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SCMP Reporter

But doctors warn without a national law covering brain-dead patients the drastic shortage of donors will continue

Shanghai legislators want the city to follow Shenzhen's lead and crack down on the widespread illegal sale of organs for transplant.

But experts warn that without a national law enabling doctors to harvest organs from brain-dead patients, the proposed regulations will do little to address the massive shortage of  legal organs,  which drives the blackmarket.

Details of the proposal tabled on Tuesday to the Shanghai Municipal People's Congress have not been revealed.

Shenzhen's law, passed last August and the first of its kind on the mainland, says organ donation can take place if a donor gives written consent; if relatives offer a family member's organs at his or her death bed with the patient's consent; or if a donor gives verbal consent to two doctors on his or her death bed. It also spells out penalties for those who trade in organs and for doctors who perform illegal transplants.

However, it does not extend protection to prisoners on death row - whose organs are often harvested  without relatives' permission.

This week, staff at the Shanghai First People's Hospital, home to one of the city's best-known kidney transplant centres, could be seen scraping adverts off walls around the hospital which offered kidneys for sale .

One hospital official said: 'I can't remember clearly when the first ad appeared, but I can say that we don't permit kidney transactions to be carried out here.'

Adverts offering  organs for sale can also be found on the bulletin boards of mainland-based web portals, including sohu.com. They give the would-be donor's blood type, a mobile phone number or e-mail address and the  price.  The cheapest kidney for sale yesterday was 50,000 yuan; others were priced in the hundreds of thousands of yuan.

A 26-year-old, using the alias 'miserable man', is among those to have posted an online ad for his organs recently. 'I had the idea several months ago when I was in a difficult situation,' he said by phone. 'But I've given up the idea now.'

Chen Zhonghua, director of the organ donation research institute at Wuhan's Tongji Hospital, is on a panel of experts advising the central government in drafting a national law on organ donation. The law is expected to set out penalties for those involved in the illegal sale, purchase or use of live organs but, according to Professor Chen, it will not address the issue of free live donation.

'I don't expect too much from the new law,' he said.  'Live organ donation will still only be permitted between family members. It's definitely not a breakthrough.'

The national law will not prohibit the harvesting of organs from executed prisoners without relatives' permission - still the main source of organs on the mainland - despite complaints from the international community.

'Taking these organs without permission is a stain on the history of medical practice in China,' Professor Chen said. He also holds out little hope that the national legislation, expected in the next five years, will define brain death.

Official figures show while 5,000 kidney transplants are carried out each year, 500,000 people are still waiting for donor kidneys, largely because of cultural resistance to removing organs after death.

Fewer than 20 per cent of people surveyed by Beijing's Tongren Hospital last year were prepared to donate their corneas after death. The mainland's 30 centres for corneal transplants have no corneas. About a million patients are in immediate need of bone marrow transplants, but in a nation of 1.3 billion, only 60,000 people have registered as  donors.

'Of course the rules on live organ donations should be tightened to prevent desperate people from doing desperate things,' Professor Chen said. 'But without legislation allowing doctors to harvest organs from brain dead patients with their prior permission or that of family members, there is no way to significantly increase the number of live organs legally available for transplant.'



Shanghai seeks to curb illegal organ trade