical application committee and the public health administrative departments respectively be cancelled FenXiangQuan organs/Cancel transplantation qualification/Revoke his practicing certificate of doctors and punishment.Constitute a crime,Shall be investigated for criminal responsibility according to law.

　　

□器官分配流程 - organ allocation process

　　1由器官获取组织录入供者信息2器官获取组织触发分配系统按照核心政策进行供受者匹配

1 by the organ for organization type donor information 2 organs for organization trigger distribution system according to the core policy matching for recipients

　　3分配系统向器官获取组织、匹配到的等待者所在移植中心发送匹配结果(系统实时通知，短信通知)

3 distribution system to obtain tissue organ/Matching to wait in the transplant centers send matching results(System real-time notice,SMS notification)

　　4移植中心回复(接受/拒绝)分配

4 transplant center reply(Accept/reject)distribution

　　5器官获取组织确认分配结果

Five organs confirm the distribution result for organization

　　6获得分配的移植中心接收器官后上传器官接收确认书

6 get assigned transplantation center after receiving organs upload organs receive confirmation

　　

□分配原则 / distribution principle

　　

如有适合病人医院享有优先权 If there are suitable for patient hospital enjoy a right of priority

　　此前有报道称，卫生部“新规”的出台将意味着获取器官的医院优先使用器官的权利将不复存在。但王海波表示，这种说法并不准确。据他介绍，此前我国的器官捐献处于医院内部自行分配的状态。和以往相比，管理办法并没有完全取消器官获取组织辖区内医院的优先权。因为管理办法将实行区域优先的原则，捐献的器官首先分配给器官获取组织所属移植医院的器官移植等待者，其次是省级行政区域内的其他移植医院的器官移植等待者，最后才在全国范围内所有移植医院的器官移植等待者中进行分配。

Earlier reports said,The ministry of health"The new gauge"Come on stage will mean for organ hospital use priority is given to the rights of organs will disappear.But WangHaiBo said,This statement is not accurate.According to he introduced,After China's organ donation in the hospital internal to the state of the distribution.Than ever and,Management measures and not completely cancel organ for organizations within the jurisdiction of the priority of the hospital.Because management measures will carry out the principle of priority areas,Donor organs first assigned to organ transplant for organization belongs to the hospital waiting for the organ transplantation,The second is the provincial administrative area of the other transplantation hospital organ transplant waiting for the person,Finally in the nationwide all transplant hospital organ transplant waiting in the distribution.

　　但管理办法也将鼓励有条件的省级行政区域可取消器官获取组织所属移植医院的优先权，实行省级行政区域内的统一器官共享。

But management measures will also encourage conditional provincial administrative area can cancel the organs for transplant hospital organization belongs to the priority,To the provincial level administrative areas organs of the unified sharing.

　　“留在医院用，前提是你有合适的病人，如果没有就一定要共享出去，不能把器官浪费了。”王海波说，保留优先权实际上也是出于移植效果考虑，器官分配给所在医院的病人，可以避免因为运送器官而产生的缺血性损伤，提升移植效果。

"Stay in the hospital with,If you have the right patient,If there is no must share out,Can't waste organs."WangHaiBo said,Keep priority in fact also from transplantation effect to consider,Organs assigned to the hospital where the patient,To avoid because of transport organs and produce ischemic injury,Ascension transplantation effect.

　　据介绍，目前有些城市打破医院优先，实现了区域共享，但这需要具备运输、协调等各方面综合条件。

According to introducing,At present some cities to break the hospital is preferred,To realize the regional sharing,But this need to have transportation/Coordination and so on various aspects comprehensive conditions.

