It's mostly routine - name, address, and other information - but there's one box

大部分是常規資訊--姓名、地址和其他資訊--但有一個框框

that sticks out.

突出的。

It reads “Do you wish to be an organ or tissue donor?”.

上面寫著 "你想成為器官或組織的捐贈者嗎？"。

You've heard about organ donation of course, but you're not really sure what it entails

你當然聽說過器官捐獻，但你並不清楚它需要什麼。

- and you've got to decide whether to sign up for it right now!

- 你得決定是否現在就報名參加!

What actually happens when you donate your organs?

捐獻器官後到底會發生什麼？

Around the world, countless people are sick because one of their organs isn't functioning

在世界各地，無數的人生病是因為他們的一個器官不能正常工作。

properly.

適當。

This could be due to an injury requiring the removal of an organ, an illness that causes

這可能是由於受傷需要切除器官、疾病導致的。

damage to the cells in the organ, or a genetic condition that slowly degrades the function.

器官細胞受損，或者是遺傳性疾病，功能慢慢退化。

In past times, there was little way to save someone with a malfunctioning necessary organ,

在過去的時代，必要器官失靈的人幾乎沒有辦法救治。

although some artificial methods like dialysis were developed.

雖然開發了一些人工方法，如透析。

But in the 19th century experiments began in transplanting a healthy organ from a donor

但在19世紀，開始了從捐贈者身上移植健康器官的實驗。

to a new recipient.

給新的收件人。

The earliest attempts at organ transplant were called autografts and involved skin - transplanting

最早的器官移植嘗試被稱為自體移植，涉及皮膚--移植。

skin from a healthy area of a person's body to a damaged area on the same person.

從一個人身體的健康部位到同一個人的受損部位的皮膚。

Some reports indicate this technique was created by the Indian surgeon Sushruta over 2000 years

有報道稱，這種技術是印度外科醫生Sushruta在2000多年前創造的。

ago, and later continued by Italian surgeon Gasparo Tagliacozzi

後來由意大利外科醫生Gasparo Tagliacozzi繼承。

The science of organ donation, though, had a long way to go.

不過，器官捐獻的科學性還有很長的路要走。

Experiments in transplanting parts from one person to another may have gone back much

從一個人身上移植到另一個人身上的實驗可能要追溯到很久之前

further, but lacked the understanding we have today.

進一步，但缺乏我們今天的認識。

Roman Catholic doctrine say Saints Damian and Cosmas managed to replace the gangrenous

羅馬天主教教義說，聖人達米安和科斯馬斯設法取代了壞疽的

leg of the Roman Emperor Justinian with the leg of a dead Ethiopian man.

羅馬皇帝查士丁尼的腿和一個死去的埃塞俄比亞人的腿。

If it happened, it would have been a miracle - even today most amputees are still limited

如果它發生了，那將是一個奇蹟--即使在今天，大多數截肢者仍然是有限的。

to state-of-the-art prosthetics, with limb transplants still being a work in progress

到最先進的假肢，而肢體移植仍在進行中。

and very rare.

而且非常罕見。

Other reports say Pien Chi'ao, an early Chinese physician, performed a double heart

其他報道稱，中國早期的醫生Pien Chi'ao進行了雙心的

transplant between two men to balance their spirits.

移植到兩個人之間，以平衡他們的精神。

But all these reports are apocryphal and heavily doubted by modern scientists.

但這些報道都是無稽之談，現代科學家對此深表懷疑。

It would be centuries later before doctors would find the trick.

幾百年後，醫生才找到了竅門。

Transplant of organ or tissue to a different donor is called the allograft, and it wasn't

將器官或組織移植到不同的供體上，稱為異體移植，而這不是

until 1837 when the first successful attempt was made - on a Gazelle, who had been used

for experiments on corneal transplants.

用於角膜移植的實驗。

Once it was successful, it would be Doctor Eduard Zirm in the Czech Republic who performed

一旦成功，就由捷克共和國的愛德華-澤爾姆博士來執行。

the first successful transplant of a cornea on a human.

首次成功地將角膜移植到人類身上。

The next step would be transplanting of Thyroid tissue to replace an organ's function, performed

下一步將是移植甲狀腺組織，以取代器官的功能，進行。

in 1883 by Doctor Theodor Kocher - twenty-two years before Zirm's breakthrough.

1883年，由西奧多-科赫醫生提出，比Zirm的突破早了22年。

While this was successful, tissue was working and organs weren't - yet.

雖然這是成功的，但組織在工作，器官還沒有--。

That changed in 1954.

這種情況在1954年發生了變化。

Richard Herrick was a Navy man who was gravely sick with kidney failure.

