Organs Extracted from Living Bodies
Living transplants in Mainland China differ from those in the rest of the world. In China, it is common practice to excise whole vital organs from living sources. Extracting a whole vital organ kills the donor.
For example, Chinese Medical University’s China International Transplantation Network Assistance Center (CITNAC) emphasized:
“In China we carry out living donor kidney transplants. It is completely different from cadaver kidney transplants you hear about in Japanese hospitals and dialysis centers…Compared to cadaver kidney transplants in Japan, what is offered here is much safer and more reliable.”1
Chinese transplant hospitals claimed to have ample supplies of young, healthy organ donors. For example, the Liver Transplant Center at the People’s Liberation Army General Hospital of Beijing Military Command stated that they had established a fast and efficient supply channel from which to obtain excellent quality livers in the vicinity of Beijing as well as from other cities and provinces.2
In medical papers published by doctors from these hospitals, donors are often described as “free of hepatitis, fatty liver, malignant tumors and chronic disease with no long-term medication history or history of alcohol consumption.” Most of these papers cited warm ischemia times (WIT: the period of time from circulatory arrest to perfusion of the organ) of less than 10 minutes, with some even listed as 0 minutes, and the majority of organ sourced from “brain-dead donors,” “cadavers,” “non-heartbeat cadavers,” and “healthy young cadavers.” We list a few examples.
Table: Warm ischemia times for liver transplants reported in medical publications
|Medical Institution||Time Period||Organ Source||Warm Ischemia Time (minutes)|
|Nanjing Medical University Affiliated Hospital||2005 - 2007||112 cadavers|
15 living donors
|0-10, average 3.96 3|
|Second Artillery General Hospital||2004 - 2007||103 healthy young cadavers||0-5, average 3.9 4|
|Shanghai Changzheng Hospital||2001 - 2004||240||0-8 5|
|Tianjin No.1 Central Hospital||2003 - 2005||195 non-heartbeat cadavers||0-8 6|
Zhang Xiaodong, director of the Kidney Transplant Center at Beijing Chaoyang Hospital, said, “After the heart stops beating, the circulation stops, and this will cause organs to fail. The tolerable WIT is 3 to 4 minutes for hearts, 5 to 8 minutes for livers, and 30 minutes for kidneys.”7
Organs are transplantable only when the time and location of a donor’s death are known in advance and the organ procurement team is well prepared. Thus, vital organs from those who have died outside of a hospital (e.g. in car accidents) are not viable for transplantation. Regardless, organs with warm ischemia times of 0 to 5 minutes from “no-heartbeat cadavers” have become a common source of transplants in China.
For decades, brain-dead donors have been the main source of transplant organs outside of China as such organs have the shortest warm ischemia times possible. Because Chinese tradition requires bodies to be preserved intact after death, China has neither brain death legislation nor significant voluntary organ donation.
Xinhua News Agency reported in August 2005 that among countries capable of transplantation, China is the only country without brain death legislation.8 As a result, 90% of Chinese doctors, as of August 22, 2014, were not aware of the criteria for verifying brain death.9
The number of organs sourced from brain-dead donors in China is negligible. On July 25, 2006, Yangcheng Evening News published a report titled “The first successful lung transplant from a brain-dead donor.” Dr. Chen Zhonghua said, “Ms. Yang, a 39-year-old woman, is the first voluntary brain-dead organ donor in our country. … This is the first case that met international criteria for a brain-dead donor.”10
The Organ Donation Management Commission of China was established on August 1, 2006. Dr. Chen Zhonghua served as the first Executive Chairman of the Organ Donation Management Commission of China.11 In July 2010, an article in the Organ Transplantation Journal stated, “since 2001, when Dr. Chen Zhonghua and his team began promoting organ sourcing for transplants from the brain dead, there have been over 60 successful organ donations after brain death in China.”12
Donations after cardiac death (DCD) were another commonly listed organ source in China’s transplant centers. Warm ischemia times of 0 to 5 minutes with “no-heartbeat cadavers”13 have become a standard practice of Chinese transplant doctors. However, there have been few recorded DCD donors despite pilot programs to expand this type of procurement.
