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March 18, 2015

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New organ donation system all about heart

WHEN the parents and brother of a French student who died while traveling in Hangzhou flied all the way to China and agreed on donating his organs, all the medical staff and volunteers at the hospital in the capital city of Zhejiang Province were moved to tears. The donated liver, kidneys and lungs finally saved four Chinese lives late last month.

The donation was conducted based on the 22-year-old’s will.

The Frenchman’s parents came to Hangzhou and agreed after learning China had stopped transplanting organs harvested from executed prisoners on January 1, according to Huang Jiefu, director of the China Organ Donation Committee and former vice minister of health.

“It was a significant move as they made the decision out of trust in China’s transparent organ donation system,” said Huang during a talk show late last week with Phoenix Satellite Television.

It also marks a surge in voluntary organ donations from Chinese people, who have mostly hesitated to donate organs as they fear the system favors people with power and money, not the needy.

According to the China Organ Donation Committee, about 1,200 organs were donated by 381 people in the first two months of the year, double the number during the same period in 2014. The committee expects the total to top 10,000 by the end of the year, up from about 1,700 in 2014.

“Organ donation has been operating in a gray area for many years. People didn’t know how to make a donation and there was no national donation system,” says Huang. “But recent data shows people are willing to donate organs if the system is transparent.”

According to a China Youth Daily survey of 43,000 people last year, 45 percent of respondents said yes to organ donation, 45 percent said no and the other 10 percent were non-committal. Of those that said no, 64 percent said they refused as they were concerned about having their organs “pooled” with ones from executed prisoners in a non-transparent system.

A regulated organ donation and distribution system was planned by the Ministry of Health and the Red Cross Society of China (RCSC) years ago. It entered trial operations in select areas in 2010 and expanded to the whole country last year. Branches of the Organ Procurement Organization and the China Organ Transplant Response System have been set up in hospitals across the country.

Seventeen hospitals in Shanghai were authorized for human organ collection and transplants from donors as part of the system in late 2012. More than 190 people have benefited from 70 organ donors in Shanghai since the system was launched, according to the Shanghai Branch of the Red Cross Society of China.

However, the system was not completely transparent as organs from executed prisoners have long been used, according to Huang. The distribution of organs has largely been shrouded in secrecy because the number of executions is a sensitive issue.

“Taking organs from prisoners was an option China took reluctantly as it did not have a voluntary donor system before 2009,” Huang says, noting the practice had compromised China’s human rights credentials and left it open to criticism from the international community.

“It is undeniable that organs from prisoners have contributed greatly to the organ transplant cause in China,” says Huang, “But it also brings problems that need to be fixed.”

China has been looking for ways to improve its organ donation system since the start of its reform and opening-up policy. The southern city of Shenzhen in Guangdong Province introduced the country’s first regulations on transplanted organ donations in 2003.

The first national regulations on this subject were implemented in 2007, banning organs from being bought or sold.

In 2013, the National Population and Family Planning Commission ordered a computer system designed in order to distribute donated organs fairly and openly.

“There has been tremendous progress in the organ donation system,” says Huang. “I now can give a clear and specific number of 22,000 people on the waiting list for organ transplants on China’s mainland, which was impossible before.”

The revamped organ donation and distribution system is designed based on medical needs, says Wang Haibo, who created the China Organ Transplant Response System.

A recent sample case shows how the system works.

A man in Shanghai’s Chongming County had agreed to donate his organs after dying. One of his sons needed a kidney. Under the new system, the information of the man’s organs needed to be entered into the system, meaning his son might not necessarily be the recipient.

The China Organ Donation Committee contacted the World Health Organization and The Transplant Society (TTS) for advice. A decision was made to give the son priority if there was a match. Unfortunately the father’s blood didn’t match.

“Many people were sad about this case as the good man was unable to help his own son while saving the lives of others,” says Wang, “But his donation added three points to his son’s score in the system, which helped him jump to the top of the waiting list in Shanghai. One month later, a matching kidney was found for him.”

Today, anyone in China can register to donate their organs upon death. Each donor has the right to change their mind at any time. The families of donors will receive priority in receiving organ transplants. Donors receive free cremation and transport.

However, immediate family members — spouses, parents and children — must consent to donations and they can override the stated wishes of a deceased prospective donor.

Since the ages-old Chinese tradition values the body as a gift from the parents, which should not be given away, many are reluctant to donate their organs.

Tang Zhaoxiang, an official with the Organ Donation Office of the Shanghai Red Cross, told Shanghai Daily in previous interviews that though many Chinese nowadays have gradually abandoned their traditional beliefs and become registered voluntary organ donors, their request sometimes cannot be completed because their family members say no.

But Huang disagrees that it is traditional values that block the progress of organ donation.

“Surely there are traditional concepts of treasuring the body, while there are also traditional values of being merciful and making sacrifices for the good of others,” says Huang, “The key still lies in setting up a transparent system that people trust.”

Though in the general practice worldwide, donors are banned from meeting the receiver, Huang made an exception for the family of a Taiwan donor who gave a liver and two kidneys to people in Foshan, Guangdong Province.

The old parents dreamed for years about their son “living” on the mainland, and asked Huang whether they could meet the people who received new lives from their son.

Huang arranged a memorial ceremony for the donor and all three organ recipients attended.

One of the male kidney recipients had a child after the transplant, and asked his son to call the donor’s parents “grandma” and “grandpa.”

Huang says it was a touching moment.

“Though our donation system is still young and immature, it is definitely a good start,” Huang adds.

He says when the donation system achieves 100 percent transparency, he will introduce a policy, if he remains in his current position, permitting the donors and receivers to meet.


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