An analysis of Chinese medical journal articles found multiple reports of transplant operations in which the organ “donor” may have still been alive. The analysis, “Cases Abusing Brain Death Definition in Organ Procurement in China,” was published in the Cambridge Quarterly of Healthcare Ethics and concluded that there is a need for “systematic investigation into organ donation from claimed brain-dead donors.” The authors, including DAFOH Advisory Board member Huige Li, MD, PhD, identified cases where the transplant procedures began with the intubation of a supposedly brain-dead donor, stating “the organ procurement procedures started with initiating ‘intratracheal intubation for mechanical ventilation after brain death,’ indicating that a brain death diagnosis was not performed.”
Two of the internationally recognized steps for determining brain death are checking for brainstem reflexes and conducting an apnea test. For both, the person must be on a ventilator before the tests are performed, and a ventilator requires intubation. An apnea test, which is part of China’s reported procedures for determining brain death, is conducted by removing a person from a ventilator to see if they can breathe independently. It would be impossible to perform this gold standard in determining brain death, without having first intubated the person to implement mechanical ventilation. Any transplant operation reported to have begun with intubation has clearly not come after an apnea test.
The peer-reviewed Cambridge University Press article also found two cases where the transplant procedure itself induced cardiac arrest without a prior brain death determination and stated, “the condition of these donors neither met the criteria of brain death nor that of cardiac death. In other words, the ‘donor organs’ may well have been procured in these cases from living human beings.”
A video from Spotlight on China expands on the topic of unethically sourced organs in China.