Although the Ministry of Health and the Chinese Red Cross launched the Human Organ Donation Pilot Program (DCD) in March 2010, many regions have not actually received any donations over the years. The Red Cross stated that, in the two years after DCD pilot program was launched, China completed 207 donations after cardiac death.14 Divided among the more than 147 participating hospitals, this is equivalent to less than one DCD case per year per hospital.
Heilongjiang Province did not complete its first DCD donation until June 2015.15 Fujian Province, a leader in heart transplantation in China, just completed its first DCD heart transplant in May 2015.16 The No. 81 Hospital of Nanjing Military Region completed the first DCD donation in the Nanjing Military Region in April 2015. It was also the second DCD donation in Jiangsu Province.17 One of the biggest transplant centers in Hubei Province, Dongfeng General Hospital, completed the first DCD liver transplant in northwestern Hubei in July 2015.18
Chinese transplant doctors have developed their own standard procedures for excising organs in order to achieve the desired short warm ischemia times. Because it is not possible to achieve a warm ischemia time of 5 minutes or less sourcing organs from cadavers, living people are killed with this type of organ extraction and turned into “no-heartbeat cadavers.”
Tianjin Medical Journal published a study in 2009 that analyzed 1,600 liver procurements performed between 2004 and 2008 at the Tianjin Organ Transplant Center.19 Among these 1,600 cases, most livers were taken from young, healthy males with an average age of 34.5 years. Based on this study, Shen Zhongyang, director of the Center, created a surgical procedure for extracting livers from “no-heartbeat cadavers” that could keep the warm ischemia time to 5 minutes or less. This procedure has been adopted widely in China.20
Other well-known transplant centers have also developed organ excision procedures to minimize warm ischemia times. Liu Yongfeng, director of China Medical University’s Institute of Organ Transplantation, created a technique for rapid extraction of an abdominal organ by excising surrounding organs simultaneously, which he claimed could reduce both organ damage and warm ischemic time. Currently, this explantation procedure is widely used in many hospitals throughout China.21
Between 2003 and August 2009, only 130 citizens successfully donated their organs after death in Mainland China.22 This translates to fewer than 30 donations per year.23 The number of livers used by the Tianjin Organ Transplant Center alone has exceeded the number of citizen organ donations in all of China.
"China International Transplantation Network Assistance Center (CITNAC) Online Answers"
"Introduction to the Liver Transplant Center of the PLA Military General Hospital of Beijing"
"Treatments for Biliary Complications of Liver Transplantation Source: China Modern Medicine, 2009 Vol. 16, Iss. 4 p.12-14 Authors: Qing Jianjie, Xia Yongxiang, Wu Zhengshan, Zhang Feng and Wang Xuehao"
肝移植术后胆道并发症的处理措施 《中国当代医药》2009年16卷04期 12-14页 作者：秦建杰, 夏永祥, 武正山, 张峰, 王学浩
"The impacts of surgical procedures to the liver function during perioperative following liver transplant China General Practice2007 Volume 10, Issue 23, p.1947-1950"
手术方式对肝移植围术期肝功能影响 《中国全科医学》2007年10卷23期 1947-1950页 作者：李耀锋 周丁华