理查德-赫瑞克是一名海軍，他因腎衰竭而病入膏肓。

His brother Ronald was willing to do whatever was needed to save him, and Dr. Joseph Murray

他的弟弟羅納德願意不惜一切代價來救他，而約瑟夫-穆雷博士

believed he could help.

相信他能幫上忙。

He performed a kidney transplant, and unlike past unsuccessful cases where recipients lived

他進行了腎臟移植手術，與以往不成功的案例不同，受術者活了

less than a month, Richard lived another eight years!

不到一個月，理查德又活了8年!

Dr. Joseph Murray received the Nobel Prize, but there was one key to this surgery that

約瑟夫-默裡博士獲得了諾貝爾獎，但這個手術有一個關鍵，那就是

wouldn't be easy to duplicate.

就不容易複製了。

The Herrick brothers were identical twins and had identical genetics, meaning the kidney

赫瑞克兄弟是同卵雙胞胎，基因相同，也就是說，腎臟的

transplant was essentially an autograft.

移植本質上是一種自體移植。

But not everyone has an identical twin to be their perfect donor.

但並不是每個人都有同卵雙胞胎作為自己的完美捐贈者。

So what's the trick to making organ donation work?

那麼，讓器官捐獻成功的訣竅是什麼呢？

Preventing rejection.

防止被拒絕。

Our bodies are complex, and two key elements have to match for an organ to be a suitable

我們的身體是複雜的，一個器官要想成為一個合適的器官，必須要有兩個關鍵的要素相匹配。

match for a person.

匹配的人。

The first is blood type, and there are four blood types - each with different compatibility

首先是血型，有四種血型--每種血型的兼容性不同

for donation.

捐贈。

While type O blood is considered the universal donor and is the most common, type A, B, and

雖然O型血被認為是通用的捐獻者，也是最常見的，但A型、B型和C型血也是最常見的。

AB are progressively more limited in who they can donate to.

AB公司能捐助的對象逐漸受到限制。

Then it's on to HLA typing, to make sure the proteins, or antigens, in the body cells

然後再進行HLA分型，以確保人體細胞中的蛋白質，或抗原。

won't conflict.

不會衝突。

If the antigens are different, the body can make antibodies against their new organ and

如果抗原不同，機體可以針對其新的器官產生抗體，並。

reject it.

拒絕它。

That's where the wonder of modern medicine comes in.

這就是現代醫學的神奇之處。

While perfect matches on HLA type are rare, medicine is available to keep the body from

雖然HLA類型完美匹配的情況非常罕見，但目前已有藥物可以讓身體免受

creating these antibodies.

創造這些抗體。

These anti-rejection medications are prescribed to people after almost all transplants, and

這些抗排斥藥物幾乎在所有的移植手術後都會給人們開出，而且。

most people wind up taking these drugs as long as they have their transplanted organ

大多數人只要有移植器官就會服用這些藥物。

- so ideally, their whole life.

- 所以理想中，他們的一生。

Medical science marched on, and with the development of anti-rejection drugs, it became possible

醫學科學在前進，隨著抗排斥藥物的發展，成為可能。

to transplant many organs that people couldn't live without.

來移植許多人們不能沒有的器官。

So what organs are transplanted today?

那麼，如今移植的器官有哪些呢？

Besides corneas and kidneys, which started it all, today heart, lung, and liver transplants

除了開始的角膜和腎臟之外，今天的心肺肝移植手術也是如此

are common.

是常見的。

Pancreas and intestine transplants are less common but possible, and tissue transplants

胰腺和腸道移植較少見，但也有可能，組織移植

of skin, bone marrow, and blood are almost routine.

皮膚、骨髓和血液的幾乎是常規。

Experiments in transplanting hands and arms have been performed, but preventing rejection

移植手和手臂的實驗已經進行，但防止排斥現象的發生

is far trickier and many have failed after a period of time.

是遠為棘手的，很多人在一段時間後都失敗了。

There are even experiments in transplanting a uterus so that a woman who has had a hysterectomy

甚至還有移植子宮的實驗，所以做了子宮切除手術的女性。

can carry children.

可以帶孩子。

The most stunning recent advancement in transplant science, though, is also the most visible.

不過，移植科學最近最驚人的進展，也是最引人注目的。

In the last twenty years, scientists have successfully managed to transplant whole faces!

在過去的二十年裡，科學家們已經成功地將整張臉移植到了這裡!

When dealing with patients who have been seriously disfigured from gunshots, industrial accidents,

在處理因槍擊、工業事故而嚴重毀容的病人時。

fires, or animal attacks, they take the facial tissue from a donor and place it on the surgically

火災或動物襲擊，他們從捐贈者那裡提取面部組織，並將其放置在手術後的面部。

prepped facial surface of the disfigured recipient.

