ISHLT Issues Unprecedented Statement on Engaging with China’s Transplantation System

On June 22, the Journal of Heart and Lung Transplantation published an unprecedented statement made by the International Society for Heart and Lung Transplantation (ISHLT) on China’s transplantation practices. The “International Society for Heart and Lung Transplantation Statement on Transplant Ethics,” co-authored by Are Martin HOLM and several other experts in the transplantation field, cautions ISHL members, about 3,000 in 50 countries, to comply with international ethical standards and refrain from supporting transplantation systems which cannot guarantee that ethical and legal standards are being met. “ISHLT members should discourage patients from seeking transplantation in countries where transplantation is not open to external scrutiny and the ethical standards of the ISHLT cannot be assured. ISHLT members should work with their own governments to ensure that such ‘transplant tourism’ that contravenes these ethical principles is made illegal.”

In regards to China’s transplantation system, the ISHLT statement noted that ISHLT members “should not participate in or support the transplantation of organs from executed prisoners or the sale of organs for transplantation. Members of the ISHLT should also refrain from knowingly teaching visiting physicians the art and science of heart and lung transplantation if it cannot be ascertained and guaranteed that those to be trained will not use their newly acquired knowledge for transplants based on organs from executed prisoners or any other transplant related crime.”

“Given the body of evidence that the government of the People’s Republic of China stands alone in continuing to systematically support the procurement of organs or tissue from executed prisoners, submissions related to transplantation and involving either organs or tissue from human donors in the People’s Republic of China will not be accepted by ISHLT for the purposes listed above,” the authors wrote. “This policy, including whether other countries systematically engage in the use of organs or tissue from nonconsenting human donors and should be subject to this restriction, will be reviewed on an annual basis pending independently obtained proof that these practices have ceased.”

According to Jacob Lavee, MD, Professor of Surgery at Tel Aviv University and founder of the Heart Transplantation Unit at the Sheba Medical Center who was one of the authors of the ISHLT statement, the ISHLT position is unique in that it is the first and only medical organization to set such definitive limits on supporting China’s illicit transplantation practices.

In recommending that ISHLT members disengage from supporting China’s transplantation infrastructure, the organization has essentially exerted an academic boycott on those in China working in heart and lung transplants. In his interview with Israeli newspaper Haaretz, Lavee noted that “doctors’ academic advancement is dependent upon their ability to publish in scientific journals and present at conferences. Now those possibilities are blocked to the Chinese and I hope that this pressure will bring about an end to the criminal use of the organs of condemned prisoners.”

ISHLT should be commended for its courage in publishing this vital statement. Every professional medical organization should be encouraged to take similar steps to disengage from China’s transplantation crimes.