Heartfelt gifts of life (2)

Expensive treatment

Chen Nan is the director of the Renal Department at Ruijin Hospital, one of the leading hospitals in Shanghai. Every year her department sees thousands of patients seeking kidney and other organ transplants.

She told the Global Times that many of the patients she treats are dying or enduring expensive dialysis treatment because of the lack of available organs.

"Every year in Shanghai some 4,000 new patients need new kidneys, either transplants or dialysis. Each of them will pay 100,000 yuan ($16,082) a year for the treatment and hospitals have to invest in more expensive equipment which puts more of a burden on both sides," Chen said, adding that it was way past time for a proper organ donor system to be established.

Chen said that at present so far most patients with kidney diseases obtain transplant organs from living relatives. But from the medical perspective, this can harm the health of the donors and puts a huge amount of stress on both the patients and the donors.

"It is just the only choice we have today," Chen said.

In 2009, she proposed to the local health authorities that Shanghai establish a donation system using organs from the victims of fatal traffic accidents. She wanted the chance to collect organs from the victims after medical experts had assessed the cases and family members had signed agreements.

"If just one tenth of the victims of traffic accidents could donate organs, it would ease the current organ shortage in China," Chen said. But to date, Chen hasn't had a reply from the authorities.

Lack of a law

Another major obstacle for organ donation in China is the lack of a law on brain death, according to experts. Brain death is defined as the irreversible loss of the brain function necessary to sustain life. Although the concept of brain death has been established in some 90 countries and regions in the world, at present the law in China defines death as when the heart ceases to function.

Chen said that even if there was just a short time between the brain ceasing to function and the heart stopping, some organs could be seriously damaged and would be unsuitable for use in transplants.

In her 2009 proposal, Chen also asked for the brain death standard to be introduced as soon as possible.

However, Huang Jiefu, the vice minister of health, told the Xinhua News Agency in November 2012 that it was not yet a good time to widely introduce the concept of brain death in China. Many people cannot accept this yet.

In fact, in practice, organ donors and their families could still select brain death, heart death or both as a standard for the doctors.

By September 2012, there had been 465 organ transplants carried out in China since the MOH and the Red Cross Society of China launched the organ transplant pilot program in March 2010. Of these, 47.5 percent of the transplant organs came from people who had been assessed as heart dead, 43.5 percent were from people assessed as heart and brain dead and just 9 percent came from people assessed as only brain dead.

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