China’s transplant strategists fail to answer medical community’s concerns

In their latest attempt to deceive the international community about their new transplant system, Chinese officials organized an organ donation conference in Beijing using Western doctors to promulgate their subterfuge

After troubling events at the Transplant Congress in Hong Kong last summer, Chinese officials invited leading transplant doctors to discuss further improvements at an organ donation conference in October 2016. Prior to the conference, a delegation of doctors was invited to visit and inspect selected transplant hospitals. Members of this delegation were asked to speak at the conference on the improvements in the Chinese transplant system. The unsettling image of bright smiles and a warm handshake between Huang Jiefu and Frank Delmonico was well covered by the international media.

China repeatedly announced that it would end organ procurement from executed prisoners, and on several occasions Chinese officials claimed that a new transplant law prohibits the practice. Leading Western transplant surgeons support these claims when they refer to the new transplant law, even at parliamentarian workshops. Almost two years after the announcement in December 2014, however, no law of this kind has been found by any researchers, nor have the transplant organizations supporting change in China provided the text of such a law. The Western delegation never saw any evidence of this new law. Their praise of China’s progress is not based on facts, but on the hope that the country is doing the right thing. The legal situation in China is in fact quite sobering as the existing 1984 provisions continue to allow organ harvesting from executed prisoners.

China made no secret of the fact that only those who expressed their support of developments in China in recent years were invited to the Beijing conference. Critics and investigators who understand the transplant system in China well, like David Matas and David Kilgour, were not invited. It is certain that if they had attended they would have asked more sensitive questions.

While the recent in-depth report by David Kilgour, David Matas and Ethan Gutmann estimates a far larger number of transplants in China than the government reports, the group of doctors inspecting the transplant hospitals failed to comment or question their hosts on the detailed information contained in the report. It remains unclear if the guests had even studied the report. A critical aspect of the transcript is that prisoners of conscience, primarily practitioners of Falun Gong, a spiritual practice that has been persecuted for over seventeen years, Tibetans, Uighurs and House Christians have been subject to forced organ harvesting. The sourcing of organs from prisoners of conscience has fostered the unprecedented rapid growth of China’s transplant system.

It is surprising that after conducting its inspections, the delegation expressed its positive views about reported changes, but did not disclose the methodology with which they inspected the hospitals. By making their methodology transparent, others would be able to assess whether concerns such as those expressed in the aforementioned report were addressed. A prescheduled inspection tour would certainly allow the host to temporarily suspend all organ procurement practices from prisoners of conscience and replace documentation in the selected hospitals. False negative findings would thus become predictable.

DAFOH has issued a statement rejecting the empty rhetoric that surrounded the recent Beijing conference. Others agree. Humanosphere’s article “Hold your applause for China’s organ donation reforms, human rights advocates say” concisely summarizes the issue.

Increasing awareness among Western media demonstrates that many see through China’s staged tricks. Benedict Rogers exclaimed “It’s time to say to China… stop beating and jailing and torturing Falun Gong practitioners whose only crime is to believe in truthfulness, compassion and forbearance; and stop ripping out the hearts, kidneys, livers, lungs and other vital organs of living prisoners of conscience and executed prisoners… Carpe diem; stop the kowtow.”

The Epoch Times article “Deleting a Question and Declining an Answer on Organ Transplant Reform in China” revealed contradictions and evasions. China’s spokesperson, Huang Jiefu, promised the world in late 2014, that organs from death row prisoners would no longer be used for transplantation. Yet as recently as August 2016, an answer to a question about prisoner donation on the website of China’s Organ Transplantation Development Foundation, a state-linked agency promoting voluntary donation, reflects a blatant reversal of Huang’s promise. In response to the 491st of 500 Frequently Asked Questions: “Can prisoners in jail apply to donate their organs after death?” The answer reads: “As long as they meet the basic requirements of organ donation, the organ function is normal, they are willing, and there is no compensation, prisoners can all the same donate organs.” After the paper brought attention to this question and answer, the item was removed from the website. Huang has never answered questions about this nor addressed the detailed evidence regarding sourcing of organs from prisoners of conscience, calling it “Ridiculous!”

