New Era for Organ Donation and Transplant in China: China Is Establishing a New National System for Organ Donation and Transplantation, Based on Chinese Cultural and Societal Norms, That Aims to Be Ethical and Sustainable

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Q: China has said it will end its reliance on the organs of executed prisoners for transplantation, when did the move towards a new system start?

A: Many major transplant countries used the organs from executed prisoners during the history of the development of their organ transplantation services. But with social progress, this unethical practice was abandoned and they started to develop national donation systems that addressed the need for transplant organs. In 2006, Vice Minister Jiefu Huang of the Ministry of Health, who is in charge of organ donation and transplantation in China, stated publicly to the transplant community [all the agencies involved in organ donation and transplantation activities] that China cannot continue to rely on the organs of prisoners and that it's time for China to move on and develop an ethical and sustainable organ donation system. In 2007, the human organ transplant regulation was passed by the State Council of China. This is a crucial piece of legislation for the development of a transplantation system for the Chinese people who need organ transplants. The World Health Organization's (WHO) support has been vital in making this law consistent with international norms.

Q: When will the practice of harvesting the organs of executed convicts stop?

A: While we cannot deny the executed prisoner's right to donate organs, an organ transplantation system relying on death-row prisoners' organs is not ethical or sustainable. Now there is consensus among China's transplant community that the new system will relinquish the reliance on organs from executed convicts. The implementation of the new national system will start early next year at the latest. This will also mark the start of phasing out the old practice. Although it took decades to establish a sophisticated national organ donation system in western countries, I am optimistic that China can leapfrog to success in a relatively short period of time given the combination of governmental support and international experience.

Q: The legislation is in place, how will you make it a reality?

A: It has been five years since the law was passed and now it's being revised to address the challenges of establishing a new national system, such as defining the role of national accountable organizations and their responsibilities in line with WHO guidelines. Based on this law, we are establishing procedures for the new system and this is a great challenge for China. On the one hand, we face a great public demand for transplant organs but, on the other hand, organ donation is not only a scientific matter but cultural and societal. That is why, we must address these non-scientific aspects of organ donation to gain public confidence and support.

Q: To gain that confidence you need transparency. How are you building transparency into the new system?

A: The Red Cross Society of China has been commissioned by the Ministry of Health to run the organ donation system. It also acts as a watchdog to see that organ donation, procurement and allocation within the medical system are done in accordance with the law. In addition, our research team at the University of Hong Kong has developed and maintains our national organ computer system, which allocates organs according to national policy that reflects urgency, compatibility and patient need, known as the China Organ Transplant Response System or COTRS. It is free of human intervention and monitored by many bodies to ensure the transparency, fairness and traceability of organ procurement and allocation. These measures provide the basis for public trust in organ donation.

Q: How will the new system work?

A: We need public awareness campaigns encouraging people to donate their organs and explaining that there is now a transparent system to handle this. The idea is for people to volunteer by registering with the donation scheme, run by the Red Cross Society of China, and, after their death, their organs can then be allocated via the COTRS. …