預備毀容受術者的面部。

After transplant, the face eventually shifts to the skeletal structure of the donor, so

移植後，臉部最終會轉移到供體的骨骼結構上，所以。

they don't look exactly like they did before - but not like the donor either.

他們看起來不像以前那樣--但也不像捐贈者。

This surgery requires vigilance with anti-rejection medication, but was successfully performed

這種手術需要警惕，使用抗排斥藥物，但成功地進行了手術

first as a partial face transplant on a woman who lost all the skin on her lower face in

第一次是在一位失去下半臉所有皮膚的婦女身上進行部分面部移植。

a dog attack.

狗攻擊。

This led to full face transplants being performed around the world.

由此，全世界都在進行全臉移植手術。

But in almost all these cases, the donors had one thing in common.

但幾乎在所有這些案例中，捐助者都有一個共同點。

They were all dead.

他們都死了。

The most common type of organ donation today is from a cadaver to a living donor, and this

目前最常見的器官捐獻方式是由屍體向活體捐獻，這種

is what you're being asked when you sign on that dotted line.

就是你在虛線上簽字時被問到的問題。

You're agreeing that should you meet an untimely end, your organs will be harvested

你同意如果你過早地死去 你的器官會被摘取下來

from your body before you're buried or cremated.

在你下葬或火化之前，從你的身體。

Those will then be given to people who need them, letting you live on beyond your body.

這些就會交給需要的人，讓你在身體之外繼續活下去。

There's no real downside - you don't need them anymore, right?

沒有真正的缺點--你不需要它們了，對嗎？

So why wouldn't everyone sign up?

那為什麼大家不報名呢？

Well, some object because of religious rules, and others worry that the doctors wouldn't

好吧，有些人因為宗教規則而反對，有些人則擔心醫生不願意

work as hard to save them in the hospital if they saw that their organs would be harvested.

如果他們看到自己的器官會被摘取，就會努力在醫院裡救治他們。

But there is no evidence of that, and doctors say that the more people who sign up as organ

但沒有證據表明，醫生說，報名成為器官的人越多。

donors, the better.

捐助者越多越好。

So what happens when an organ becomes available?

那麼，如果有了器官，會怎麼樣呢？

Organ donors whose organs can be used are usually in good health, with their organs

可以使用器官的器官捐獻者通常身體健康，其器官的

functioning well.

運作良好。

But anything can happen, and a piano can fall on the head of anyone at any time.

但任何事情都有可能發生，一架鋼琴隨時可能落在任何人的頭上。

If a person is dead or brain dead and they're an organ donor, the hospital springs into

如果一個人已經死亡或腦死亡，他們是一個器官捐贈者，醫院就會跳出來。

action to keep the organs in good condition until the time.

動，使器官保持良好的狀態，直到時。

If someone is still clinically alive, they may be kept on life support longer than usual

如果一個人在臨床上仍然活著，他們可能會比平常更長時間地保持生命支持。

to keep their organs healthy.

以保持其器官健康。

If they didn't have a directive either way on whether they're an organ donor, the doctors

如果他們對自己是否是器官捐獻者沒有任何訓示，醫生就會

will often ask the grieving family if they would be willing to sign the papers - but

往往會問悲傷的家人是否願意簽署文件 - 但

it is always up to the person or their family.

始終取決於當事人或其家人。

From there, the organs will go to the next person on the organ donation list.

從此，器官將被送到下一個器官捐贈名單上的人手中。

Wait, there's a list?

等等，還有一個名單？

In the United States, the United Network for Organ Sharing oversees the transplant system

在美國，"器官共享聯合網絡 "負責監督移植系統。

for most cases, keeping a registry of everyone who is in need for an organ.

在大多數情況下，為每個需要器官的人保留一個登記冊。

When an organ comes in, they filter it by compatibility, size, and geography to give

當一個器官被送來時，他們會根據兼容性、大小和地理環境進行篩選，從而給出了

the transplant the best chance for success.

移植成功的最佳機會。

Each person's place on the list is determined by their medical urgency, their waiting time,

每個人在名單上的位置是由他們的醫療緊急程度、等待時間決定的。

and their age - with younger recipients being higher on the list.

以及他們的年齡----年輕的受助者在名單上的排名較高。

The things that don't play a role?

不起作用的東西？

Income, insurance status, or celebrity status.

