Greater awareness is needed, expert says

China's organ donation network has developed rapidly to form a model fit for the country's needs. However, there is still a severe shortage of organs, which means more people need to understand how such services work, said Hou Fengzhong, director of the China Organ Donation Administrative Center.

In March 2007, the State Council, China's Cabinet, passed the Regulations on Human Organ Transplantation to strengthen supervision of related practices and provide a legal basis for transplants. It also ordered Red Cross societies at all levels to participate in the promotion of organ donation. Hou said the Red Cross's role is the promotion of voluntary, free and dedicated guidance.

China approved voluntary posthumous organ donations in 2010, and stopped using organs from executed prisoners in January 2015. That means voluntary post-death donations and living donations between relatives are the only legal sources. The country currently ranks second in the world for the number of organs donated every year.

In March 2010, pilot programs for posthumous organ donations were launched in 10 provinces, and the center drew on the experiences of organizations overseas to establish the post of coordinator.

"At the time, there was the question of who should first speak to the potential donor's family members to ask if they were willing to donate the organs," Hou said.

In June 2010, about 100 people, mainly medical professionals and Red Cross volunteers, participated in the first training session for donation coordinators.

It covered almost every step of the process, including identifying and assessing potential donors, learning how brain death is determined, the removal of organs, their maintenance and allocation, and the legal, ethical and psychological issues involved. So far, about 3,700 people have received such training, according to the center.

About 6.2 million people have registered with the center as volunteer posthumous donors. However, registration is simply an expression of an individual's intention to donate, and the process can only be undertaken after strict medical assessment and with the consent of immediate family members. Therefore, voluntary registration does not necessarily mean that a donation can be realized, Hou said.

In addition to publicity about donation policies at all levels, the State provides much support.

For example, in 2016, a "green channel" was established by various bodies — including civil aviation, railway and highway authorities — to ensure the timely delivery of donated organs.

Hou said that as more people become aware of changes to organ donation policies, many are concerned about whether they have been donated according to the wishes of the donor's family, and whether they are distributed fairly and used reasonably. Coordinators play an important role in these areas.

Donated organs are allocated through the China Human Organ Allocation and Sharing Computer according to the patient's match type, age, region and illness, and in line with the principles of fairness, justice and openness, the center said.

The center always treats donors with respect, and many cities have allocated special sites for memorial parks to express appreciation, which rarely happens in other countries, Hou said.

He added that although China's organ donation service has developed rapidly, improvements are still needed in some aspects — such as laws and regulations, and personnel training — so more people will understand and recognize the selfless nature of donation.