　　即使在同一家医院，到底谁才是最需要器官的人也是一个问题。王海波对此表示，器官分配政策是一个综合的评分体系，不同的器官移植供受者匹配需要考虑的因素不同，分配政策也不同。(见链接)

Even in the same hospital,Who is the most need organ is a problem.WangHaiBo expressed,Organ allocation policy is a comprehensive rating system,Different organ transplant recipients for matching need to consider different factors,Distribution policy is also different.(See links)

　　

■链接 S link

　　

肝脏移植分配政策 Liver transplantation distribution policy

　　1.区域优先原则；

1. Regional priority principle;

　　2.儿童匹配优先原则；3.病情危重优先原则；4.血型匹配；

2. Children matching principle of priority;3. The priority principle of critical illness;4. Blood group matching;

　　5.器官捐献者及其直系亲属的优先权；

5. Organ donor and its directly-related members of one's priority;

　　6.已登记自愿捐献器官者的优先权；

6. Registered voluntary donor priority;

　　7.等待顺序优先原则。

7. Waiting for the order priority principle.

　　肾脏移植分配政策1.区域优先原则；2.血型匹配；3.肾移植等待者评分系统。由等待时间得分、器官捐献者及其直系亲属优先权、等待者致敏度、人类白细胞抗原配型匹配质量、儿童等待者优先权及已登记自愿捐献器官者优先权组成。

Renal transplantation distribution policy 1. Regional priority principle;2. Blood group matching;3. Kidney transplant waiting for the rating system.The waiting time scoring/Organ donor and its directly-related members of one's priority/Waiting for the sensitization degree/Human leukocyte antigen type-specific matching quality/Children waiting for the priority and registered voluntary donor of priority.

　　

□对话 / dialogue

　　

不论富翁还是高官系统只登记患者病情 No matter rich or official registration system only patient

　　京华时报：分配系统试点以来取得了哪些效果？

Jinghua times:Distribution system since the pilot made what effect?

　　王海波：从匹配质量到效率都有提升。比如效率问题，我们现在找到合适的等待者只需0.96秒，以前要很久。美国做过实验，如果是打电话，一个一个打过去，最多会到30个小时，器官就浪费掉了。

WangHaiBo:From the matching quality to efficiency have ascension.Such as efficiency,We now find the right waiting for is just 0.96 seconds,Before long.The United States did the experiment,If the call is,A a hit in the past,At most to 30 hours,Organ is wasted.

　　京华时报：系统在分配的时候，操作系统的人知不知道获取方的身份？

Jinghua times:System in the distribution,The operating system of the people know the identity of the receiving party?

　　王海波：所有的病人都没登记他的身价多少，是富翁还是高官，记录的只是他的病情。所以说大家担心统一分配会不会优先给当官的、有钱的，系统做不到这一点。另外每个人所有的操作都是有记录的，我们有能力恢复任何一个分配，无论是谁来查询，我们都可以回溯当时的分配情况，看看操作是不是合理。

WangHaiBo:All patients had no registration he is worth much,Is a millionaire or high-ranking officials,Record is his illness.So, we worry about uniform distribution will give priority to be an official/rich,The system can't do this.In addition each people all the operations are recorded,We have the ability to restore any distribution,No matter who to query,We can trace the distribution,Look at the operation is reasonable.

　　京华时报：有没有给分配操作人员私下“打招呼”的可能？

Jinghua times:Have to distribution operating personnel in private"Say "hello""may?

　　王海波：操作人员根本不知道“打招呼”涉及的等待者在系统里的状态，他没有这个权限。这个器官获取组织看不到病人的情况，是隔离的，即使是分配完了，他连获得者的名字都不知道。

WangHaiBo:Operating personnel didn't know that"Say "hello""Those involved in the system the waiting for the state,He doesn't have this authority.The organ for organization can't see the patient's condition,Is isolated,Even distribution over,He even the name of the winner of all don't know.

　　京华时报：怎么确保数据匹配的时候不会出错？

Jinghua times:How to ensure that data matching time will not go wrong?

　　王海波：我们有很多的技术、流程上的设计来保证这一点。比如血型很重要，一旦搞错会死人。我们就规定血型的输入需要输两次，一个人输完以后，必须由另外一个人重新再输一遍，这两个人必须是不同的人、不同的账户，两次要在不同的时间检测。这样交叉来确定这个数据不会出错。这也是我们为什么对使用者有一个很强的限定，如果出了错，追踪是谁出的错，如果有违规，我们会知道是谁违规。

WangHaiBo:We have a lot of technology/The process design to ensure this.Such as blood type is very important,Once make a mistake will be dead.We'll regulation blood type of input need to lose two times,A man after losing,Must by another person to lose it again,The two men must be different people/Different account,Two times in different time detection.Such cross to make sure that the data is not an error.This is also why we to the user has a strong limit,If the wrong,Who is tracking the wrong,If an illegal,We will know who is illegal.

