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Organ trafficking stirs concern
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13:43, August 24, 2009

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The number of organ transplants from deceased donors in China has only been 130 since the first case in 2003, one of the country's leading transplant experts said at a seminar Sunday.

About 11,000 transplant operations are performed each year in China, including both living- and all deceased-donor transplantations, including executed prisoners, making the country the second-largest in the world to the U.S. in total number.

But that number is far from enough to meet demand, Chen Zhonghua, the Chinese Medical Association's deputy director for transplanting, said at the seminar held in Xining, capital of Qinghai Province. The meeting was organized by the Ministry of Health and a subsidiary of the Novartis company.

Chen told the Global Times that that organ trafficking is the major obstacle facing China's organ-transplant practice.

According to official figures, more than 1.5 million people in China need organ transplants each year.

"The huge shortage of organ donors and organs has created a significant black market for organs, which in turn has ruined public faith and willingness to donate organs," Chen said. "There are already signs of backlash, with the nationwide number (of donations) falling last year to 36, from 41 the previous year, and only about 10 cases so far this year."

Chen noted that executed prisoners, with written consent either from themselves or their family members, still provide the major source of transplants in China.

He claimed, however, that organs from executed convicts are dwindling gradually amid a dramatic drop in the number of executions. This started, he said, after China's Supreme People's Court started reviewing some death penalty cases in 2007.

China passed the Regulation on Human Organ Transplantation in 2007 to ban all forms of such trafficking, prevent "transplant tourism" by foreigners, and request that living donations be restricted to spouses, lineal blood relatives or collateral blood relatives within three generations, or people sharing family bonds.

But despite the crackdown, "organ brokers" have procured organs from the poor and jobless by making them "relatives" of organ recipients by forging documents with the help of lawyers and medical workers, Chen said.

"In 2006, living transplants accounted for 15 percent of the total number of national organ transplantations; in 2007, the number reached 50 percent; last year, the number varied between 40 percent and 60 percent," Chen said, adding that the sharp rise in the past two years is closely related to the “fake relative” phenomenon.

Mainland hospitals conducted 450 liver transplants from living donors in 2007, and 438 in 2008, accounting for most of the 1,162 total cases from 1993 through May of this year, according to data collected by CLTRnet, an online data collection system run at the University of Hong Kong.

A sina.com blogger, identifying himself as Li Zhe and an organ-transplant dealer, regularly lists contact information to get matching data for kidney transplants.

"If there are available matching organs for patients, trading can start immediately. I'll take care of all the procedures, while the receivers will bear the cost," Li said.

"A single case costs as much as 200,000 yuan for a patient who needs a kidney transplant," Li told the Global Times by telephone, adding that the medical checkups for potential donors run at around 10,000 yuan. But he refused to say how much he could make out of such a deal.

It takes at least a month for the donor to go through necessary medical procedures at hospitals, and another two weeks for the operation and recovery of the receiver, Li said.

Dealers also have to fake the identities of patients to show that donors and receivers are related. Apart from bribing relative departments to obtain all essential documentation, money has to be paid to physicians who will carry out the operation, Li said.

"30,000 yuan is an average sum for doctors in Beijing," he said.

Authorities have stepped up their crackdown on illegal organ-transplant dealings this year, following reports that 17 Japanese tourists spent about 595,000 yuan each for liver or kidney transplants at hospitals in the southern city of Guangzhou, Li said.

"The number of hospitals that are accessible for us dropped sharply this year. But the number of patients who need organs and want to buy from us remains, expanding the time needed to process each case," Li said. "The business is even more risky and difficult. You can only count on luck. A fruitless year for me is not rare at all. Four to five cases per year could be really good."

"There are four to five thousand people who are willing to trade their organs in the country, according to our estimate. Meanwhile, three to four thousand organ dealers like me are mainly scattered in Henan, Beijing and Northeast regions."

Zhengzhou, the capital of Henan Province, has seen the most trade of organs, Li said, adding that many donors are from there. He put the country's total number of organs traded at several hundred a year.

"I haven't dealt with any foreigner receivers. That must be very tricky. It would be extremely troublesome for us to fake identities for their stay and access to Chinese hospitals and the medical facilities," Li said.

But that doesn't mean there's a lack of interest. Li noted that he would do business with foreigners as long as they pay more and have Asian faces, preferably South Koreans and Japanese, which he said would make business easier.

From a legal and safety standpoint, Chen noted that the illegal organ trade must be phased out. As a lucrative business, violent disputes often arise, and organ recipients often turn to loan sharks to pay for their operations.

According to a report by transplantation.org.cn, police found a corpse missing organs June 15 in Guizhou Province.

Preliminary investigations indicated that a local organ broker killed a healthy man and sold his organs to three doctors at the Guangdong-based Third Affiliated Hospital of Sun Yat-sen University.

The hospital is one of the 164 medical institutions officially qualified to carry out organ transplants.

The Ministry of Health didn't confirm the information, saying only that they have seen the report.

But the ministry has launched an overhaul of illegal organ transplantations at mainland hospitals. Under the leadership of the National Organ Transplantation Committee and the ministry, an expert team has begun final evaluation of the 164 practitioners.

"We'll let the people know and decide which hospital to go to for quality and ethical transplants," the ministry said in an Aug. 12 statement.

"A waiting list will be made public to secure transparent and fair practice in terms of organ-donation allocations and procurements," Vice Minister of Health Huang Jiefu said.

The Red Cross Society of China, in collaboration with the ministry, plans to establish an independent organ-donation system that would include a waiting list of patients, as well as stipulations on the sources of donations, according to its executive vice president, Jiang Yiman.

As the initiator and director of the first organ-donation platform for the deceased, which is based in Shenzhen, Chen said he was worried about the low donation rate on the Chinese mainland of just 0.03 donors for every million people, far lower than that of Spain, which is 36 donors per 1 million people – the highest proportion in the world.

"It will take China five to 10 years to raise the number to 0.3 in 1 million people," Chen estimated.

Source: Global Times

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