China Headlines: To donate or not? -- China struggles for more organ donations

Five people have lived on Yang Huaiyuan's donated body organs since he was announced brain dead on April 3.

His heart, lungs, liver and kidneys have been successfully transplanted to five patients from Sichuan, Fujian and Hubei and they are currently functioning well. His corneas have also been preserved for those in need.

"He always liked to help others and he would like to do this (donation)," said Yang's mother Zhang Zun'e, who decided to donate Yang's body parts after the 39-year-old Sichuan man died in a car crash.

Yang's body will help at least seven people, according to Deng Shaoping, president of the Sichuan Provincial People's Hospital.

In China, many believe in the tradition of keeping the entire body for the dead in order to help their reincarnation or enable them better lives in the afterlife.

But as the nation progresses, organ donation has become a more acceptable alternative with encouragement from the central government.

In 2014, there were 1,700 donors giving more than 5,000 organs, exceeding the total number of the previous five years.

Despite the increase in donors, their is still a vast gap for supply and demand.

And the gap may continue to expand.

On January 1, China banned the harvesting of organs from executed prisoners, which was a major source of transplants.

"The donors are too few, and usually a patient has to wait for 1.5 to 3 years for a lung. Many died while waiting," said Chen Jingyu, a member of the Chinese Society of Organ Transplantation.

Liu Deruo, a noted thoracic surgeon with the China-Japan Friendship Hospital, said he last performed a lung transplant four years ago simply because no lungs are available for the desperate patients.

However, Huang Jiefu, head of a national human organ donation and transplant committee, said the ban, aimed to preserve justice and human right, would not aggravate the shortage of organs for transplant in the long run.

"The more respect we pay to prisoners on death row, the more citizens will donate their organs," said Huang.

In 2014, voluntary donation from Chinese citizens became the major source of transplant organs, accounting for 80 percent of all donated organs, Huang added.

Huang said use of organs from executed prisoners was a "reluctant option", which violates medical virtues and had long been criticized by the international community.

The option has gradually been phased out since China set up a system of voluntary donation in 2010, resulting in a final ban this year.

MOTIVATE MORE DONORS

Government statistics show that about 300,000 patients each year need organ transplants in China, while just more than 10,000 received such operations.

While lack of organs is the primary reason, Huang says the high cost paid by recipients of donated organs for the transplant surgery is another contributor for the disparity.

From 2010 to the end of January, a total of 3,326 people donated their organs after death, an average of less than 900 donors every year. The rate is quite low rate considering the 6 million deaths each year in China.

Instead of traditions such as keeping the deceased's body intact, poor administrative management is often the first target of blame for the low donation rate, said Huang.

A poll conducted by Huang's committee showed more than 40 percent of the surveyed were not sure whether to donate organs or not. The found part of the reason people are unsure, Huang says, is because they don't know who or how the organs will be used.

"So it is vital to establish an open and transparent organ distribution system, under which every organ can be traced back to the exact donors," he said.

China has developed an automatic organ distribution and sharing system, which sequences the patients according to the severity of illness and other internationally recognized factors.

The system can effectively exclude personal interference, if, it is well implemented, according to Huang

Some patients and their family members said they also worry about whether the hospital will take into consideration organ donor status when deciding whether or not to go all out to save a patient.

Huang said that's impossible, as every patient must be confirmed as dead before any of their body parts are taken away. Currently the dead can be classified as "heart dead," "brain dead" and "heart and brain dead."

But some involved in the transplant circle suggest introducing a third-party medical assessor to ensure the patient's death and avoid possible conflict between the family members and medical staff.

WHAT DO THE DONORS GET?

Currently, there are no subsidies to help pay for burial or cremation of organ donors in China.

Every single family interviewed by Xinhua reporters said the fact that organ donors don't even have funeral expenses paid for makes them feel pathetic.

Some families said they hoped the government would help cover more of the medical expenses of the dead donors. Last year, the central government allocated 840,000 yuan (about 137,000 U.S. dollars) to help pay the treatment fee for 1,200 donors, that's too little, said Gao Xinpu with the China Organ Donation Administrative Center.

Huang and Gao said subsidies for the donors' families are reasonable human comfort and aid, and that subsidies are never equal to trading of organs, which is illegal in China.

Some also proposed to build a public cemetery or monument to memorize these donors.

The government is also asked to provide more professional assistance during the patient donation.

Generally, when a doctor learns that a patient is willing to donate organs, he or she should immediately inform a special coordinator from the Red Cross Society of China, who will be responsible for communicating with the donor's family and dealing with the legal issues concerning the donation.

Meanwhile, one or more medical coordinators from the Organ Procurement Organization of the Chinese Hospital Association will communicate with doctors and assess the condition of the patient's organs.

China has only 169 registered special coordinators and 378 medical coordinators. "The number is far from enough especially when China's organ donors are increasing rapidly," said Gao.

With the ban on organs from the executed prisoners, the coordinators' task will become heavier as more donations need their participation, Gao said.

Gao revealed that the Chinese government is training another 660 coordinators and they will go to work soon. Endi