A year ago the relatives of a Hong Kong robbery-murder victim made headlines by donating his liver and kidneys for transplants, giving the gift of life to three people. The recipients were among the lucky ones on long waiting lists. About 30 patients die in this city each year while waiting for a liver transplant.
The donor became an icon for the crusade to increase organ donations, but the campaign still faces an uphill battle. While a shortage of organs for transplant remains a problem internationally, in Hong Kong it is exacerbated by cultural sensibilities about removing organs after death.
Leading surgeons in the University of Hong Kong liver transplant team have called for laws to improve the supply of donor organs. Their proposal is aimed at reducing missed opportunities for organ donation. They want the government to require doctors to promptly report brain death in potential donor patients dependent on life support so that action can be taken to maintain their organs in good condition while relatives are consulted about donation. They say that does not always happen now. As a result, they cannot use the organs for transplant and the chance to save more lives is lost.
Their proposal may be a more efficient way of matching donors with patients awaiting transplants. But safeguards would have to be put in place to ensure that it can have no influence on the medical treatment of the potential donor. Supporters must also win over doctors who may feel that their professional duty ends with the treatment of their patients. The Hong Kong liver-transplant surgeons rightly do not support the 'opt out' system followed in Singapore, where people have to state their objection to organ donation rather than 'opt in' by registering as a potential donor, as in Hong Kong. It can too easily give rise to conflict with distressed relatives and doctors would not go against their wishes.
About 40,000 potential donors are identified on a Hong Kong Medical Association registry - not that many in a city of 7 million. The Health Department's plan to convert it into a centralised registry that potential donors can join on the internet is to be welcomed.