Richard Reeb reported in Red China plays defense on its organ harvesting that international transplant leaders told their Chinese colleagues at last summer’s international transplant meeting in Hong Kong that “their country’s decades-long practice of using the organs of executed prisoners had horrified the rest of the world.” Yet just a few weeks later at an ‘invitation-only’ conference in Beijing, the same leaders championed China’s ‘reforms,’ as AP reported in Doctors hail China’s pledge to stop harvesting inmate organs. Chinese officials have been praised for reforms they claim to have made, while substantial evidence to the contrary exits.

Beijing’s stage-managed conference was just the latest attempt by China to whitewash and cover up abuses in its organ procurement procedures. The conference was held with the support of the China National Organ Donation & Transplant Committee (CNODTC), the International Society for Organ Donation and Procurement (ISODP), The Transplantation Society (TTS) and the World Health Organization (WHO). In attendance were eminent international physicians who allegedly made statements in praise of China’s unsubstantiated reforms despite the absence of evidence demonstrating that China now sources all organs for transplantation in an ethical or transparent way.

DAFOH asserts that the government of China has once again failed to demonstrate the end of human rights abuses in its organ donor program. Doctors, medical professionals and patient advocates from around the world remain skeptical for many reasons:
  • A semantic trick used by China has re-classified organs harvested from executed prisoners as “donations,” or “voluntary citizen donations,” which bypasses international ethical terminology making it impossible to determine the actual source of organs.
  • Conference attendees reportedly visited pre-selected transplant hospitals in order to see for themselves the success of China’s touted reforms. Failing unbiased standards of inspection, the claims that “Chinese practice is safe, transparent, and ethical,” per WHO delegate Dr. Jose Nunez, are misleading and premature.
  • The deterioration in ethical standards of international transplant organization leaders in this case is alarming, and they do not represent the majority of concerned transplant doctors and healthcare professionals worldwide. These organizations have a duty to their members and to the public to maintain independence in their interactions with China in order to retain any credibility. It is deeply disturbing that WHO officers and others blindly champion China’s claims as it is widely known that the Chinese Red Cross Society has openly implemented an unethical system of offering financial incentives to relatives of deceased patients, a practice that is condemned by four of the eleven WHO Guiding Principles on organ transplantation.
  • Ongoing reports and a mass of evidence concerning China’s dependence on prisoners of conscience as the primary source of organs cannot be arbitrarily denied or ignored. Prescheduled hospital tours easily accommodate a temporary halt of organ sourcing from prisoners of conscience for the duration of the inspection time. The delegation did not investigate for the existence of this criminal abuse nor provide a methodology for their investigation of this matter.
  • It is of concern that the conversion rate, i.e. the actual consent for donation by the relatives of the deceased, has inexplicably jumped an unprecedented 50% within just one year. Cultural taboos concerning donation, paired with widespread public distrust in corrupt medical practices, suggests that voluntary donation numbers would be very unlikely to increase. Yet China’s incredulous transplant figures follow an artificial course: from 1999 to 2004, the annual transplant numbers increased from approximately 3,000 to over 12,000, an increase of 300%. From 2006 to 2007, when China did not have a donation system, the number of living kidney donations increased by 470%. On Dec 31, 2015, the number of registered organ donors increased by precisely 25,000 in only one day.
  • The claim that the “recorded usage of drugs given to transplant patients matched up with China’s reported numbers of transplants” as supporting evidence is misleading. Drug consumption by transplant tourists, who fly in and out of China within days of surgery, cannot be accurately assessed given China’s high rate of drug falsification (see articles on this topic below from Radio Free Asia and the Epoch Times). The number of transplants can thus be far larger. In conclusion, China continues to fail to address acute concerns and evidence brought forward by investigators like David Kilgour, David Matas and Ethan Gutmann as well as by organizations such as Doctors Against Forced Organ Harvesting (DAFOH) and the World Organization for the Investigation of the Persecution of Falun Gong (WOIPFG). While hand-picked delegates in rose-colored glasses applaud China’s claims of reform, real change can only be realized when independent investigators have open access to unscheduled visits in transplant centers.


Reassurance of China’s cessation of forced organ harvesting from all prisoners requires the completion of this to-do-list:
  • Abolish China’s 1984 provisions
  • Make publicly accessible the text of any new transplant law that ends organ harvesting from all prisoners
  • Provide transparent access to all transplantation data
  • Provide the conditions to trace all transplant organs to their original donor.

Without new transplant laws in China and without an investigation into the evidence of forced organ harvesting from prisoners of conscience, no medical organization can give the green light to China’s transplant ‘reforms.’