The challenges China faces as it stops using organs from executed prisoners

kanhua_yincan_wangFrom 1 January 2015, China stopped using organs from executed prisoners for transplants. This was announced by Jiefu Huang, China’s former vice minister of health and current head of the Organ Donation Committee.

This comes after a series of legislative frameworks for organ donation and transplantation since 2007, as well as several pilot programmes that were conducted between 2010 and 2012. According to Huang, 300,000 patients in China need transplants each year, but only 10,000 can receive them.

Among these transplants, more than half come from deceased donors, 90% of which come from executed prisoners. However, the average organ donation rate is 0.6 per million people in China. Based on these data, we have reason to believe that the gap between organ supply and demand will increase further in the next few years, when the new regulation is implemented.

To tackle this problem, further revisions of legislative frameworks are required, which could extend to a clearer definition of brain death and a more detailed description of donor criteria. This would help reduce the confusion of potential organ donors and family members. In addressing their anxieties about corruption and foul play during the organ donation process, efforts should be made towards ensuring a fair and transparent organ donation registry.

A focus on raising public awareness of volunteer donation is urgently needed. The organ donation systems in Singapore and Hong Kong offer some great insights, considering many traditional values are shared between these societies. Using the influence of celebrities and public media is an option, as seen in recent AIDS campaigns in China. Additionally, civil organizations and public education events led by organ receivers or healthcare providers could play an important role. In the end, physicians and nurses should become pioneers in the volunteer organ donation.

The new regulation will certainly usher in the long overdue transition towards a standard and fair organ donation platform in China. It will also be a powerful signal to the physician-scientists engaged in the transplantation research. Historically, there has been an academic embargo that prevents Chinese researchers from publishing organ transplantation clinical studies in international academic journals. By phasing out prisoner donors and encouraging volunteer public donations, it could be expected that an increasing amount of research will be published about organs that have been channeled through legitimate, traceable, and ethical sources.

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Kanhua Yin is a seventh year medical student at Shanghai Medical College, Fudan University, China.

Can Wang
is a fifth year medical student at Shanghai Medical College, Fudan University, China.

Competing interests: None declared.