Long road ahead for troubled organ donation system

(Ecns.cn) – It has been nearly ten months since the launch of the nationwide system to track organ donation and allocation in China, and even though more than 160 qualified hospitals have joined the program, the country's organ donation system is still far from satisfactory.

Chinese people in need of organ transplants have suffered from demand outstripping supply for decades; every year there are about 300,000 final-stage liver disease patients who need transplants in China, but only 1,500 underwent the operation last year, according to the Beijing News.

The worsening shortage has also led to rampant illegal organ trafficking and a large number of unqualified hospitals carrying out live organ transplants without fear of repercussions.

With the new system to monitor organ donation in place, the government is attempting to learn from experience and gradually improve the situation.

Donated liver finds home in three minutes

In the early morning on December 22, 2011, Liu Rui was wheeled out of the operating room at a hospital in Guangzhou after getting a liver transplant, according to the Beijing News.

Just one day earlier, Dr Li Peng of the Guangzhou General Hospital of the Guangzhou Military Command had been informed of the donated liver that Liu Rui would soon receive. Though it was late at night, Dr Li entered the information into the system, which tracks organs shared among 163 hospitals and medical centers.

In another office at the same hospital, Dr Wang Shaoping of the Liver Transplantation Center received a text message alerting him that a donated liver was available for the waiting list.

According to allocation regulations, the hospital where an organ donation takes place has the highest priority, but if there are no transplant candidates on the hospital's waiting list, the opportunity will go to the nearest hospital.

Seconds after Dr Li Peng clicked the "allocation" button, five names showed up on the screen, all of them transplant candidates. After confirming that the liver was healthy, Dr Wang Shaoping succeeded in obtaining the organ quickly, since Liu Rui ranked highest on the list.

Debatable regulations

A lack of organs is one of the many problems frustrating patients in need of transplants, many of whom do not understand the allocation regulations at all.

Last April, the Ministry of Health launched a nationwide system to monitor organ transplants, which mainly serves to track the organ supply and sharing process in a scientific and convenient way.

That same month, a female student at the Guangdong University of Foreign Studies was sent to the Guangzhou General Hospital of the Guangzhou Military Command. After careful testing, she was diagnosed with severe liver disease, which might've claimed her life in seven days. With some luck, she was able to receive a transplant operation quickly. However, she still did not survive.

The case has since stirred debate among doctors and patients about why the system prioritized the girl on the waiting list.

"Suppose there are two patients who both need the same organ at the same time, and there is less than a 50 percent possibility that a dying patient will live for another year, but there is a more than 90 percent chance that the other patient, who is in better condition, will live for another year – who should get it first?" asked Jiang Wenshi, an expert who believes it is an ethical issue.

"In medical science, we know that the dying patient will pass away in about a week's time and may not have a second chance to wait for the next organ, but it is still a thorny issue," said Jiang.

Others have asked why the waiting time is not the most important factor in deciding who gets organs first. Jiang explained that this often brings about injustice, and that the U.S. had actually used this method in the past without success.

In China, the allocation regulations are more scientific, and take many factors such as blood type and health conditions into consideration too, added Jiang. With more lessons drawn from experience, this standard will be further improved and help prevent fights over different interests, he noted.

Plight of organ donation

China's ratio is one transplantable organ to every 150 patients in need, compared to the average of 1-to-30 globally, according to the World Health Organization. The ratio is 1-to-5 in the United States and 1-to-3 in Britain, said Caixin Online.

In 2010, the Ministry of Health issued a rule to direct the allocation of organs to guarantee open and fair distribution. Since then, hospitals have been required to register donated organs for unified allocation.

Moreover, the China Liver Transplant Registration Center has been conducting research into organ allocation policies in other countries and proposing adjustments to the policy in China. The current organ allocation and sharing system is said to be effective in ensuring fairness in organ distribution.