英国新闻听力 128（在线收听）

REPORTER: Since a team of doctors in the USA did the first kidney transplant in 1954, hundreds of thousands of people have had organ transplants. But whether it was kidneys, heart, liver or lungs, there are still a world-wide shortage of organs available for transplant. In the UK alone, at least one person dies a day while they are on the waiting list. To try to overcome this problem, some countries have introduced a system where instead of signing up to say that if you die you'd be happy for your organs to be transplanted, you sign up if you don't want to do it. And it assumed that everyone else does, they call it "presumed consent". In a moment we will be discussing whether more countries should adopt the system. But before that the BBC's health correspondent Brangwyn Jefferies has been in Madrid finding out how the system works in Spain, a country with a high level of organ donations.

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BRANGWYN JEFFERIES: In the pale wintry sunshine of his Madrid flat, Tito Mora listens to his record Vivo por Ti, an old-style Coruna. He's also one of Spain's best-known transplant patients, and this is his plea for more organ donors.

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His liver transplant was 16 years ago, since then he was able to travel and go back to performing.

TITO MORA: I was a hundred per cent ...fantastic, I have a…. life, a very good life, and I have to take medicine, but as soon as you know, just a pill in the morning and a pill at night, and I have a wonderful life.

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BRANGWYN JEFFERIES: The operating theaters of San Carlos Hospital are already busy; Professor Jose Roman Nuoliez is on call.

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The potential organ donor had been identified by ambulance crew, the paramedic restarted her heart and their alert is over. Professor Nuoliez is the transplant coordinator of San Carlos, this wary charismatic surgeon, persuades bereaved families to agree to organ donation, and the results are startling. Last year in this hospital, the refusal rate was just 3%. Jose Roman Nuoliez says it's all about how you approach relatives.

JOSE ROMAN NUOLIEZ: When we get to the family, we will bring clearly with them, and trying to get into their mind what's the important of that decision they are going to have, saying yes or saying no depends a few lives and also depends the quality of life of many patients.

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BRANGWYN JEFFERIES: Palomar Gonzalez's family is on the other side of the transplant system, the 45- year-old died unexpectedly two months ago. Spain has a system of presumed consent, when you have to opt out of organ donation. But in practice, families are always consulted. Two months after Paloma's death, her sister Lola told me she hasn't had a moment of doubt.

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LOLA GONZALEZ: The decision, well, truthfully, I just thought about her, she was a really generous person who always helped others when she could, so I knew she would have agreed what I want to do tonight.

BRANGWYN JEFFERIES: This is where organs are matched with waiting patients, the National Transplant Organization's headquarters. As they are declaring House, they also carried out audit, checking hospital debts, and whether families were approached. The creator of the system, now globally admired, is Dr Rafael Martazans. He sees no reason why the success of their coordinators couldn't be replicated in the UK.

RAFAEL MARTAZANS: In 2005, there were 45 British who were dying in Spain, 45 British families who were approached, and 45 say yes. So that means that the families refusal are real British, which in UK is 40%, and in Spanish is zero.

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BRANGWYN JEFFERIES: Tito Mora's sentimental appeal for donors is barely needed in Spain. They found that talking and listening to families can prompt extraordinary altruism in the mists of grey.

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REPORTER: Brangwyn Jefferies is reporting from Spain on the high number of organ donations there.

记者：自从美国在1954年成功进行了首次肾移植手术后，成千上万的人进行了器官移植手术。但是无论是肾，心脏，肝脏还是肺，在全球范围内都非常紧缺。仅仅在英国，每天都有一个位于等待器官移植名单中的人死亡。为了克服这个问题，一些国家引进了一个体系，即假设你去世，你愿意签署器官移植。所以你只需在不愿意的时候签署就可以了。它假设其他人都这么做。这种形式的同意被称为"推定同意"。等会儿我们要讨论是否应该有更多的国家采用这个体系。但是在此之前，正在马德里采访的BBC健康栏目的记者布来温·杰夫里，将会告诉我们有着高器官捐赠率的西班牙政府是如何运作这个体系的。

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布来温·杰夫里：在冬日温暖怡人的阳光下，在飞往马德里的班机上，蒂多·摩拉正在听Vivo por Ti，这是一首怀旧的克鲁尼亚唱片。他是西班牙著名的器官移植手术病人之一，他呼吁更多的人捐赠器官。

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十六年前，他进行了肝脏移植手术，从那时开始，他才能够去旅游，能够重新开始他的表演生涯。

蒂多·摩拉：我想说的是生活开始变得美好起来，我的生活……非常棒。现在我还是得吃药，但是，如你所见，只要早晚按时服药就好，我很幸福。

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布来温·杰夫里：圣卡洛斯医院的手术室已经很忙碌了，琼斯·罗曼·纽斯教授随时待命。

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救护车的工作人员已经确认了潜在的器官捐赠人，护理人员会对她做心肺复苏术，这样家属们就放心了。纽斯教授是圣卡洛斯医院的移植手术协调员，这位技术精湛的外科医生的主要工作就是说服死者家属同意器官捐赠，而且成功率很高。去年，在这家医院，拒绝器官捐赠的人仅有3%。琼斯·罗曼·纽斯教授认为关键在于你如何同家属进行交流。

琼斯·罗曼·纽斯：当我们见到死者家人的时候，我们让他们清楚的意识到他们所作的决定是如何重要，他们的决定，将决定另一些人的生死，同时也决定了另一些病人的生命质量。

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布来温·杰夫里：两个月前，当45岁的帕罗马·哥扎里意外死亡后，她的家人同意捐赠器官。西班牙政府实行的是一套"推定同意"的体系，除非你放弃，否则便视为同意器官捐赠。但是在实际操作中，医院都会事先跟家属联系，征得同意。在帕罗马去世两个月后，她的姐姐罗拉告诉我她对遗体捐赠从未有过一丝怀疑。

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罗拉·哥扎里：做这个决定时，坦白来说，我只想到她本人，她生前待人慷慨，并且总是尽力帮助他人，所以我相信她一定会同意我为她所作的决定。

布来温·杰夫里：这里是国家移植组织的总部，在这里，医生会验证那些捐赠的器官是与等待的病人匹配。据他们介绍，他们还审计、核对医院的债务，也会决定是否与死者家属打交道。拉非·马塔赞博士因为创办了这个体系获得了全世界人的赞誉。他认为英国也可以实施这种体系，获得成功。

拉非·马塔赞：2005年，有45位英国人在西班牙去世，在我们与这45个家庭取得了联系之后，他们都同意进行器官捐赠。这表明，尽管在英国有40%的家庭拒绝进行器官捐赠，但是在西班牙，这个概率为零。

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布来温·杰夫里：在西班牙，像蒂多?摩拉这样的积极呼吁并不需要。同家属聊天并倾听他们的心声就能够让他们在阴霾中更多的为他人考虑。

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记者：这是布来温·杰夫里在有着高器官捐赠率的西班牙发回的报道。