收入、保險狀況或名人身份。

If you wind up on the organ donation list, it doesn't matter who you are - the factors

如果你被列入器官捐獻名單，不管你是誰---------------------------------------因素

are always the same, and you can't buy your way into a higher slot ahead of someone who

始終是一樣的，你不能買到你的方式進入一個更高的插槽前面的人誰

needs it.

需要它。

And when the time comes, the organ donation team moves fast.

而當時間到了，器官捐獻團隊的動作也很快。

A patient comes in and can't be saved.

一個病人來了，救不了。

They are assessed for organ health and matched to a recipient.

他們將接受器官健康評估，並與受體匹配。

The organs are harvested and chilled until use, but the clock is ticking.

器官採摘後，冰鎮後再使用，但時間在流逝。

Doctors will try to find a match as close as possible, but if a high-priority recipient

醫生會盡量尋找匹配的對象，但如果是高優先級的受術者。

is far away, they will transport that organ via courier with the highest priority.

遠，他們會通過快遞將該器官以最優先的方式運輸。

The goal is to get it to the hospital for transplant while it's still fresh and keep

我們的目標是趁著它還新鮮，把它送到醫院去移植，並保持

it from getting damaged - although, despite what a TV show once showed, there are no reports

雖然，儘管一個電視節目曾經展示過，但並沒有報道說，它被損壞了

of transplant hearts getting eaten by dogs along the way.

的移植心臟被狗沿途吃掉。

The problem is, there are a lot more people in need of organs than there are organs available,

問題是，需要器官的人比現有的器官多得多。

especially for those with rarer blood types.

特別是對於那些血型比較罕見的人來說。

That's why there's another way.

所以才會有另一種方式。

If you sign up to be an organ donor, the only time this will be relevant is if you're

如果你報名成為器官捐獻者，只有在以下情況下才有意義

dead or almost dead.

死了或幾乎死了。

But since the first living donor transplant between the Herricks, living donor transplants

但自從Herricks夫婦進行了第一例活體捐獻移植後，活體捐獻移植就開始了

have become more common, especially for rare blood types who could be waiting a long time.

已經變得越來越普遍，特別是對於罕見的血型，可能要等很久。

Approximately one in three donors of kidneys is now still living, and it's common for

現在大約每三個腎臟捐贈者中就有一個還活著，常見的是

them to be from family or close friends of the person who needs a kidney.

他們是來自需要腎臟的人的家人或親朋好友。

Doctors will assess the person's physical and mental health and the health of their

醫生會對患者的身心健康和健康狀況進行評估。

organs, and make sure they're not under any duress.

機關，並確保他們沒有受到任何脅迫。

But what happens if someone doesn't have anyone they know willing to donate a kidney?

但是，如果有人沒有認識的人願意捐腎，怎麼辦？

The advance of the internet and social media have given new hope.

互聯網和社交媒體的發展給人們帶來了新的希望。

People with a rare blood type have put out blasts on social media, asking for help to

罕見血型的人在社交媒體上放出了爆料，請求幫助，以

find a donor.

找到一個捐贈者。

In 2009, Chris Strouth managed to find a kidney donor on Twitter.

2009年，Chris Strouth在Twitter上成功找到了一位腎臟捐贈者。

And when there's no direct match, a new possibility has emerged - kidney chains.

而當沒有直接匹配的時候，又出現了一種新的可能--腎鏈。

This is when someone gives a kidney to someone other than their loved one, in exchange for

這是指有人將腎臟捐給親人以外的人，以換取

one being given by another donor to theirs.

由另一捐贈者提供給他們的一個。

This can be as simple as a swap between two families, but for more complex cases, open-ended

這可以是簡單的兩個家庭之間的交換，但對於更復雜的情況，開放式的。

chains have begun.

鏈條已經開始。

This can develop into a long, elaborate chain connecting dozens of families and giving one

這可能會發展成一個長長的、精心設計的鏈條，連接幾十個家庭，給一個

person in each a new lease on life.

人在每個人身上都有新的生命。

So what's donating a kidney like for the donor?

那麼對於捐腎者來說，捐腎是怎樣的呢？

Donating a kidney is a serious operation, but not usually one with any complications.

捐腎是一項嚴肅的手術，但通常不會出現任何併發症。

While some surgeries are more invasive than others, with minimally invasive laparoscopic

雖然有些手術的創傷性比其他手術大，但隨著微創腹腔鏡

surgery becoming more popular, it's common for a hospital stay for a donor to be between

手術變得越來越流行，捐贈者住院的時間通常介於

four and six days.

四天和六天。

Afterwards, it's mostly a matter of letting the incision heal, and heavy lifting and contact

之後，主要是讓切口癒合，重物搬運和接觸的問題

sports should be avoided for about six weeks.

