With the development of technology and medicine, organ transplants in China have gradually become more common and safer. At present, the volume of organ transplants carried out in the country is second only to the United States. In the coming decade, to enable more patients to receive healthy organ replacements through legal channels, China will need to make policy changes and improve public education.
“There’s still a huge gap between the supply and the demand for organs, so we still have some way to go,” said Huang Jiefu, director of the China Human Organ Donation and Transplantation Committee. Huang stated that the current situation could be attributed to the following three factors: many people can’t afford the surgery and treatment costs due to the still ongoing medical reform; there are only a limited number of qualified hospitals and surgeons with the skills required to perform such complex surgery; and the procedures for organ donation require further development.
The National Health Commission published a list of medical institutions qualified to carry out organ transplants on June 11. The list shows that a total of 180 hospitals in China can perform such procedures, transplanting organs including the heart, lungs, liver, kidney, pancreas, and small intestine.
More specifically, the list reveals that 67 hospitals are qualified for carrying out heart transplants, 50 for lung transplants, 109 for liver transplants, and 143 for kidney transplants. Only 32 hospitals are qualified to transplant all four organs.
Unregistered and/or unqualified medical institutions are prohibited from carrying out transplant surgery. And unsurprisingly, registering to carry out organ transplant surgery is not easy. The Human Organ Transplantation Guide published by the State Council outlines the following requirements for qualification:
- Licensed physicians and medical staff for human organ transplantation and related procedures
- Medical facilities and the right equipment to carry out transplant surgery
- A human organ transplantation clinical procedure and ethics committee composed of professional personnel with expertise in medicine, law, and ethics. The number of medical professionals should not exceed 25 percent of committee members
- Comprehensive quality control and supervision for transplant surgeries
Undoubtedly, the 180 qualified medical institutions only make up a tiny proportion of all domestic hospitals. According to the 2020 China Healthcare Development Statistics Report, there are 11,870 public hospitals and 23,524 private hospitals. Among them, 2,996 hospitals are classed as tier one, with 1,580 of those classed as being tier one grade A.
“Many hospitals that should have the qualification are not yet qualified, and not enough doctors can carry out organ transplants,” commented Huang.
Aside from the restrictions on medical institutions, potential recipients can only receive an organ donation if their donor meets certain criteria.
Since the implementation of the Human Organ Transplantation Guide in 2007 which specified the required origins of donated organs, donations can now only come from a spouse, direct blood relative or collateral blood relative separated by no more than three generations –– and the donor must be over 18 years old; organs can also be donated from deceased individuals with the consent of relatives and allocated from the human organ distribution and sharing digital system.
In 2015, China officially banned the sourcing of organs from executed criminals, and the volume of organs donated through the organ distribution and sharing digital system exceeded the number of organs given by family members for the first time. The number of donated organs reached 6,302 in 2018, with the number only dropping to 5,222 in 2020, despite the impact of COVID-19.
But in spite of improvements to the donation system and the increasing number of people willing to donate, significant problems remain –– and demand still outstrips supply. The cost of undergoing an organ transplant is still prohibitively high, often reaching 100,000 yuan (well above $15,460). As the majority of the medical expenses are not covered by people’s health insurance, transplant surgery is simply not an option for most patients. Also, due to the very limited supply, some patients turn to the black market to find the organ they need illegally.
According to statistics, approximately 300,000 people are waiting for organ transplants in China at any one time, yet due to various obstacles, only around 20,000 manage to actually receive one.
How can China improve the system and provide help for patients in need? Wang Yong from the China Philanthropy Times responded with two critical points, and he outlined the previous efforts made by various governmental and social organizations. The two aspects are as follows:
- Allow the public to learn more about organ donation: the Red Cross Society of China has been actively promoting the concept and educating the general public since 2011. The government is also encouraging party members to take the lead in donating organs through various activities.
- Make registration for organ donation easier: since December 2016, a Chinese citizen can express his or her interest in organ donation by registering on the platform Save Life, which takes as little as 10 seconds. And since November 2020, Save Life has added new features, such as a section for supporters to register.
“As long as we work hard to promote healthcare reform, China will likely become the top country for organ donation,” said Huang.