Dr. Jiefu Huang presented at the Madrid Conference 2010

At the Madrid Conference on Organ Donation and Transplantation, March 2010, Dr. Jiefu HuangVice Minister of Health of the People’s Republic of China held a presentation on the organ transplantation program in China. In his presentation Dr. Huang published transplant figures of the years 2008 and 2009 in China. He stated that 6274 kidney and 2334 liver transplantations were performed in 2008, and 6548 kidney and 2181 liver transplantations were performed in 2009.

Dr. Huang stated that 1888 livers (80.9%) in 2008, and 1884 livers (86.4%) in 2009 used for liver transplantations stemmed from deceased donors.

He also indicated that 3609 (57.5%) kidney transplantations used kidneys from non-heart-beating donors in 2008, while 2665 (42.5%) kidney transplantations used kidneys from living donors.

For the year 2009 the numbers were: 3856 (59%) kidney transplantations used organs from deceased donors versus 2629 (41%) kidney transplantations used kidneys from living donors.

In the same presentation Dr. Huang also stated that over 90% of the organs from deceased donors stemmed from executed prisoners. This would imply that in order to supply the demand of liver transplantations with enough liversat least 1690 inmates were executed in each of the years 2008 and 2009.

For kidney transplantations this would imply that 3248 kidneys stemmed from deceased donors in 2008, which would require at least 1624 executions;for 2009 it would mean 3470 kidneys stemmed from deceased donors, which would imply that at least 1735 inmates were executed.

Due to potential multiple organ harvesting a final absolute number of executions is not traceable.

Given the situation that not all livers from executed prisoners might be suitablefor transplantation (e.g. prevalent liver diseases, old age etc. of the donor) or due to the lack of finding a matching recipient (e.g. blood and tissue matching; limitation due to ischemic time; after 2007, according to the CMA, organ donations only to direct family members are permitted), and due to the situation that not in all executed prisoners liver and kidneys might be suitable for transplantation, the numbers of executions needed to supply the transplantation demand with enough livers might even exceed the estimated numbers of 1690-1735 executions.

This raises the question if the promise of the Chinese Medical Association(CMA) given at the World Medical Association (WMA) conference in Copenhagen in 2007, that executed prisoners should not be used as organ source anymore (with a few exceptions of donating to direct relatives), is fully implemented. Dr. Huang’s presentation from March 2010 and the release of transplant figures for 2008 and 2009 questions if the promise of the CMA, given prior to the Olympic Games in Beijing, was put into effect over the past 3 years.

Dr. Huang also indicated that China is lacking of an established organ donation system. Until 2010 only registries for kidney and liver transplants were established. This raises again questions about the organ sourcing and underlines the role of executions as a source for organs in the past years. In his presentation Dr. Huang described a sudden increase of living organ donors starting in 2007. Given that China is still lacking of an established organ donation system and that 90% of the organs from deceased donors are still sourced from executed prisoners, the sudden increase of living organ donors raises the question if more death row candidates and other prisoners are now forcibly organ harvested while being alive. The latter was previously reported in the context of organ harvesting from living Falun Gong practitioners.
Although the number of organ transplantations to foreign recipients seemed to decrease after 2007, the absolute number of transplantations stayed at a high level and continues to question where the organs come from given an organ donation system that is still in progress. The presentation of Dr. Huang is concerning, as it affirms that the organ procurement in China is still lacking transparency and that Falun Gong adherents as a persecuted group of people continue to be at risk being subject to unethical organ harvesting.