Myth: One donor provides organs to multiple recipients in China

Most donated organs in China are wasted

On November 23, 2015, Huang Jiefu, China’s top transplant official, said that there were 2,500 organ donors nationwide in 2015, which could theoretically allow 2,500 heart transplants and 5,000 lung transplants. However, he said there were only more than 100 heart and lung transplants completed in the whole country, and that almost all of the organs were wasted.^{1 2}

Huang Jiefu said on May 6, 2016 that 20% of transported organs are wasted during transportation.³

Very few institutions in China could procure and transplant multiple organs from a single donor

Strict limitations on ischemia times of organs for transplantation place high technical demands on hospitals to conduct transplants with multiple organs from the same donor. Until recently, very few institutions in China were capable of procuring and transplanting multiple organs from a single donor.

A December 2011 report said that more than 60 doctors carried out 6 transplant surgeries simultaneously at No. 303 Hospital of Guangzhou Military Command on that day. These included liver, lung, pancreas-kidney, and kidney transplants, as well as two corneal transplants.⁴ Dr. Sun Xuyong, president of the hospital’s Transplantation Research Institute, revealed that the six organs were procured from the same donor. However, he did not explain the source of the donor.

Lan Liugen, deputy director of the surgery division at No. 303 Hospital of Guangzhou Military Command, said that only two hospitals in China had this capability at the time. In addition to his hospital, the other was the Tongji Organ Transplant Research Institute of Huazhong University of Science and Technology.⁵

Reports in October 2015 indicated that the 2nd Affiliated Hospital of Harbin Medical University carried out multiple transplants simultaneously using organs from the same donor—the first case in Heilongjiang Province.⁶

An August 2016 report indicated that the People’s Hospital of Jiangsu Province carried out heart and lung transplants for two patients using organs from the same donor, and that it was the first such case in the country.⁷

Factors affecting organ usability

Organ Life: Human organs are a “non-reusable resource with an expiration time limit.” When an organ is removed from the donor, it must be kept in preservation solution, and the transplant operation must take place within a limited time. According to the Ministry of Health’s Notice on Management Regulations for Liver, Kidney, Heart and Other Transplantation Technologies, the time should not exceed 24 hours for kidneys, 15 hours for livers, and 6 hours for hearts.⁸

Geography: Until the end of 2013, China did not have a national organ sharing network. Tissue matching was mostly done within specific hospitals or regions.⁹ Unavoidably, given the time limits involved in how quickly organs must be used after being extracted from a body, many organs in China were wasted as a result. In fact, for many bodies, only one organ was utilized.¹⁰

It was not until October 2013 that the National Health and Family Planning Commission announced the “(Trial) Regulations for Obtaining Organs from Voluntary Donors and Organ Assignment,”¹¹ which required all 165 approved hospitals to use the new National Organ Sharing Network; it also required all donated organs to be allocated by this system. Since then, the National Health and Family Planning Commission has required all transplant centers to register their patients to build a national waiting list.

There is an unwritten allocation rule that organ sources can be accessed locally only. Local hospitals have monopoly control over local organ sources. Some local hospitals have abundant organ sources but cannot find suitable matching recipients; many organs are thus wasted. Hospitals in other regions, short of organ sources, have to try to obtain them from hospitals in localities that control abundant organ sources.¹²

We conclude that this efficiency cannot be applied in most cases. The use of multiple organs from one donor cannot explain the source of the huge transplant volume carried out every year.

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