Chinese leaders affirm commitment to Hangzhou Resolution on ethical organ donation and transplantation

by Michael Woodhead
Chinese health officials and hospital leaders have committed to upholding the new ethical framework for organ donation and transplantation as outlined in the recently signed Hangzhou Resolution.
In a update statement, officials and transplant surgeons affirmed the new five point plan that will outlaw practices such as use of organs from executed prisoners and the 'sale' of organs to foreign buyers.
The new statement also includes a list of 38 Chinese transplant centres that have already confirmed  to have stopped using organs from prisoners, with others "anticipated in the days ahead".
The statement published in Hepatobiliary Pancreatic Diseases International is co-authored by China's leading transplant specialist Professor Huang Jiefu  and international transplant specialists including Dr Francis Delmonico, President of the Transplantation Society.
It notes that the Hangzhou Declaration commits China to adopting  a new organ transplantation system overseen by the National Health and Family Planning Commission (NHFPC) and the Red Cross. The new system will set up a national voluntary organ donation scheme and a new organ procurement and allocation system that is based on clinical needs and which is "open and transparent". China will set up a human organ transplant clinical network based on 169 authorised transplant centres, an organ registry system and an organ donation regulatory system.
"The NHFPC expressed the resolution of the government of China that the dependence upon organs from executed prisoners must be terminated. The government of China has affirmed its commitment to prohibit transplant tourism and to shut down organ trafficking and transplant commercialism," the statement says.
The move to the new organ donation system will also mean that China is no longer the subject of an academic boycott on organ transplantation.
Health minister Li Bin also pledged her commitment "to bring China back to the international community and to promote an academic exchange based upon the five-point NHFPC plan elaborated."
The next step will be to implement the agreement in all China's provinces. The statement says China will also host a meeting this year with leaders of the major international transplantation societies and WHO representatives.
"The meeting will affirm the new resolution in the practice of organ donation and transplantation in China. The meeting will be a milestone for China transplant professionals to practice according to the international standards set by WHO Guiding Principles."
Meanwhile, in a public show of support for the new organ transplant system, senior Chinese leaders have registered to donate their organs.
Officials including Chen Zhu, vice-chairman of the Standing Committee of the National People's Congress and a former minister of health; and Hua Jianmin, head of the Red Cross Society of China added their names to the new online organ registry at the Beijing Union Medical College Hospital .
The registry, overseen by the society's China Organ Donation Administrative Center, is available for people aged 18 and over who are willing to be organ donors after their death.
In December, the State Council issued a guideline related to funeral reform, encouraging Party members and officials to register to donate their organs after their death, according to China Daily.

Hospitals warned of disciplinary action for illegal organ transplants

translated by Michael Woodhead
All hospitals in China that do organ transplantation must follow new ethical guidelines or face being banned from doing transplants and losing their funding, a senior official has warned.
Hospitals will also be banned from making arrangements with courts to accept organs from executed prisoners.
Dr Huang Jiefu, director of the the National Health and Family Planning Commission Committee on Human Organ Transplant Clinical Application Management, said all 169 transplant centres will have to take part in a new organ donation supervision and inspection system that will ensure that the system for transplants is fair, open and ethical.
Speaking at China's annual meeting of organ transplantation specialists at Shanghai Jiaotong University, he said any hospital and any practitioner that does not adhere to the voluntary donation system and the shared organ program after the death of a patient will have their authority to do transplants revoked and also have funding removed.
Dr Huang said all hospitals must take part in the new computerised organ sharing database set up by the former Ministry of Health and the Red Cross Society. All organ transplants must be done according to the principles of the new system, which are based on clinical need and priority rather than financial payment, he said. Priority categories for organ donation should be  region, condition , age, wait time and meeting screening requirements.
The new system also means that hospitals must sever all links with law courts to procure organs from executed prisoners, he added.
The new human organ donation regulations " strictly prohibit hospitals and transplant organs and the courts to have a direct link to use organs, and all organs sources should be traceable," said Dr Huang
With the support of the State Council , the National Health and Family Planning Commission and the Red Cross Society of China will jointly set up an Organ Donation and Transplantation Management Committee.

Attempts to establish a voluntary organ donor system in China face many obstacles

The outdated and sometimes cruel organ donor system in China is failing patients and organ donors.
The Ministry of Health, in cooperation with the government-affiliated Red Cross and its branches around the country, has been busy since November 2009 reorganizing transplant services and building a national system for recruiting voluntary donors and fairly allocating transplantable livers, kidneys, corneas and other body parts.
Assigned to lead the effort is a Hong Kong University team supervised by Wang Haibo, at the La Ka Shing Faculty of Medicine and the initiative’s chief engineer. The ongoing task has involved building a database and setting medical standards that blend established international practices with health ministry regulations and domestic circumstances.
Three years on, though, the program designed to match voluntary donors and needy recipients has faced one setback after another.
And it’s thus yielded scant results: Only about 400 transplants from organ donors have been conducted since the ministry and Red Cross started working together to link donors and patients in March 2010. More than 100 of these have been in Guangdong Province, which includes Shenzhen.
Indeed, the ministry says every year only about 10,000 of some 1.5 million ill people across the country who need a transplanted organ are fortunate enough to get one.
And a significant number of these transplanted organs come from not willing benefactors but deceased prison inmates — a common organ-harvesting practice that China has pledged to phase out.
“Why is it so hard to do something good?”
That question, in fact, has long been on minds at the highest levels of China’s health system. Offering a short-form answer Aug. 22 was Vice Health Minister Huang Jiefu, who has urged reform for the nation’s organ donation arrangement.
 “What holds us back are not traditions or morals, but our system,” Huang said. “If China cannot establish a voluntary organ donation system for its citizens, inevitably there will be a severe organ shortage.”
The system’s failures have roots in a lack of confidence that’s worsened over the years because the richest and best-connected transplant candidates have enjoyed easier access to organs than most Chinese people.
Potential volunteer donors often hesitate or decide against offering organs because they don’t want to support a system that helps only high-status patients with enough money to pay the right people.
The ministry has tried to rebuild trust since putting Wang’s team to work in 2009 and announcing in December 2010 that procedures for patients “applying for human organ allocations and transplant sharing should conform to medical needs and adhere to the principles of fairness, justice and openness.” 

Read more: Caixin Online