Allocation troubles
Faced with these growing worries, COTRS is expected to address issues of fairness and efficiency in China's transplant organ allocation and gradually replace the current hospital-led organ transplant system.
Until the allocation system is fully rolled out, the Red Cross-led efforts mean that when a dying patient is found suitable for donation, hospitals notify an organ donation coordinator from the local Red Cross society.
The coordinator then seeks to persuade the family members of the dying patient to have the organs donated. The donated organs are then procured by an organ procurement organization (OPO) in hospitals. The country now has 169 OPOs accredited by the top health authority. They also have transplant qualifications and can allocate the organs within the hospitals.
The allocation of donated organs within hospitals can be based on money, power and connections, as hospitals also need to make profits, said one doctor belonging to an OPO in Guangzhou, who declined to reveal his name.
The Beijing News also reported on Monday that local Red Cross Societies usually demand hospitals donate a large sum of money to organ donors via the Red Cross but never publicize the detailed use of the money. If hospitals refuse to pay, they are not given donated organs, the report said.
In contrast, the new system doesn't collect any data on patients' social or wealth status. "These are absolutely not considered in our system," said Jiang Wenshi, statistical analysis director of COTRS, adding that "the most amazing thing about the system is no one knows the background of the patients so that it can prevent the privileged from obtaining organs through unfair means."
Built into the complicated calculation are medical factors including seriousness of the illness, distance from donors, compatibility of the organ to the recipient, and many other objective elements. The system automatically calculates rankings for all waiting patients and their condition is updated frequently to ensure continued accuracy.
Once a doctor identifies donated organs and inputs their information into the system, the system, which functions 24 hours a day, is able to make a match in less than a minute.
Doctors in charge of the five candidates that best match the donor's organ needs are then informed via text message by the system and requested to reply within an hour as to whether they will accept the organ if not. Once one candidate accepts the organ, the allocation automatically informs the others.
Wang said the organ allocation was designed to be carried out with the least human intervention. "All the data is stored on cloud computing, and human intervention is reduced to the lowest," he said.
The center also swears to indicate its sources cleanly. All the registered organs are provided by OPOs and so far 149 OPOs have already used the system.
"The new system will dissipate the reliance on organs from executed convicts," said Wang in his interview with World Health Organization last year.
Wang Jiefu, former Vice Minister of the Ministry of Health stated publicly in 2009 that more than 65 percent of transplanted organs came from the executed prisoners. In comparison, all 770 organs COTRS has allocated to date came from volunteers, said Wang.
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