Purpose

Based on allegations that China has been harvesting organs from prisoners of conscience in extrajudicial killings on a large scale, this report examines the extent to which transplants are conducted on demand.

Method

We assessed industry organ procurement standards and methods, quoted wait times, ischemia times, number of transplants performed concurrently by individual hospitals, multiple and repeated transplants for the same patient, and types of transplants performed by hospitals. The data were taken from hospital publications, transplant registries, news reports, and medical journals.

Results

China Liver Transplant Registry's 2006 Annual Report indicated that among 4,331 liver transplants, 26.6% were emergency transplants, for which organs must be located within 72 hours. Waiting times for elective transplants were commonly listed in weeks.

We found numerous cases of hospitals carrying out multiple transplants concurrently; twenty or more transplants being conducted in a single day; and doctors procuring multiple organs for the same patient in quick succession, either due to rejection or as spares. A hospital advertised “donors seeking matched recipients” and promised, “in case of failure, to continue to perform transplants until one is successful.” Hospital websites listed vast arrays of organ types and their fees.

In China, it is common practice to excise whole vital organs from living sources. This occurs in the absence of brain death legislation and significant organ donations.

An industry standard for liver extraction developed in 2009 reduced warm ischemia times to under 5 minutes. It was followed by an even more rapid process of excising surrounding organs simultaneously to reduce graft damage and warm ischemia time. Such short warm ischemia times could not have been obtained from cadavers as claimed.

Wang Lijun, a high-profile law enforcement official, won an award for developing a lethal injection drug that reduces organ rejection rates after transplantation. This development was based on thousands of experiments on living bodies. He was also awarded a patent for a “primary brain stem injury impact apparatus,” which could also be used to cause brain death with fewer adverse effects on transplantation compared to lethal injection.

Conclusion

The organ transplantation system in China can procure organs on demand despite the lack of voluntary donations.

CITATION INFORMATION: Yin G., Li D., Fu M., Xia Y. Organ Transplant Abuse in China (3): Transplants Conducted on Demand Am J Transplant. 2017;17 (suppl 3).

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