Hangzou Resolution

HANGZOU RESOLUTION

From left to right: Zhou Jun, Deputy Director-General, Department of Medical Administration, NHFPC; Wang Haibo Director, China Organ Transplant Response System Research Center (COTRS); Huang Jiefu, Head, National Organ Transplantation Committee of the NHFPC; Francis L. Delmonico, President, The Transplantation Society, Representative of the DICG, Bin Li, Minister, NHFPC; Ren Minghui, Director-General, Department of International Cooperation, NHFPC; Liu Yong Division Director, Department of Medical Administration, NHFPC

Report of Meeting with Minister Bin Li of the National Health and Family Planning Commission of the People's Republic of China

This meeting at the Ministry was arranged with much appreciation by Huang Jiefu.

Minister Bin Li initiated the discussion with a prepared statement of a five-point plan for organ donation and transplantation under the authority of the National Health and Family Planning Commission of the People’s Republic of China (NHFPC).

FIVE-POINT PLAN FOR ORGAN DONATION AND TRANSPLANTATION

  1. Human Organ Donation System:
    The practice of human organ transplantation will be “open and transparent” by an executive order released from the NHFPC in August 2013 that requires:
    • transparency in the allocation of organs to a computerized waitlist (COTRS);
    • the development of the organ procurement organization structure in each province;
    • the training of organ donation coordinators.

    This regulation of the NHFPC is aligned to the State Council directive that mandates transparency and fairness in the practice of organ transplantation in China.

  2. Human Organ Procurement and Allocation System:
    The implementation of an information technology system (COTRS) that accomplishes a transparent and fair practice of the distribution of deceased donor organs;

  3. Human Organ Transplant Clinical Service System:
    The authorization of 169 transplant centers in China;

  4. Scientific Registry System for Human Organ Transplantation:
    A registry system that will record each case of organ transplantation in China with appropriate follow-up of the recipient;

  5. Human Organ Transplant Regulatory System:
    A regulatory authority of NHFPC that oversees the practice of organ donation and transplantation in China, referenced to 30 existing laws and regulations developed by PRC State Council and NHFPC (since 2007).

Thus far in 2013, there has been 1161 deceased organ donors (not involving the use of organs from executed prisoners) resulting in more than 2700 organ transplants — and combined with the experience of living donor transplantation, these deceased and living donor transplants now constitute 49.7% of organ transplantation in China.

Minister Bin Li expressed the resolve of the PRC Government — that the reliance of transplant centers upon organs from executed prisoners — must cease. The government of China has affirmed its commitment to prohibit transplant tourism and shutdown organ trafficking and transplant commercialism.

The five-point plan as elaborated above is to be promulgated in the upcoming conference Hangzhou (November 1-3) — releasing a Hangzhou Resolution of the commitment of NHFPC to align practices of organ donation and transplantation in China with WHO Guiding Principles and those of the Declaration of Istanbul — adopted by the World Health Assembly.

From left to right: Xiaoshun He, Vice President, The First Affiliated Hospital of Sun Yat-sen University; Shusen Zheng, President, Chinese Society of Transplantation; and Yongfeng Liu, President-elect Chinese Society of Transplantation committing their centers to fulfill the NHFPC program of Minister Bin Li.

China needs the support of the international community to implement this new system and the international community needs the involvement of China in progress of organ transplantation as a field of medicine. The Minister was concerned to learn that the experience of Chinese transplant professionals had not been either sought or accepted because of the reliance upon the use of organs from executed prisoners. However, as of this seminal interaction, she pledged her commitment to resolve that exclusion and to promote and academic exchange with international community based upon the five-point NHFPC plan elaborated, to include the cessation of the use of organs from executed prisoners and an end to the practices of organ trafficking.

A proposal was made to the Minister that NHFPC convene a meeting of the international community in China in June 2014 that would also involve the participation of the leadership of the World Health Organization The Minister accepted this proposal and plans are now underway to develop such a Congress.

The support of the NHFPC for the Hangzhou Resolution was affirmed at the meeting with Minister Bin Li (and for the leadership of Dr. Huang Jiefu and for the transparent system — COTRS that developed by Haibo Wang).

From left to right: Yongfeng Liu, President-elect Chinese Society of Transplantation; Shusen Zheng, President, Chinese Society of Transplantation; Francis L. Delmonico, Philip J. O’Connell, Haibo Wang, John Fung and Michael Millis.

On November 1, 2013, the Human Organ Transplant Committee of the National Health and Family Planning Committee (NHFPC) held the 12th OTC meeting in Hangzhou, Zhegiang, China to promulgate the Hangzhou Resolution before the 2013 China National Transplantation Congress and organized by the Chinese Organ Transplant Association. The meeting in Hangzhou featured a keynote address by OTC Head Jiefu Huang who proclaimed a "New Era for Organ Transplantation in China”.

The Resolution requires all transplant professionals to comply with the five-point plan of the NHFPC as elaborated by Minister Bin Li in accordance with State Council law. The Hangzhou Resolution aligns the practice of transplantation with China culture and to WHO Guiding Principles (and those of the Declaration of Istanbul).

Henceforth organs must be recovered from deceased donors following the national protocol for the three China categories of deceased organ donation:

  • China Category I: organ donation at the brain death
  • China Category II: organ donation after circulatory death
  • China Category III: organ donation after brain death followed by the determination of death by circulatory criteria.

The Hangzhou Resolution concludes the reliance of transplant centers to use organs from executed prisoners. The leaders of more than 30 transplant centers came forward to immediately commit their centers to no longer use organs from executed prisoners. The names of these centers and these transplant leaders will be presented to the international community to enable the publication of data from their centers in the medical literature and their presentations at international scientific congresses.

Philip J. O'Connell, John J. Fung, Francis L. Delmonico, Haibo Wang and J. Michael Millis

The support of the NHFPC of the Hangzhou Resolution is now affirmed (and for the leadership of Dr. Huang Jiefu and for the transparent system — COTRS that developed by Haibo Wang).

With the release of the Hangzhou Resolution and the engagement of those centers committed to no longer use organs from executed prisoners, the Declaration of Istanbul Custodian Group will work with Foundation support from within China to accomplish the widespread implementation of the NHFPC five-point plan throughout all the provinces of China involved with organ transplantation.

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