Will China continue to 'harvest' organs from death row prisoners?

International doctors have differing opinions on whether China has fulfilled its commitment not to harvest organs from executed prisoners.

Doctors perform surgery in China. Photo: Reuters.

A Canadian patient received a kidney transplant after waiting just three days during a trip to China, surprising surgeons in the region.The Transplant Community (TTS) is based inMontreal suspects that the organ may have been taken from a death row inmate who was executed, according to AP.

The incident has further fueled international medical doubts about whether China has fulfilled its commitment to stop "harvesting" organs from executed prisoners. This practice has been condemned by the World Health Organization and many others who fear it could encourage executions and lead to forced organ harvesting.

China officially announced it had stopped harvesting organs from executed prisoners in January 2015. Some foreign doctors working in China say the authorities are acting more responsibly, but other observers argue that China has not done enough to prove it has fulfilled that commitment.

China sought to use the annual TTS congress, held in Hong Kong this month, as recognition of its changes. But Dr. Philip O'Connell, president of the TTS, rejected that interpretation, although some reform measures appeared to have been effective.

"We recognize that this won't change overnight," O'Connell said. "It's impossible to instantly transition from a system that uses organs from death row inmates, condoned by corruption and money, to a system that is completely open, transparent, and ethical."

Dr. Huang Jiefu, head of the transplant oversight system in Chinese hospitals, is considered a leading figure in efforts to change the status quo of organ transplantation in the country. Huang publicly admitted in 2005 that Chinese doctors had been using organs from executed prisoners. In 2011, Huang and other officials estimated that 65% of organs harvested from corpses originated from executed prisoners.

Mr. Hoang Khiet Phu. Photo: AP.

In an interview last weekend, Mr. Hoang said that he believed hospitals under his management were now using donated organs, but that illegal organ harvesting still existed.

"We still have a long way to go," Mr. Hoang said.

Mr. Huang said he had spoken to government officials about the reforms needed to win the world's trust. One of the necessary reforms is cracking down on the illegal organ trade and establishing more regulations on organ trafficking procedures. China also needs to train many more doctors and hospitals to perform the surgeries, he said.

"Our organ transplantation work must rely 100% on voluntary organ donations from the public," Mr. Hoang said. "Otherwise, we cannot stand on the world stage."

China is believed to execute the most people in the world, although the exact number is kept secret. Amnesty International estimates the annual number to be in the thousands.

A pilot organ donation registry established in 2010 has been expanded into a national system. Chinese media frequently publish positive stories about families donating organs from deceased relatives – a clear attempt to change long-standing cultural perceptions of organ donation.

According to the government, Chinese doctors performed 10,057 organ transplants in 2015. Health officials also said they hope to increase the number of hospitals capable of performing transplants. China estimates that approximately 300,000 patients per year need organ transplants. Its organ donation rate is higher than Japan and most other Asian countries, but still significantly lower than the United States and most Western European nations.

Chinese government statistics often generate deep skepticism, with many critics saying they don't believe the figures. Some point to the prevalence of clandestine surgeries, arguing that the actual number of organ transplants is far higher than the official figures, and that death row prisoners remain a major source of organs.

Dr. Torsten Trey, executive director of the Doctors Against Forced Organ Harvesting group, argues that outsiders do not have a clear understanding of the system to truly assess the accuracy of the statistics or claims about China's progress.

"Change failed because there was no change," Trey wrote in an email.

Signs of change

For more than a decade, doctors outside of China have worked with Huang and other officials. Huang said he invited transplant surgeons to visit hospitals and meet with Chinese doctors.

Michael Millis, a surgeon at the University of Chicago, visited several dozen transplant centers in China while volunteering there. He said one sign of the change is that doctors in these centers used to have regular, pre-scheduled surgeries. Now, they say some days they perform many surgeries, but other days or weeks they don't perform any at all. This suggests they are operating on a fluctuating schedule driven by voluntary organ donation, rather than executions, Millis said.

"These are stories that, based on my own experience, I can say have led to change," said Millis.

Milis said the Canadian patient's case shows that clandestine surgeries still occur in China, but not to the extent that others have alleged.

"There is no evidence to suggest that it is a large-scale black market system obtaining a large number of organs from death row prisoners," Millis added, noting that clandestine organ transplants also occur elsewhere in the world.

Dr. Milis and other doctors hope to improve China's system by collaborating with health officials they find receptive and willing to consider reforms.

In the case of the Canadian patient, TTS was notified shortly after the patient returned to Canada and told his doctor that he had purchased a kidney and needed post-operative care. TTS sent a letter to Mr. Huang urging an investigation into the matter just before the meeting in Hong Kong.

Mr. Huang later stated that Chinese authorities had revoked the licenses of the surgeon and the hospital that performed the operation and launched a criminal investigation.

According to O'Connell, TTS told Chinese officials: "This is damaging to what you're trying to achieve, and you need to take action."

"Only the Chinese themselves can bring about change or reform in their own country," O'Connell said. "What we're trying to do is identify the people we believe support reform in China and try to encourage them."

According to VNE