"231 cases and 240 times of liver transplantation retrospective analysis Source: Shanghai Medical Journal， 2004 Volume 27, Issue 11, p.805-807 Author: Fu ZhiRen, Wang Zhengxi"
例240次肝移植手术方式回顾分析 《上海医学》2004年27卷11期 805-807页 作者：傅志仁,王正昕
"Chinese Journal of Hepatobiliary Surgery Chinese Journal of Hepatobiliary Surgery 2007 Volume 13, p.132-133"
《中华肝胆外科杂志》2007年13卷02期 132-133页 淮明生，朱志军，高伟，张威，蔡金贞，冯钢，沈中阳
"Organ donation encountered difficulties: constrained by death criteria"
器官捐献遭遇困境：两头热中间冷 受死亡标准制约 2012年02月23日 来源：人民日报
"The Ministry of Health Conference on Organ Transplantation Center in October Source: Xinhua net August 13, 2005"
“卫生部器官移植中心10月挂牌” 来源：新华网 2005年08月13日
"No brain death regulation in China, 90% of doctors are not clear about the specifications either qq.net August 22, 2014"
“我国脑死亡立法空白 90%医生不清楚鉴定标准” 来源：腾讯网新闻 2014年8月22日
"First brain dead donor lung transplant successful Source: ycwb.com July 25th 2006"
首例脑死亡患者供体肺成功移植 来源： 金羊网 2006-07-25
"Dead Child Donated Organs that Saved Three Lives Source: Legal Evening News Sept 10th, 2006 Author: Yao Yi"
辞世患儿捐器官 挽救仨生命 来源： 法制晚报 2006年09月10日 作者：姚奕
"Clinical application of lungs from brain death donor harvested by international standardized methods Source: Organ Transplantation July 2010 Issue 4, P. 230-233 Authors: Weidong, Chen Jingyu"
国际标准化脑死亡供肺的临床应用3例报告 《器官移植》2010年第4期 230-233 作者：卫栋, 陈静瑜
"Evidence of Live Organ Harvesting of Falun Gong Practitioners Collected from Chinese Medical Papers"
http://www.upholdjustice.org/node/263 https://archive.is/KBEMK 中国大陆医学专业论文中有关中共活体摘取法轮功学员器官的证据
"Organ Donation Pilot Program did not Solve the Dilemma of the Supply and Demand Disparity After Two Year Trial Source: New Beijing Paper March 26, 2012"
我国器官捐献试点两年未破供求悬殊困局 作者：吴鹏 底东娜 来源：新京报 发布时间：2012-3-26
"Our province completed the first DCD donation Source: Health and Family Planning Commission of Heilongjiang Province Heilongjiang Daily June 08, 2015"
我省首例DCD捐献完成 黑龙江卫生和计划生育委员会新闻办 来源：黑龙江日报 2015-6-8
"Fujian province completed the first DCD heart transplant reviving a heart in 37 minutes Source: Dongkuai Net May 06, 2015"
福建首例DCD心脏移植成功 37分钟"复活心脏" 来源：东快网 2015-5-6
"The No.81 Hospital completed the first DCD donation of Nanjing Military Command Source: Dongkuai Net May 06, 2015"
第八一医院完成南京军区首例心死亡供体捐献 来源：解放军第八一医院官网 2015-4-28
"Dongfeng General Hospital completed the first DCD liver transplantation in the Northwest of Hubei Province Source: Dongfeng General Hospital Website July 14, 2015"
东风总医院完成鄂西北首例DCD肝移植手术始末 来源：东风医院官网 2015-7-14
"Precautions and Related Issues Analysis of Quick Liver Extraction Source: Tianjin Medical Journal 2009 Volume 37 Issue 9 p.793-794 Authors: Cheng Litian, Shen Zhongyang etc."
“供肝快速切取术中应注意的相关问题分析”《天津医药》2009年37卷09期 793-794页 作者：陈立天, 沈中阳, 朱志军, 郑虹, 邓永林, 潘澄, 臧运金
"Shen Zhongyang Source: Ho Leung Ho Lee Foundation"
"Explore and Innovation Cast Brilliance – on Organ Transplantation department of the First Clinical College China Medical University Paper, 2005 Edition 126 December 27, 2005"
"The Way of Legalizing Organ Donation, Huang Jiefu: Stopping the use of organs from executed prisoners starting next year First Financial Daily December 3, 2014 Author: Zhang, Liuchang"
器官捐献的法治化之路 黄洁夫：明年起停止死囚器官使用 《第一财经日报》 作者：张流常 日期：2014-12-03
"Mainland China has only 130 donors donate organs in 6 years Source: Chinanews.com 2009-08-23 First Financial Daily December 3, 2014 Author: Zhang, Liuchang"
中国内地6年仅130人死后捐献器官 来源: 中国新闻网(北京) 2009-08-23 10:25:17