Name: 外科醫だけど「移植手術」について質問ある？ (外科医だけど「移植手術」について質問ある？| Tech Support | WIRED Japan)
Uploaded: 2025-07-20T18:23:47.000Z
Duration: 19 min 34 s

I'm Dr. Danae Simpson, abdominal transplant surgeon, and I'm here today to answer your questions from the internet.

我是腹部移植外科醫生達娜-辛普森（Danae Simpson）博士，今天我來回答大家從網上提出的問題。

At MrAnnie11 asks, how much do you think I can get for my kidneys?

在 MrAnnie11 問到，你認為我的腎臟能賣多少錢？

In the United States, getting money or any other type of gift or coercion to donate is illegal.

在美國，獲取金錢或任何其他類型的禮物或脅迫進行捐贈都是非法的。

You cannot get a raise, you can't get a brand new car, you can't get a house, you can't get a money gift to donate an organ.

你不能得到加薪，不能得到一輛嶄新的汽車，不能得到一套房子，不能得到捐贈器官的金錢禮物。

We don't want people to feel pressured to donate their organs.

我們不希望人們在捐獻器官時感到壓力。

And actually, in the case of living donation, when a living donor comes forward to any transplant center thinking about donation, they actually have to meet separately with a psychiatrist and a living donor advocate to determine if there is any coercion going on behind the scenes.

實際上，就活體捐獻而言，當一個活體捐獻者來到任何一個移植中心考慮捐獻時，他們實際上必須分別與一名心理醫生和一名活體捐獻倡導者會面，以確定是否有任何幕後脅迫行為。

Unfortunately, outside of the United States, that's not always true.

遺憾的是，在美國之外，情況並非總是如此。

Coercion or even deception to donate organs is fairly common.

脅迫甚至欺騙捐獻器官的現象相當普遍。

A Reddit user asks, how long does the process of liver transplant last from when the doctors decide to go the liver transplant route to the actual surgery?

一位 Reddit 用戶問：從醫生決定進行肝臟移植手術到實際手術需要多長時間？

Why does it always seem like we're rushing in the movies when we decide to go for a transplant?

為什麼當我們決定進行移植手術時，總是像在電影裡一樣匆匆忙忙？

Organs don't last forever, even when they're on ice.

器官不會永遠存在，即使是在冰上。

There is a certain amount of time that we need to be working against to get that organ into a body, into a warm environment where oxygenated blood is flowing through that organ.

我們需要在一定的時間內，讓器官進入身體，進入一個溫暖的環境，讓含氧的血液流經器官。

Otherwise, the organ starts to die and it's no longer usable.

否則，器官就會開始壞死，無法繼續使用。

That amount of time varies by organ, believe it or not.

時間長短因器官而異，信不信由你。

Kidneys can stay out of the body on ice or on a pump machine, we'll get to that later, for up to 36, sometimes even 48 hours.

腎臟可以在冰上或泵機上（我們稍後再談）離開人體長達 36 小時，有時甚至 48 小時。

On the opposite end, however, hearts and lungs, only four to six hours.

而心臟和肺部則相反，只需要四到六個小時。

Now I mentioned a pump and pump technology is changing the face of transplantation.

現在我提到了泵，而泵技術正在改變移植手術的面貌。

This is an exciting technology that kind of mimics being in a body.

這是一項令人興奮的技術，可以模擬人體。

So you can hook a liver, you can hook a heart or lungs up to this pump and blood is pumped through the organ, thereby extending the amount of time until we have to transplant it.

是以，你可以把肝臟、心臟或肺臟連接到這個泵上，然後血液就會通過這個器官，從而延長移植手術的時間。

The Only Kid asks, if a body rejects an organ transplant, can that organ be used by someone else or is it no longer usable?

唯一的孩子》問道，如果身體排斥器官移植，該器官還能被其他人使用嗎？

It's no longer usable because what rejection means is that our immune system attacks that organ and causes damage that makes it no longer usable.

因為排斥意味著我們的免疫系統攻擊該器官，造成損傷，使其無法再使用。

Now, depending on the organ though, what we do with it varies.

現在，根據器官的不同，我們對它的處理也不盡相同。

With kidneys, we can just leave it there and then transplant a new kidney into a new spot.

對於腎臟，我們可以讓它留在那裡，然後在新的地方移植一個新的腎臟。

You get your third kidney when you get your first transplant.

當你第一次接受移植手術時，你會得到第三個腎臟。

If you have rejection over time, you can get a fourth kidney, you can get a fifth.

如果隨著時間的推移出現排斥反應，你可以得到第四個腎臟，也可以得到第五個腎臟。

I've had a patient who had six kidneys in his body.

我曾接診過一個病人，他體內有六個腎臟。

Do donated organs age according to the donor's age or do they adapt to the age of the new body?

