Objective We investigated the effectiveness of legislation in developed countries by analyzing
their legislation, and produced ideas and strategies for organ transplantation and brain death legislation in China.
Methods Official websites were searched as follows: UNOS, TCE, CLTR, ANZDATA, and SRTR through December
6, 2008. We included statistical reports and data analysis of organ donations and transplants, and excluded literature
about non-solid organs. The absolute transplantation numbers were standardized to per one million people.
Results 1.The following data was retrieved: The number of eight kinds of organ transplants and organ donations in Britain, the United States, New Zealand, Spain, France, Italy, Germany, and Australia from 2003 to 2005; the number of deceased donors in the United States and Spain from 1988 to 2007; the total number of organ transplants in Australia from 2002 to 2006; the amount of organ transplants in the United States from 1993 to 2006; liver and kidney transplant totals in the United States from 1988 through March, 2008; liver transplants number of China from 1993 through March, 2008; and the number of kidney transplants in some provinces and cities in China. 2. Transplant totals were greatest in the United States; in Spain, after ONT was founded in 1990, the rate of donation from the deceased was the most in the
world. 3. Spain had the best rate of donation with 34.5 pmp, 10.9 pmp higher than in the United States with separate legislation from 2003 to 2005. There was a rate difference of 0.98 pmp between Germany and the United Kingdom
which implemented separated legislation nine years earlier. 4. Southern Australia had a maximum rate of average kidney
transplant in the country from 2002 to 2006. 5. Live donor kidney transplants accounted for 31.2~44% compared to4.3% and 4.1% for liver transplants in 2006 and 2007 respectively in the United States. 6. The following have been applied
globally to regulate organ transplantation and brain death: 1) International or multilateral treaties; 2) Regulation of
NGOs; 3) Self-discipline in the field of organ transplantation; 4) Expert consensus; 5) Establishment of patient’s alliance.
Conclusion Countries that have implemented organ transplantation and brain death laws have developed successful
measures to improve and support insurance and follow-up information for donors and recipients, however, legislation is
still urgently needed in China. As long as brain death and organ transplant laws are reasonably developed and legislators
resolve to deal with the difficult issues, then the legislation and its subsequent enforcement will reflect the interests of the people and improve health quality for all.
Citation:
SONG Ruliang,CHENG Lan,CHEN Qunfei,LI Ling,YUAN Qiang,WANG Li,Deng Shaolin,LI Youping. Organ Transplantation and Brain Death Legislation in China: Strategies and Thoughts. Chinese Journal of Evidence-Based Medicine, 2009, 09(4): 400-407. doi: 10.7507/1672-2531.20090076
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Copyright © the editorial department of Chinese Journal of Evidence-Based Medicine of West China Medical Publisher. All rights reserved
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- 2. UNOS. OPTN/UNOS 2008 Annual Report. Available from: URL: http://www.optn.org/data/annualReport.asp.
- 3. Miranda B, Fernández Lucas M, de Felipe C, et al. Organ donation in Spain. Nephrol Dial Transplant, 1999, 14(Suppl 3): 15-21.
- 4. ANZDATA. The 30th Annual Report 2007 Report-Data to 2006.Availablefrom: URL:http://www.anzdata.org.au/v1/report_2007.html.
- 5. SRTR. OPTN/SRTR 2003 Annual Report. Available from: URL:http://www.ustransplant.org/annual_Reports/default.aspx.
- 6. SRTR. OPTN/SRTR 2007 Annual Report. Available from: URL:http://www.optn.org/latestData/rptData.asp.
- 7. CLTR. CLTR 2007 Scientific Annual Report. 中国肝移植注册. Available from: URL: https://www.cltr.org/view.jsp?id=64.
- 8. 周彬. 加强行业管理, 规范人体器官移植技术. 继续教育学, 2007, 21(11): 40-42.
- 9. 熊玮, 江华. 脑死亡的概念和历史发展. 三思科学电子杂志, 2002, 9(15): Available from: URL: http://www.oursci.org/magazine/200209/020926.htm.
- 10. 杨熙华. 器官捐献的“西班牙模式”. 上海市器官移植临床医学中心. 2005-09-25. Available from: URL:http://www.shotmc.net/tpms_simple/educationview.asp?key=28.
- 11. 杜瑞芳. 人体器官移植立法问题探讨. 科技与法律, 2003, 3: 74-80.
- 12. Unknown. Human Organ Transplants Act 1989. Available from:URL: www.opsi.gov.uk/acts/acts1989/pdf/ukpga_19890031_en.pdf.
- 13. 卫生部. 卫生部关于印发肝脏、肾脏、心脏、肺脏移植技术管理规范的通知. 2006-06-27.
- 14. 卫生部. 卫生部关于印发《人体器官移植技术临床应用管理暂行规定》的通知. 2006-03-16.
- 15. 申卫星, 王琦. 论人体器官捐献与移植的立法原则. 比较法研究, 2005, (4): 34-47.
- 16. Unknow. Guiding principles on human organ transplantation.World Health Organization. Lancet, 1991, 337(8755): 1470-1471.
- 17. The Ethics Committee of the Transplantation Society. The Consensus Statement of the Amsterdam Forum on the Care of the Live Kidney Donor. Transplantation, 2004, 78(4): 491-492.
- 18. 宋儒亮, 袁强, 李玲, 等. 中国“器官移植与脑死亡立法”的现状与挑战. 中国循证医学杂志, 2009, 9(2): 187-194.
- 19. 宋儒亮, 刘分玲, 李立, 等. “脑死亡与器官移植立法”课堂调查问卷分析. 中国循证医学杂志, 2009, 接受.
- 20. 江希娟. 脑死亡立法的社会学意义、阻力和推动程序. 见: 陈忠华, 主编. 现代死亡学. 北京: 科学出版社, 2004. 167.