经济学人2019.4.13/Kidney transplants/part2
Shortening them will save more than personal misery. In Britain a kidney transplant, which lasts for 10 to 13 years on average, starts saving the National Health Service (nhs) money compared with the cost of dialysis in the third year. In America a transplant saves $60,000 per year compared with remaining on dialysis. (In poor countries few people can afford dialysis, and so cannot wait for a deceased donor, meaning no waiting lists.)
将肾捐献等待名单缩短会比个人痛苦节省更多资金。在英国，一次可作用平均10-13年的肾移植移植手术费用与透析治疗费用相比，从第三年便开始为国民健康服务(nhs)省笔钱。在美国，与继续透析相比，肾移植每年可节省6万美元。(但是在贫穷国家，很少有人能负担得起透析，所以不能等待一位已故的捐赠者，这意味着没有等待名单)。
Roughly two-thirds of kidney transplants in rich countries are from deceased donors (see chart on next page). The rest are from living donors who part with a kidney to help someone. One kidney can perfectly well manage the job of the two that most people are born with.
在富裕国家，大约三分之二的肾脏移植来自已故的捐赠者（看表格）。其余的来自活体捐赠者，他们捐出一个肾来帮助别人。一个肾可以很好地实现大多数人与生俱来的两个肾所带来的功能。
Historically, northern European countries have promoted kidney donations from living donors. Southern Europeans have had reservations about the unnecessary surgery involved. Instead they have sought ways to increase donations from the dead. In Spain just 15% of families refuse to donate the organs of relatives who die; in Britain a third say no. Some are unsure what the deceased person wanted; others think that doctors might not do all they can to save their loved one if they can take the organs. Cultural differences play a role, too. Most Japanese, for example, feel uneasy about the idea of taking organs out of a dead body.
从历史上看，北欧国家一直提倡活体捐赠者捐献肾脏。南欧国家对这项不必要的手术持保留意见。相反，他们设法增加死者的捐款。在西班牙，只有15%的家庭拒绝捐赠死亡亲属的器官;在英国，三分之一的人拒绝捐献。有些人不确定死者的想法;另一些人认为，如果医生能够摘取这些器官，他们可能不会尽其所能来拯救他们所爱的人（个人认为是担心医生不能很好的做手术而造成死亡，再把亡者器官捐献出去）。文化差异也是一个原因。例如，大多数日本人对于从尸体中取出器官的想法感到不安。
By and large more people say they want to donate than actually volunteer to add their names to a donor registry. This has encouraged more countries to follow Spain, which has the world’s highest organ-donor rate and in 1979 became the first country to introduce a law making organ donation upon death the presumed choice of anyone who has not registered to opt out. England, France and the Netherlands recently changed their laws to that effect; Australia and several other countries are debating the idea.
总的来说，表示愿意（有意向）捐出自己的器官的人比自愿将自己的名字加入捐赠登记的人要多。这鼓励了更多的国家效仿西班牙。西班牙拥有世界上最高的器官捐献率，并在1979年成为第一个引入专门的器官移植法律的国家，该法律规定，没有登记的人可以选择在死后捐献器官。英国、法国和荷兰最近为此修改了法律;澳大利亚和其他几个国家正在讨论这个想法。
词汇
Registry/ 注册；登记处；挂号处；
opt out/决定退出；插播；请求免除
But in practice these new laws may not make much difference. In Spain, for a decade after 1979, donations did not increase. They did so only after other measures were introduced: a new transplant co-ordination hub; intensive-care doctors and nurses were trained in organ donation; and looking out for potential donors became the norm. Croatia copied the Spanish model (rebranding it “the Croatian model”) and saw organ transplants more than double between 2007 and 2011.
但在实际中，这些新法律可能不会产生多大改变。在西班牙，1979年后的10年里，捐款没有增加。只有在其他措施出台之后，他们才会这么做:建立一个新的移植协调中心;加强护理医生和护士接受器官捐赠方面的培训;寻找潜在的捐赠者成为了一种常态。克罗地亚复制了西班牙的模式(将其重新命名为“克罗地亚模式”)，在2007年至2011年间，该国的器官移植数量增加了一倍多。
词汇
intensive-care/重病特别护理
All but a few presumed-consent countries still give next-of-kin a final say, as an extra safeguard (and to avoid an outcry from critics of organ donation). Mark Murphy, the outgoing head of the European Kidney Patients Federation, sees the fuss around presumed consent as a distraction. Politicians, he says, prefer to blame the organ shortage on bereaved people than to invest in the logistics and incentives proven to increase transplants.
除了少数几个假定捐献人同意同意的国家，其他所有国家仍然给予近亲最后发言权，作为额外的保障(同时也避免了器官捐赠批评者的强烈抗议)。即将离任的欧洲肾病患者联合会(European Kidney Patients Federation)主席马克•墨菲看到围绕“假定捐献人同意”一说的纷争。他说，政客们更愿意将器官短缺归咎于失去亲人的人（不愿意捐献），而非注重建设肾脏储备和肾脏捐献鼓励政策，但是这些政策已被证实能够增加肾移植的数目。
词汇
Safeguard/保护；保卫
Fuss/ 大惊小怪
Outcry/强烈抗议；
Consent/同意；赞成；答应
Bereaved/丧失的；死了…的
Logistics/后勤；物流
