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Caijing Investigates Illegal Organ Transplant Trading Network

02-14 13:41 Caijing
The prosperity of China’s organ transplant cause depends on the success of the DCD approach. After implementing the DCD approach, an opt-out mechanism would evolve naturally over time.

By staff reporters Xu Kai and Sun Tao
 
On April 28, 2011, with the “help” of five medical workers, 17-year-old Xiao Wei “sold” his kidney to a middle-aged Malaysian at a hospital in Chenzhou, Hunan Province.

Xiao, one of many donors in China’s illegal organ transplant trading network, received 24,000 yuan in exchange for his kidney. The operation left a long and narrow scar on his right side. With the money he earned, Xiao bought electronic devices including a mobile phone and a tablet computer. His mother saw the scar after he returned to his hometown in Anhui province. Shocked and enraged, she called the police.

Police investigated the incident and uncovered a transnational underground organ transplant trading network. Local authorities in Chenzhou have arrested a dozen suspects since the investigation began. The police found that the network, which is closely intertwined with online brokers, is made up of primarily young donors, overseas recipients, medical staff and hospital contractors. Together, they form an integrated chain which allows organs to be illegally harvested from donors and transplanted into recipients.

On April 28, 2011, the Ministry of Health issued a notice on strengthening the regulation of human organ transplants, stipulating that “offending medical staff’s licenses to practice medicine would be revoked.” The ministry also launched a nationwide crackdown on illegal organ transplantation at the end of 2011. Back in 2010, the Ministry of Public Security launched a similar crackdown and uncovered several organ-trading gangs in Henan, Shandong and Beijing.

Four days after Xiao had his surgery, the eighth amendment to China’s Criminal Law came into effect, which stipulates that criminals guilty of “organizing the trading of human organs shall be subject to fines and sentenced to up to five years in prison; serious violations are punishable by fines, confiscation of property and more than five years of imprisonment.” In Xiao’s case, five suspects were caught by the police and prosecuted by the local procuratorate on the charge of “conducting illegal business.”

China currently has a severe shortage of organs available for transplant candidates. Each year, only 10,000 out of 1.5 million Chinese who need organ transplants receive legitimate surgery. The demand/supply ratio is 150:1, which is much higher than the global average of 20-30:1 provided by the World Health Organization, let alone the ratio in the United States (5:1) and the United Kingdom (3:1) during the same period.

Low supply and high demand has allowed a select few to reap high profits: “donors” generally only receive about 20,000 yuan for their kidneys while recipients must often pay more than 200,000 yuan for transplants. The difference is divided among doctors, hospitals and brokers. High profits have attracted a large number of brokers who not only cater to domestic market demand, but also organize foreigners to travel to China for illegal transplant surgery.

In the meantime, China has been under tremendous domestic and international pressure for the widespread practice of harvesting organs from executed criminals and the trading of organs harvested from living “donors.” Huang Jiefu, vice-minister of the Ministry of Health and an organ transplant expert, wrote in the Chinese Journal of Organ Transplantation in 2011 that by the end of 2009, over 65 percent of transplanted organs [in China] came from executed criminals, of which over 90 percent of transplanted organs were harvested from cadavers. Medical journal The Lancet published an article written by Al Caplan, a medical professor at the University of Pennsylvania, and others, which calls for a boycott of Chinese science and medicine pertaining to organ transplants from executed criminals.

In terms of developing an organ donation system, the Ministry of Health has been wavering between adopting a Donation after Brain-Stem Death (DBD) approach or a Donation after Cardiac Death (DCD) approach. It has also yet to decide whether to adopt an “opt-in” or an “opt-out” mechanism. Huang contended that the prosperity of China’s organ transplant cause depends on the success of the DCD approach. After implementing the DCD approach, an opt-out mechanism would evolve naturally over time.

The Ministry of Health started a pilot program on DCD transplantation in 2011, entrusting the Red Cross Society of China (RCSC) with the organization of organ donations as a third party. In addition, the State Council plans to amend the Regulation on Human Organ Transplants in 2012.

Wu Youmin, a consultant to the Ministry of Health’s Organ Transplant Committee (OTC), stated that the key determinants of a country’s organ donation rate include the country’s GDP and per capita GDP, per capita health care investment, the gap between rich and poor, the public’s recognition of transplant organ donation, relevant laws and regulations, and the country's transplant capacity. Wu stressed the need to establish an efficient donation system and a fair distribution mechanism to alleviate the severe shortage of organs available for transplant candidates.

As one of China’s pilot areas, the Tianjin Municipality has witnessed 19 DCD cases, ranking first throughout the country. Staff at the local branch of the RCSC found that conventional thinking and the lack of donation-related knowledge are the main obstacles to organ donation. Besides, how to provide proper financial aid to donors without inducing the “trading” of human organs is an issue yet to be resolved.

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Full article in Chinese: http://magazine.caijing.com.cn/2012-02-13/111676437.html

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