Background and Purpose

In 2006, allegations emerged that the People's Republic of China has been harvesting organs from prisoners of conscience in extrajudicial killings on a large scale. Over the course of a decade, we investigated the extent to which these allegations are true by studying China's organ transplantation system from the perspectives of scale, on-demand nature, growth and latest developments, organ sources, and drivers of these abuses.

This first report assesses the scale of China's organ transplantation system.

Method

For the 169 transplant hospitals approved by the Ministry of Health, we calculated the minimum system-wide capacity based on bed count requirements needed to maintain their certification. We examined all the individual hospitals' actual bed counts, utilization rates, surgical capacity, and personnel. We analyzed the severity of underreporting in official transplant data. We also cross-verified transplant volume with the market for immunosuppressant drugs.

Results

Based on the Ministry's minimum bed count requirements, the 169 approved transplant hospitals would have a capacity of approximately 69,000 transplants per year, or a total of over one million transplants since 2000.

All transplant centers exceed the minimum bed counts, including some with hundreds of dedicated transplant beds and utilization rates greater than 100%. For example, Tianjin Central Hospital had at least 500 transplant beds and operated at 100-131% occupancy, translating into a capacity of more than 8,000 transplants per year.

Over 1,000 hospitals applied for permits in 2007 to continue performing transplants, suggesting that they also met the minimum requirements. Many of them continued to conduct transplants without permits.

There are wide gaps between the data reported to registries by transplant centers and actual numbers due to financial interests and unaccountable organ sources. For example, a 2011 report found that Tianjin First Central Hospital had reported only 7 liver transplants in 2010, despite its leading rank in the registry for over a decade.

In 2006, the domestic immunosuppressant market was worth nearly 10 billion RMB and could have supported more than 50,000 transplant patients per year since 2000. By 2004, domestic drugs had captured half of the market share from that of foreign companies.

Conclusion

China's official figure of 10,000 organ transplants per year since 2006 is surpassed by just a few hospitals and understated by multiple times.

CITATION INFORMATION: Yin G., Li D., Li M., Fu M. Organ Transplant Abuse in China (1): Scale Am J Transplant. 2017;17 (suppl 3).

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