捐贈器官是根據捐贈者的年齡老化，還是適應新身體的年齡？

The age of the organ does matter somewhat.

So if you get an organ from a younger donor, you can expect the lifespan of that organ to maybe be a little bit longer, particularly in the case of organs that don't have the ability to heal themselves like the liver.

是以，如果你從年輕的捐贈者那裡獲得器官，你可以預期該器官的壽命可能會更長一些，尤其是像肝臟這樣沒有自愈能力的器官。

However, getting an organ from somebody who's very, very young does not mean that you get 20, 30 extra years on your life per se.

然而，從一個非常非常年輕的人身上獲得器官，並不意味著你的生命本身就能多活 20 或 30 年。

PWTI007 asks, is there an organ shortage?

When we think about all the number of people who need organ transplants and the number of people who are either willing to give organ transplants in living donation, which you can do with liver and kidney, or people who pass away and are donor designated on their driver's license, we don't have enough to go around.

當我們考慮到需要器官移植的人數，以及願意通過活體捐獻進行器官移植的人數（肝臟和腎臟可以通過活體捐獻進行器官移植），或者考慮到去世後在駕照上被指定為捐獻者的人數時，我們就會發現器官數量不夠用。

In fact, there are over 100,000 men, women, and children currently awaiting an organ transplant.

事實上，目前有超過 10 萬名男性、女性和兒童正在等待器官移植。

Micah Fox-Long asks, how do organ transplants actually work?

Micah Fox-Long問：器官移植究竟是如何進行的？

How do we connect them to the body of the recipient?

我們如何將它們與接受者的身體聯繫起來？

I love this question because whenever I talk to my patients about transplant, I always say that I, as a surgeon, am basically a plumber.

我喜歡這個問題，因為每當我和病人談論移植手術時，我總是說，作為一名外科醫生，我基本上就是一名水管工。

If I were gonna take a sink and bring it into the room, it's not gonna work unless I connect it to pipes that bring water in and out of the sink, and a transplant is the same thing.

如果我要把一個水槽搬進房間，除非我把它連接到水槽進出水的管道上，否則它是不會工作的，移植也是同樣的道理。

The red is the artery, the blue is the vein.

These bring oxygenated blood to the organ and deoxygenated blood away from the organ, and we need to connect those pipes in order for the organ to work.

我們需要將這些管道連接起來，器官才能正常工作。

And the third pipe we connect is the functional pipe of the organ.

我們連接的第三個管道是管風琴的功能管道。

In this case, it's the bile duct, which brings bile from the liver to the intestine, which helps us to digest our fatty foods.

在這種情況下，它就是膽管，它將膽汁從肝臟帶到腸道，幫助我們消化脂肪食物。

And the way we connect them is with stitches.

而我們連接它們的方式就是縫合。

We have to wear glasses with magnifying lenses on the end, and we will painstakingly but quickly sew those pipes together.

我們必須戴上末端裝有放大鏡的眼鏡，費力而快速地將這些管道縫合在一起。

Saccharin 000 asks, I wanna ask my microbiology professor so badly if the fecal transplant episode of South Park is real, but I can't.

糖精 000 問：我好想問我的微生物學教授，《南方公園》裡的糞便移植情節是不是真的，但我不能問。

It's a poop transplant, believe it or not.

信不信由你，這是大便移植手術。

What this involves is taking fecal matter from a healthy individual that has all the good bacteria that we want in it and transplanting that into the intestine of someone who needs it.

這就是從健康人的糞便中提取出我們需要的所有有益菌，然後將其移植到需要的人的腸道中。

So the case where this is often used is if someone has a really bad infection of their colon called C. diff.

是以，經常使用這種方法的情況是，有人患上了非常嚴重的結腸感染，稱為 C. diff。

And so Clostridium difficile is the bacterium there that causes a terrible, terrible infection in the colon that can sometimes result in the entire colon needing to be removed.

艱難梭菌是一種在結腸中引起可怕感染的細菌，有時會導致整個結腸被切除。

The way that C. diff. works is that it replaces all the good bacteria, essentially, in the colon.

C.diff.的作用原理是，它基本上取代了結腸中所有的有益細菌。

So only the C. diff. are there, and they're just causing a mess.

所以只有 C. diff.在那裡，他們只是造成了混亂。

To try to push those out, you wanna get good bacteria in there.

要想把這些細菌趕走，就得讓好的細菌進去。

And so you basically, it's like a poop shake.

是以，基本上就像搖大便一樣。

It gets put down into the intestine and does its job.

Self Manifesto asks, how do surgeons connect nerves to donated organs?

自我宣言》問道：外科醫生如何將神經與捐贈器官連接起來？

Well, for our solid organs, we actually don't, believe it or not.

不管你信不信，對於我們的固體器官來說，我們實際上是不需要的。

And nerve regeneration will happen slowly over time.

