Responses to comments on “Liver transplantation in mainland China: the overview of CLTR 2011 annual scientific report”
Recently, we published an article entitled ‘Liver transplantation in mainland China: the overview of CLTR 2011 annual scientific report’ on the Hepatobiliary Surgery and Nutrition (1). Shortly after that, we received comments as below from a reader. Hereby, we respectfully reply to the comments.
Comments from a reader
“If there were 115 liver transplantation performed with ‘Chinese category donors’ out of approximately 1,850 (~6%) donors in 2011, where did all the other livers come from for transplant. The paper discusses the ‘new system’ for donor designation, but there is no mention of the past (or present) use of executed prisoners. Is this practice still in place? I know reforms have taken place, just not sure why none of this is mentioned in the article?”
Response from the authors
Thank you for the reader’s comment on our article.
The China Liver Transplant Registry (CLTR) 2011 annual scientific reports aimed to provide scientific statistics to the government, the professionals and the patients with the description of the current status and trend of liver transplantation activities in Mainland China. This article, as an accompanying document of CLTR 2011 annual scientific report and only provided the outline of scientific results for liver transplant (LT) in China. More detailed statistics including the distribution of the organ source have been summarized in the original Chinese reports.
The organ donation from death penalty prisoners with informed consent from prisoners themselves and their family is currently allowed by Chinese policies. Medically and scientifically, it was classified as the uncontrolled donation after circulatory death (DCD) in the scientific reports. However, the Ministry of Health has acknowledged the reliance on death penalty prisoner organs for transplantation is not sustainable and also ethical controversial. Ministry of Health (MOH) openly expressed the will to use the new deceased organ donation program to replace the practice. The new national program for deceased organ donation officially kicked off in Feb and the new deceased organ donation that not involving prisoner donation has reached 25% of overall transplantation in eight months. These important developments were not included in the published reports, which only cover activities before 2011.
I had very thorough and constant discussions with our international colleagues on the topic of use of death penalty prisoners’ organs with informed consent. The practice should not be adopted. However, this is not the theme of this paper and the limitation of the space would not allow us for thorough discussion on this topic, which involved many layers of complicated ethical discussions.
Two papers were recently published regarding organ donation system in China: (I) the National Program for Deceased Organ Donation in China, published on Transplantation; (II) a Welcomed New National Policy in China, published on Transplantation (2,3), as well as response from international transplant society (4). Please kindly find them for your reference.
We hope the above clarification answers the reader’s question well and we would like to express our appreciation for your support and concerns about the progress of organ donation in China.
Thank you!
Acknowledgements
Disclosure: The author declares no conflict of interest.
References
- Wang H, Jiang W, Zhou Z, et al. Liver transplantation in mainland China: the overview of CLTR 2011 annual scientific report. Hepatobiliary Surg Nutr 2013;2:188-97.
- Huang J, Wang H, Fan ST, et al. The national program for deceased organ donation in China. Transplantation 2013;96:5-9. [PubMed]
- Delmonico FL. A welcomed new national policy in China. Transplantation 2013;96:3-4. [PubMed]
- Alcorn T. China’s organ transplant system in transition. Lancet 2011;377:1905-6. [PubMed]
