BBC.地平线.2013.移植指南

在卡上签名给他人一次再生的机会
现在就领一张
因为新的科技
The new card is being issued
大大扩展了
because new techniques are increasing
可捐献器官的范围
the range of organs which can be donated.
理论虽好 但现实中 总是供不应求
Great in theory, but in reality, demand always outstrips supply.
器官短缺总是让器♥官♥移♥植♥带来的希望
Organ shortage meant that the hope offered by transplants
在等待中变成绝望
often turned to despair for those on the waiting lists.
本可以得到治疗的数千病人 在死亡边缘挣扎
Thousands of people who could be saved are dying
因为没有足够的肾源
because there aren't enough kidneys.
这位病人已经成家
This patient has a husband,
若她单身或已离婚便会失去移植机会
if she'd been single or divorced she'd have been turned down.
对医生来说
And for the doctors
这意味着必须艰难地决定
it meant making difficult decisions
谁能得到重生的机会
about who should get a second chance.
在盖伊医院 病人的生死
At Guy's Hospital whether a patient lives or dies
1972年 地平线 人命在握
由肾脏科的每周例会决定
is decided at this weekly meeting of the renal unit.
例会很不正式 讨论十分激烈
It's very informal, often heated,
有时让人头疼
sometimes agonising.
-很匹配 -巴西人 年轻 健壮
- Very fit. - Brazilian. Young. Tough.
他有心绞痛
He's got angina.
是啊 但他快不行了
Yes, but he's dying.
过去两三个月里
We have changed our policy considerably
我们已经大幅改动政策了
over the last two or three months.
那就再改动 这四个病人都很焦急
And changed it in the face of four people coming in through the roof
他们都到了肾功能衰竭的终末期
with terminal renal failure,
这些你都不曾去了解过
none of whom you know about yet,
其中三个正接受血透 等待移植
three of whom are on hospital dialysis waiting for graft.
有没有考虑问问圣托马斯医院
Have we thought about approaching Thomas' on this?
我们这儿实在供不应求
Cos we are very very jammed at the moment.
随着外科医生越来越敢于冒险
As surgeons became more adventurous,
器官短缺问题也更加棘手
the problems around organ shortage became more acute.
尤其是活体捐献
Particularly when it came to living donors.
若我的兄弟姐妹需要移植肾脏
If one of my brothers or my sister needs a kidney
我很乐意捐献
then I am happy to donate.
可如果需要移植的器官不适于分享呢
But what if the organ is less expendable?
你是否愿意为了亲人的一线生机
Would you risk your health
而赌上自己的健康
for the hope of saving a loved one?
2000年地平线 生命的呼吸
自上世纪60年代起
Since the '60s,
洛克伦家族就为一种致命的疾病所困扰
the Loughran family have lived with life-threatening illness.
去年 现代医学逼迫他们必须作出
Last year, medical science confronted them
一个无人愿意面对的可怕决定
with a terrible choice none of us would wish to make.
我希望这能让她快乐地活上很多年
I hope it will give her a large number of very happy years,
能给他人生命的馈赠
and... to give the gift of life to somebody,
这是次难得的机会
that is a wonderful opportunity to do something
也无疑会成为
which is undoubtedly going to be
我一生所做的最伟大的事
the greatest thing I ever do in my life.
没有任何事
Nothing that I have learned
曾动摇我的决心
has changed my commitment to doing this.
但不得不承认
But I have to say
医生告诫我的可能后果还是让我感到惊恐
have been horrified by some of the information.
这对我有利无弊 无论如何
I'm only going to gain, whatever way,
我没什么可以失去的了
I've got nothing to lose.
即使有一天他们不愿意做了
Even if it gets to the day they don't want to do it,
我也不介意他们反悔
I don't mind them saying no.
我不希望他们 你知道的
I don't want them to suddenly think, you know,
因为这对他们不公平
because it is not fair that they should...
我不希望他们
I just don't want them to...
我不想毁了他们的生活
I don't want it to ruin any part of their lives.
希拉·巴彻勒患有囊性纤维化病
Sheila Batchelor suffers from cystic fibrosis,
英国最常见的遗传紊乱疾病
the most common genetic disorder in this country.
这一不治之症正缓慢侵蚀她的肺部
It is an incurable disease which is slowly destroying her lungs.
她必须24小时吸氧
She needs to be on oxygen 24 hours a day.
去年三月份
By March last year,
洛克伦家族梦魇成真 希拉濒临呼吸衰竭
the Loughran family were beginning to face their worst fear.