約六週內應避免運動。

The most common risk during the surgery is serious bleeding, but it's a rare complication

手術中最常見的風險是嚴重出血，但這是一種罕見的併發症。

and doctors are good at preventing damage.

而醫生善於預防損傷。

After the surgery, donors can live a normal life - although they should be more careful

手術後，捐獻者可以過上正常的生活--雖然他們應該更加小心謹慎

to protect themselves from injury, as they only have one kidney remaining.

以保護自己不受傷害，因為他們只剩下一個腎臟。

And there is one perk of donating a kidney - if you should need a kidney donation later

而且捐腎還有一個好處--如果你以後需要捐腎的話

in life, being a previous living donor bumps you up the list.

在生活中，作為以前的活體捐獻者，你的名單就會被提升。

But have doctors perfected the art of living donations for any other organs?

但醫生們是否已經完善了其他器官的活體捐獻技術？

Yes and no.

是，也不是。

Most of our organs, we only have one or need both - like lungs.

我們大多數的器官，我們只有一個或者需要兩個--比如肺。

But for liver transplants, it is possible to transplant a lobe from a living donor's

但是對於肝臟移植來說，可以從活體供體的肝葉移植。

liver to someone who is dying of end-stage liver disease.

肝臟給臨終肝病的人。

This was originally common for parents to give a part of their liver to save their sick

這原本是父母捐出部分肝臟救治病人的常見做法。

child, who wouldn't need a full-sized adult liver.

孩子，誰也不需要一個全尺寸的成人肝臟。

As this involves cutting into an organ, the risk of complications for the donor is higher

由於這涉及到切開器官，捐贈者出現併發症的風險較高。

than with kidney donation, but the need for blood transfusions are still rare and most

比捐獻腎臟的情況要好，但需要輸血的情況仍然很少，而且大部分的人都是通過輸血來實現的。

donors recover in two to three months.

捐贈者在兩到三個月內恢復。

Sounds like living donors are usually pretty safe.

聽起來活體捐贈者通常很安全。

And you only need one kidney, right?

而且你只需要一個腎臟，對嗎？

Many people have asked the question - if I can save a life with a kidney and I only need

很多人都問過這樣的問題--如果我能用腎臟救人，而我只需

one, can't I sell my kidney to someone in need?

一，我不能把我的腎賣給需要的人嗎？

Well, that's illegal.

嗯，這是非法的。

Despite a worldwide shortage of organs available for transplantation, organ donation for profit

儘管世界範圍內可供移植的器官短缺，但以盈利為目的的器官捐獻

isn't allowed in any country but Iran.

除了伊朗，任何國家都不允許。

While some have argued that the potential good outweighs the ethical issues, experts

雖然有些人認為，潛在的好處大於道德問題，但專家們認為，他們的觀點是："如果我們不這樣做，我們就不會有這樣的機會。

say that allowing the sale of organs would encourage corruption, lead to the poor selling

說允許買賣器官會助長腐敗，導致窮人賣官。

organs to survive, and give a boost to the black market where kidneys could be harvested

器官來生存，並推動了黑市的發展，在黑市上可以收穫腎臟

from trafficking victims.

販賣人口的受害者；

The oversight on this is serious - while the medical costs of donors are usually paid for

這方面的疏漏是很嚴重的--雖然捐獻者的醫療費用通常都是自費的

through insurance, any financial incentive such as a gift from the recipient family could

通過保險，任何經濟激勵，如來自接受家庭的饋贈，都可以；

be seen as a bribe, and is grounds for the transplant to be called off by the hospital's

被視為賄賂，是醫院叫停移植手術的理由。

ethics team.

道德操守小組。

As of 2020, there are over a hundred thousand candidates on the waiting list for organ transplants

截至2020年，器官移植的候選者名單上有十幾萬人。

in the United States alone.

僅在美國就有。

The wait for a heart or liver transplant can be close to half a year, while those with

心臟或肝臟移植手術的等待時間可能接近半年，而那些患

the highest priority rating on the heart transplant list can still wait over two months on average.

心臟移植名單上優先級最高的人，平均仍可等待兩個多月。

So the people at UNOS are hoping everyone who qualifies checks yes on that organ donation

所以UNOS的人希望每個符合條件的人都能在器官捐獻上打鉤

form - they need every organ they can get.

形式--他們需要每一個他們能得到的器官。

For more on the black market organ trade, check out “How Much Is an Entire Human Body

關於黑市器官交易的更多資訊，請查看《一具完整的人體要多少錢》。

Worth?”, or check out this video instead.

值嗎？"，或者看看這個視頻，而。