　　京华时报：如果捐赠器官所在的医院没有合适的病人就要把器官拿出来共享，这对医院的积极性会不会有影响？

Jinghua times:If the organ donation in the hospital without appropriate patient will take out the organ sharing,The hospital's enthusiasm will there be influence?

　　王海波：实际上在试点过程中，很多医生很欢迎这个系统。因为当人来操作的时候，会有各种因素的干扰，有时候医生本来不想这样做，但是很难抵抗这个干预。另外试点医院在规定的时间内必须完成一定数量的公民逝世后捐献案例，如不能，将取消试点医院的移植资质。因此这对医院来说某种程度上促进了器官捐献。

WangHaiBo:In fact in the pilot process,Many doctors welcome this system.Because when people to operations,There will be various factors of interference,Sometimes the doctor didn't want to do so,But it is difficult to resist the intervention.Another pilot hospital within the time prescribed by the must complete a certain number of citizens donors after death case,If you can not,The pilot will cancel the transplantation of hospital qualification.So this is for the hospital to a certain extent promote the organ donation.

　　京华时报：我有一点不明白，比如器官所在的医院有患者需要器官，但得分比较低，另外一家医院得分高，这个情况是考虑本医院优先还是运到另外一家医院？或者其他的处理方式？

Jinghua times:I am a little bit don't understand,Such as organ in the hospital has patients need organ,But scoring is low,Another hospital score high,This situation is to consider the hospital priority or to another hospital?Or other processing mode?

　　王海波：最好就是综合性考虑，前提是有数据的，我们分析器官从一个城市到另外一个城市造成的影响，判断出来一个人得多少分该共享，多少分不共享。超紧急的患者，可能生存时间很短了，这些患者我觉得是应该打破医院优先权的，但是这种患者到底有多少，我们要等有数据之后，来看会出现什么情况，这个政策是由器官捐献专家委员会和工作委员会来定的，可以提交讨论它的可操作性到底是不是公平的，临床会产生什么效果，政策一旦这么改了以后，我们可以用数学模型来模拟对患者疗效的冲击。你问的问题也是我们在思考的问题。我觉得应该对超紧急患者实施打破医院优先，这会在系统使用一段时间，有了相关数据之后递交给专家委员会讨论。

WangHaiBo:It is best to comprehensive consideration,Premise is a data,We analysis the organ from one city to another city the impact of,Tell a man score this sharing,How many points do not share.Super emergency patients,May survival time is very short,These patients I think should break the hospital priority,But this how many patients,We have to wait until after the data,To see what would happen,This policy is by the organ donation experts committee and working committee to decide,Can submit to discuss its maneuverability is what is fair,Clinical will produce what effect,Policy once so changed later,We can use mathematical model to simulate the impact of the curative effect to patients.The question that you ask is also we are thinking about the problem.I think should be to super emergency patients implement break hospital is preferred,This system USES period of time,After the data submitted to the expert committee for discussion.

　　京华时报：病情重也优先于匹配度吗？比如一个人病危，但是匹配度并没有另外一个人高，器官会给谁？

Jinghua times:Illness weight also take precedence of matching degree?For instance, the person is dying,But the matching degree and not another high,Organ will give who?

　　王海波：病情和匹配度相互之间涉及复杂的风险和效益的平衡和计算，是一个复杂的医学问题。要决定哪种对患者是利大于弊的。(记者 张然 制图 吴尚楠)

WangHaiBo:The illness and matching degree between each other in complicated risk and benefit balance and calculation,Is a complex medical problems.To decide which to patients of outweigh the drawbacks.(Reporter ZhangRan drawing WuShangNan)