Gap in supply and demand
Meanwhile, the huge demand for organ transplants cannot be ignored.
The supply-and-demand ratio of organ transplants in China is one transplant operation for every 30 patients on the waiting list; the ratios are 1:4 in the US and 1:3 in the UK.
In China, the overall rate of registration for organ donation across the population is 0.03 per 1 million people - 1,000 times lower than the highest country, Spain.
In addition to the 1.5 million patients currently waiting for organs, the number is rising at a rate of 100,000 more per year.
Chen Xiaosong, coordinator at the Renji Hospital at Shanghai Jiao Tong University's School of Medicine, said that about 1,000 patients are waiting for kidney transplants at his hospital, and the average waiting time is three years. And over 130 are waiting for liver transplantation every year.
"Compared to kidney transplant patients, those waiting for liver transplants are always of higher hazard level. Some are suffering advanced tumors or cirrhosis, and many are just kept waiting until death."
"The organ shortage has become the barrier for organ transplant development. Citizens' voluntarily donation will be the best solution," Lu Jian, an ICU doctor at Shanghai General Hospital who was certified as organ donation coordinator in 2013, said.
Looking for potential organ donors and informing upstream parties, as well as promoting organ donation to relatives, are all part of his job. But because of traditional ideas, this work is never easy. "At beginning, only one of nine cases can be achieved."
The dilemma
What is impeding organ donation?
A Harbin Medical University poll on organ donation showed that public support rate for organ donation was 69.61 percent, much higher than the actual donation rate.
"Traditional ideas are like an invisible hand, restricting people's actions," Zhang Peifang, the head nurse at the organ transplant center in Shanghai Changzheng Hospital said.
In traditional opinion, the autopsy goes against ritual; it's widely deemed as a cruel act that children should not allow it to happen to their parents.
Chen Xiaosong agreed. "In China, ideas like 'everything that people have is given by their parents' and 'burial brings peace to the deceased' have firmly lodged themselves in the public mind. The organ transplant law also requires the agreement of immediate family members (including parents, spouses and children) at the same time."
Zhang said she believes people are willing to donate their organs but fail because they don't know where to go and the procedures are too complex.
Meanwhile, the society's lack of understanding about death is another hurdle. Chen said that many family members mark death only when the heart stops, whereas donating before that could make a crucial difference.
"In most countries, inactivity in the brain or heart both meets the standard of death, and donations from brain deaths account for about 90 percent of total donations. However, once the heart stops beating, the organs will lose their supply of blood and oxygen, which makes the quality of organs difficult to ensure."
Chen Guoqing, a staff member of the Organ Donation Office at Shanghai General Hospital once handled such a case: a youth who had just graduated from university was in a car accident and diagnosed as brain dead.
At first, his family refused to donate his organs. Although they finally agreed after painful consideration, the deceased's heart had stopped when Chen arrived. In the end, Chen decided against harvesting the organ for donation.
"The organ is going to be transplanted to another patient, we have to take the responsibility of the recipient by ensuring the quality of the organ," he said.
