China starts to move away from using organs from executed prisoners for transplantationsBMJ 2009; 339 doi: http://dx.doi.org/10.1136/bmj.b3567 (Published 02 September 2009) Cite this as: BMJ 2009;339:b3567
China’s Ministry of Health and the Red Cross Society of China have jointly launched a pilot organ donation system in five cities and five provinces to harvest organs from brain stem dead patients. The system is a step towards bringing transplant organ procurement procedures into line with internationally accepted practices.
Announcing the programme, China’s deputy health minister, Huang Jiefu, admitted that more than 65% of current organ donors are executed prisoners, with only a tiny proportion of organs coming from brain stem dead people. “Executed prisoners are definitely not a proper source for organ transplants,” he told the state run newspaper China Daily.
The new donor system, launched on 25 August, covers five major cities—Nanjing, Shanghai, Tianjin, Wuhan, and Xiamen—and the provinces of Guangdong, Jiangxi, Liaoning, Shandong, and Zhejiang provinces. It has been welcomed by observers as a small but important step in the right direction.
“The number of organ donations from brain stem dead patients remains quite small,” said Fan Sheung-tat, professor and head of the department of surgery at the University of Hong Kong’s Li Ka Shing Faculty of Medicine, which administers the China Liver Transplant Registry. “I anticipate that there may be some increase in that number, but the change won’t appear within a short time.”
From 1993 to July 2009 the number of liver transplants registered with the registry was 16 062, of which 0.8% were organs from brain stem dead donors, 6.5% from living donors, and 92.7% from what the transplant centres providing data to the registry described as “non-heart beating donors.”
“The use of executed prisoners’ organs is something that has long been known, but this was the right time for Dr Huang to make that comment,” said Professor Fan. “If China wants to join the international transplant community it must do away with using organs from executed prisoners.”
The Chinese Medical Association announced an agreement in 2007 to restrict the use of organs from executed prisoners to donation to immediate relatives; and in the same year the government introduced regulations aimed at curbing transplant tourism and organ trafficking. However, it is widely acknowledged in China that a vibrant black market in organs exists, that illegal transplantations for foreigners are conducted, and that demand for organs far outstrips supply. Only 10 000 transplantations are carried out each year, but 1.5 million domestic patients need organs, according to official statistics quoted in China Daily.
The number of prisoners given the death penalty is a state secret in China, and no published data exist on the source of organs for transplantation.
Sam Zarifi, director for the Asia Pacific region of Amnesty International, said, “We can’t verify that 65% figure, and we would like to encourage the government to publish more statistics on the death penalty.”
He said that Dr Huang’s comments signal the Chinese government’s concern about the high level of legitimate and black market demand for organs from prisoners and its concern about the issue of the death penalty being linked to the demand for organs.
He added: “We fear there will always be a black market, but we hope this announcement will address the issue of demand. It is a step in the right direction, and it will at least remove some of the more gruesome motivations ascribed to the Chinese government for imposing the death penalty.”
Cite this as: BMJ 2009;339:b3567