Media reports announcing an end to the use of organs from executed prisoners in China are misleading

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Media reports announcing an end to the use of organs from executed prisoners in China are misleading

December 13, 2014

Evidently relying upon statements made during a plenum of the Chinese State Council in October 2014, international media have reported that the Chinese government has promised that organs for transplantation will no longer be obtained from executed prisoners as of January 1, 2015.1,2 The Declaration of Istanbul Custodian Group (DICG) welcomes this announcement and applauds the leadership of Chinese colleagues to accomplish this objective, but for several reasons remains skeptical about the promised timeline.

First, the announcement was not accompanied by formal assurance that the Hangzhou Resolution, developed by Chinese transplant professionals and government officials in 2013, is indeed being implemented.3 The objectives of the Hangzhou Resolution include:

  • establishing credentials for Chinese transplant professionals,
  • banning the sale or purchase of human organs,
  • preventing organ trafficking and transplant tourism, and
  • treating transplantable organs as a national resource for Chinese patients.

The Resolution’s aims are to achieve national self-sufficiency in transplantation while complying with World Health Organization (WHO) standards for organ donation and allocation.

Over the past twenty years, China has developed substantial capacity to perform transplants. Until recently, much of it was devoted to performing highly paid organ transplants for “transplant tourists,” relying entirely on organs from executed prisoners. The recent news coverage does not provide any information on whether the relevant ministries and healthcare facilities are prepared to adjust the pace of transplantation (and limit it to domestic patients) if the alternative programs of deceased organ donation now being developed do not initially provide as many organs as the transplant programs have been used to receiving from executed prisoners. Nor has there been mention of the government’s commitment to adhering to global standards, as embodied in the WHO guidelines endorsed by China, that forbid providing financial rewards to the families of deceased patients who donate organs.

Third, reports indicate that the existing practice of obtaining organs from executed prisoners may not actually be ended but merely replaced by using organs from individuals condemned to death who have “consented” to organ removal, with family approval at the time of execution.4 However, as the DICG leadership wrote in an April 2014 “open letter” to Xi Jinping, President of the People's Republic of China, “it is obvious that prison inmates condemned to death are not truly free to make an autonomous and informed consent for organ donation and that no legal due process exists to assure consent.”5

The DICG remains eager to support the intention of the Chinese transplant community to build an infrastructure of donation that complies with the Hangzhou Resolution and is consistent with WHO guidelines so that the promises conveyed in the recent media reports are fulfilled.

3. Huang JF, Zheng SS, Liu YF, Wang HB, Chapman J, O'Connell P, Millis M, Fung J, Delmonico F. “China organ donation and transplantation update: the Hangzhou Resolution.” Hepatobiliary & Pancreatic Diseases International. 2014. 13: 122-24.
5. Delmonico F, Chapman J, Fung J, Danovitch G, Levin A, Capron A, Busuttil R, O'Connell P. “Open letter to Xi Jinping, President of the People's Republic of China: China's fight against corruption in organ transplantation.” Transplantation. 2014. 97: 795-96.

CONTACT: Francis L. Delmonico, MD, Executive Director, DICG: This email address is being protected from spambots. You need JavaScript enabled to view it.

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