但随后他们了解到一种先进的新手术
But then they heard about a radical new surgical procedure
即活体肺移植手术
called living donor lung transplantation.
技术由美国人发明
Conceived of in America,
这一极具争议的手术率先在英国进行
this controversial operation is being pioneered in the UK
领头人是马吉迪·雅各布爵士兼教授
by Professor Sir Magdi Yacoub,
世界知名的心肺移植外科医生
the world-famous heart-lung transplant surgeon.
为解决器官短缺这一问题
Using two living donors, instead of a dead donor,
外科医生尝试使用两位活体捐献者
it is the latest attempt by medical science
来替代一位尸体捐献者
to solve the donor organ shortage.
我能有新生活了 全新的生活
Going to be given a whole new life again. Brand-new life.
我觉得不是每个人都有这种机会
I don't think many people can be given that.
与活体肾移植手术不同
Unlike living kidney donor operations,
肺移植手术对捐献者来说更危险
lung transplants are both more dangerous for the donors
对接受者来说成功率也更低
and far less successful for the recipients.
因为肺是十分脆弱的器官
This is because the lung is a very fragile organ,
不易进行移植
and does not transplant easily.
明天见
See you tomorrow.
再见
Bye.
这一手术过程从未被拍摄过
This operation has never been filmed before.
手术在三间手术室中同时进行
It involves three separate theatres
由雅各布教授的三个手术团队负责
staffed by three surgical teams working to Professor Yacoub.
他估计手术的成功率为70%
He estimates Sheila's chances of survival at around 70%.
该手术的第一阶段历经8小时
The first stage of this eight-hour operation
先切除希拉病变的右肺
is to remove Sheila's diseased right lung.
两小时后 教授开始将达米安的肺叶
Two hours in, the professor begins to connect Damian's lobe
与希拉胸腔中的气管和血管相连
to the windpipe and blood vessels in Sheila's chest.
这是个细致且缓慢的过程
It is a slow and delicate process.
然后 她病变的左肺才能被切除
Her diseased left lung has been removed
接受另一位供体约瑟芬的肺叶
in readiness for Josephine's lobe.
最后 希拉终于可以离开手术室了
Finally, Sheila is ready to leave the theatre.
她可以用新肺进行呼吸了
She is breathing with her new lungs.
整个手术超过12个小时
The operation has lasted over 12 hours.
术后第一晚希拉就出现危象
Sheila had a rocky first night,
她的新肺出现了积水 十分凶险
because there was a dangerous build-up of fluid on her new lungs.
两天过去了
Two days later,
她依旧需要呼吸机支持供氧
she still needs to be on a ventilator to support them.
所以不得不持续保持麻醉状态
Because of this, she is kept sedated.
达米安与约瑟芬术后恢复缓慢
Damian and Josephine's progress is slow.
他们的胸部空缺以气囊填充
They have substantial pockets of air around their lungs.
令人难以想象的疼痛
The pain has been absolutely incredible.
简直无法形容
I have no way of describing it.
有一种彻底的无助感
The feeling of total helplessness.
但我还是想尽快恢复健康
But part of what I want to do is be... to look as fit as possible
等待希拉醒来
for when Sheila wakes up.
最好让她觉得这只是小菜一碟
Look like it was a complete breeze.
尽管医生已竭尽全力
Despite the medical team's best efforts,
但还是无法控制
they could not control the infection
希拉的全身感染
that was raging through Sheila's body.
术后第三周
Three weeks after the operation,
希拉终于无力与死神继续对抗
Sheila finally lost her fight for life.
五个月后
一切都变了 一切
Everything has changed. Everything.
我试着不去想这件事
I have tried not to think about it very much,
刻意让自己保持忙碌
deliberately tried to keep as busy as possible,
把往事尘封起来
just... just sort of locking into a bit of a shell.
让内心强大起来
Just growing strong on the inside, I think,
虽然我外表看起来没什么变化
because I probably look exactly the same but you know,
但却有伤口证明这件事发生过
I've got the scars to prove it
我的内心也发生了改变
and I've got things that have changed inside me.
我想这改变了我看待生命的方式
And it's a mesh of perspective on life, I guess.
每失去一个病人
Every time we lose a patient,
我们都会感到极度的悲痛
there is great sadness.
我们试着去分♥析♥原因
And what we try and do is to analyse why,
然后决定
and then make a decision
是否继续向病人提供这种手术疗法
about whether to offer this type of operation to people or not.
尽管风险很大