Two interesting articles were published recently on kidney transplantation. Both, about China, point to a transplant system that is struggling. The article in the China Daily discusses the rampant illegal trading of organs. The other article in the Lancet discusses the ethical and legal issues in kidney transplantation in China.
1. The first successful renal transplant in the People’s Republic of China was in 1972; As of 2008, there have been 86,800 renal transplantations.
2. The shortage of donor organs limits the potential number of successful organ transplantations in China to about 10,000 each year, of which 4,000 are kidney transplants.
3. Between 1 and 1.5 million Chinese patients are placed on organ transplant waiting lists each year, yet less than 10% of them manage to receive an organ.
4. In China, 65% of the transplantation operations done in China use organs from deceased donors, over 90% of whom are from executed prisoners. The other 35% of transplantations use organs from live donors.
5. Renal transplantation units are generally not Government run, and mostly are private clinics.
6 Over 90 countries use brain death as the criterion to declare death, but since organ transplantation’s inception in China in the 1960s, cardiac death has been used.
7. Until 2007, no legal framework for national oversight of China’s transplantation system existed. Even now there is no national system for transplantation. In 2007, the Chinese Ministry of Health published the Regulation on Human Organ Transplantation, which outlined China’s initial steps to regulate organ transplantation, but the system remains under-regulated.
8. Only one-in-five hospitals (≈123 hospitals) are approved to perform kidney transplantation. Quality surveillance and management of transplantations have improved substantially (JAMA).
9. China remains a center for transplant tourism because there is access to organs and the cost is lower than in developed countries. The cost is estimated as ≈ $50,000/kidney (Daily Telegraph UK).
10. An increasing number of Americans are traveling to China to receive transplanted kidneys, livers, corneas and other body parts from executed Chinese prisoners (New York Times article). In China, despite the 2007 guidelines prohibiting payment, organ donors continue to receive financial compensation.