神經再生會隨著時間的推移慢慢發生。

And so solid organs refer to things like the liver, the kidney.

是以，實體器官指的是肝臟、腎臟等。

But when you're thinking about transplanting a limb, such as hand transplant or even face transplant, that is a case where nerve connection does become important.

但當你考慮移植肢體時，比如手部移植，甚至面部移植，這時神經連接就變得非常重要。

SoupBullerChris asks, now that a penis transplant is a thing, can I get on that list?

SoupBullerChris 問：既然陰莖移植已經成為一種時尚，我能加入這個名單嗎？

I love my old penis, but it's retired and ready to move on.

我愛我的老二，但它已經退休，準備繼續前進。

You can't get a penis transplant just because you're tired of your old one.

你不能因為厭倦了舊陰莖，就去做陰莖移植手術。

The usual reason for a penis transplant is because there's been trauma to the penis that has required it to be removed, such as cancer or a burn or some other type of trauma.

陰莖移植的通常原因是陰莖受到創傷而需要切除，如癌症、燒傷或其他類型的創傷。

At Last Thing You Forget asks, can I get a brain transplant?

在《最後一件你忘記的事》中，有人問：我能進行大腦移植嗎？

Although brain transplant has yet to be successful, the nature of this question makes me think that maybe there is a pretty big need for brain transplant.

雖然大腦移植尚未成功，但這一問題的性質讓我覺得，也許大腦移植的需求相當大。

ChironXC asks, at what point will stem cell research just allow us to grow clones of our own organs for transplantation?

ChironXC問：幹細胞研究到什麼時候才能讓我們培育出用於移植的克隆器官？

This would certainly solve our organ shortage issue.

這無疑會解決我們的器官短缺問題。

The good news is, is that researchers are working on this every day.

好消息是，研究人員每天都在為此而努力。

I once worked with a researcher who was doing a lot of work in this area, and he had actually managed to grow a kidney with stem cells that made what we called bland urine.

我曾經與一位研究員共事過，他在這方面做了很多工作，他實際上成功地用幹細胞培育出了一個腎臟，而這個腎臟製造出了我們所說的平淡尿液。

And by bland urine, I mean just water, meaning the kidney's not doing the job to filter out any of the other toxins that it's supposed to.

我說的 "平淡無奇的尿液 "指的是尿液中只有水，這意味著腎臟沒有起到過濾其他毒素的作用。

So it didn't do all the functions that a kidney should do, but at the very least it was making some liquid, and that's mind boggling to me.

是以，它並沒有完成腎臟應該完成的所有功能，但至少它還在製造一些液體，這讓我感到不可思議。

I've been told that organs that are grown with stem cells are just a few years off, but that was a few years ago.

有人告訴我，用幹細胞培育的器官還需要幾年時間，但那是幾年前的事了。

A Quora user asks, what was the first human organ to be successfully transplanted?

一位 Quora 用戶問：第一個成功移植的人體器官是什麼？

In 1954, Dr. Joseph Murray did the first successful kidney transplant between two twin brothers in Boston, Massachusetts.

1954 年，約瑟夫-默裡醫生在馬薩諸塞州波士頓為兩對雙胞胎兄弟進行了首次成功的腎臟移植手術。

What I find really cool about this is that transplant is such a young field that I actually had the privilege of meeting Dr. Murray when I was a resident at Brigham and Women's Hospital, which is where he practiced and trained.

我覺得這一點很酷的是，移植是一個如此年輕的領域，當我在布里格姆婦女醫院擔任住院醫生時，我就有幸見到了穆雷博士，他就是在布里格姆婦女醫院執業和接受培訓的。

SacktheVignesh88 asks, what is xenotransplantation and what role is it going to play in the future?

SacktheVignesh88 問：什麼是異種移植，它在未來將發揮什麼作用？

Xenotransplantation is a fancy word for saying you're getting a transplant from some animal that is not a human.

異種移植是一種花哨的說法，是指從某種非人類動物身上進行移植。

And I do think that it has a big role for the future.

我認為，它在未來將發揮重要作用。

There is an organ shortage, so we have to find creative ways to solve that problem.

器官短缺，所以我們必須找到創新的方法來解決這個問題。

And xenotransplantation just may be the answer.

Ed Krasen asks, would you allow doctors to put a pig heart into your body?

埃德-克拉森（Ed Krasen）問道，你會允許醫生將豬心放入你的體內嗎？

If I was on death's door and I was not going to have an offer for a human heart anytime soon, yes.

如果我已經瀕臨死亡，而且很快就不會再有人給我心臟了，那就可以。

Both kidneys and hearts have been successfully transplanted into humans.

腎臟和心臟都已成功移植到人體內。

However, long-term success still has not been shown.

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外科醫だけど「移植手術」について質問ある？ (外科医だけど「移植手術」について質問ある？| Tech Support | WIRED Japan)

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