China admits majority of organs from executed

As China announces a national organ donation system, official media admit the system will replace transplant organs from executed prisoners, which "experts estimate account for more than 65 percent of total donors".

From China Daily, 26 August 2009

Public call for organ donations
By Shan Juan (China Daily)
Updated: 2009-08-26 07:38

China launched a national organ donation system yesterday in a bid to gradually shake off its long-time dependence on executed prisoners as a major source of organs for transplants and as part of efforts to crack down on organ trafficking.

The system, operated mainly by the Red Cross Society of China with assistance from the Ministry of Health, will begin as pilot projects in 10 provinces and cities.

"The system is in the public interest and will benefit patients regardless of social status and wealth in terms of fairness in organ allocation and better procurement," said Vice-Minister of Health Huang Jiefu.

Under the system, the Red Cross is responsible for encouraging post-death organ donations among the public, receiving donor registrations, keeping a database, starting a fund to provide financial assistance for needy, surviving families of donors and overseeing the allocation of donated organs according to set principles.

"Transplants should not be a privilege for the rich," Huang said.

The late, famous Chinese actor Fu Biao received two liver transplants within several months in 2005, raising doubts about the fairness of organ allocation, given that the waiting time for the general public can be years - even if one is lucky enough to get a match, let alone have a second surgery.

Currently about one million people in China need organ transplants each year while only 1 percent receive one, official statistics show.

Only about 130 people on the mainland have signed up to donate their organs since 2003, according to research on the promotion of organ donation after death by professor Chen Zhonghua with the Institute of Organ Transplantation of Tongji Hospital.

The system will help find more willing donors who didn't know how to donate, said Jiang Yiman, the society's deputy director at the launch yesterday in Shanghai. "The Chinese have a tradition of helping others in need and the potential of organ donations from the public is yet to be tapped," she said.

Organ donors
Executed prisoners, who experts estimate account for more than 65 percent of total donors, "are definitely not a proper source for organ transplants," said Vice-Minister Huang.

That the rights of death-row prisoners to donate is fully respected and written consent from them is required, he told China Daily.

Qian Jianmin, chief transplant surgeon with the Shanghai Huashan Hospital, said hospitals performing transplants not only treat patients getting organs from executed prisoners, but have to deal with other levels of government, including the justice department.

"Corruption can arise during the process," he said.

Some just ignore legal procedures regarding organ donations from executed prisoners and make a fat profit, Huang said.

All costs are passed on to patients. Sometimes the recipient pays up to 200,000 yuan ($29,000) for a kidney, not including other medical services.

China issued an organ transplant law in 2007 that bans organ trafficking and only allows donations from living people to blood relatives and spouses, plus someone considered "emotionally connected."

However, organ middlemen have been faking documents in order to make a person who is desperately in need of money be considered "emotionally connected" to the recipients, reports said.

Living transplants increased to 40 percent of total transplants from 15 percent in 2006, Chen Zhonghua said.

"That's one of the daunting tasks facing us as we try to end the organ trade by establishing this system," Huang noted.

Other goals include preventing organ tourism, improving transplant quality, better defining donors' rights and satisfying patients' needs for transplants in an ethical manner.

"With more organ donations from the public, the total cost for transplants will decrease," he said.

The exact cost for transplants varies from place to place and largely remains an industry secret. But experts said it's at least 100,000 yuan.

Praise for initiative
"We welcome the emphasis put on fair practice in organ procurement, allocation and transplant, echoing the WHO guiding principles on transplantation," said Luc Noel, coordinator of clinical procedures in the essential health technologies department at World Health Organization headquarters in Geneva.

"China is establishing the national network and authority necessary to initiate and maximize organ donations from deceased donors and thus progress towards the global mainstream in organ donation and transplantation," he said.

The system will be operated at both State and provincial levels. Donated organs would be allocated locally first and then nationally.

"My colleagues and I welcome the system, which will facilitate our efforts to save more patients and help medical workers concentrate more on practicing medicine," said transplant surgeon Qian, whose hospital performs about 150 transplants each year.

Wang Yuling, a young white-collar worker in Beijing, said she'd donate if it really helps someone in need instead of making someone rich.

The pilot projects will take place across the country, including Shanghai, Tianjin, Fujian (Xiamen), Jiangsu (Nanjing), Hubei (Wuhan), Liaoning, Shandong and Jiangxi. The system will then be introduced nationwide, Jiang said.

When asked for a specific timetable when the system will cover the whole country, Huang said the process took 20 years in United States.

"I hope it'll be faster in China. We are still searching for the best way," he said.

"Details about the system, like how to clearly define responsibilities for all stakeholders under the system, including the Red Cross and health administrations, are still under discussion," Jiang said.

(China Daily 08/26/2009 page3)

[Emphasis added]

Related stories:
China admits organs from prisoners -- 6 December 2006
Stop transplant tourism: surgeon -- 28 November 2006
China restricts organs from executions -- 29 March 2006