Transplant Tales: to China and back

Tuesday, April 25, 2006



42 A.T.

We had another appointment at UCSF today. The doctor says everything looks fine. They tapered down a bit of the meds. That's a good thing.

I was out browsing the internet tonight, and came across a readers' poll that the San Francisco Chronicle had posted. I thought it was interesting to see the results.

Does anyone agree or disagree with what we did? If you were sitting there with liver cancer, no sign of spread. The Dr.'s told you Chemo was you only option. What would you do?

22 Comments:

Anonymous Puja said...

Hey Lori,

What would I do? Given the position you and Eric were in, I would have done the same thing.

I also agree with you that the UNO transplant standards and practices must be revised. It is a damn shame that so many die because of the lack of donors.

Don't worry about the nay-sayers. People are quick to point fingers about morals when they aren't in the life or death situation Eric was in.

You did the right thing. There was only one option, and you didn't chose to be in that position.

4/26/2006 9:56 AM  
Blogger blaine said...

Hello Lori,

I also agree wholeheartedly with puja. My situation has some similarities and some differences with Eric's but I would have done the same!

4/26/2006 10:51 AM  
Blogger TransplanTraveler said...

Blaine,
You had asked a couple questions previously. I will try to answer them now.

My husband's meld score was 25 just before they removed him the list. So when we went to China when he was no longer on a list. My husband the entire time since diagnosis did not show any signs of being ill.

Second, we did some brief research on India as well as Philipines. Talking about selling body parts. These are two countries really did not look or give us a good feel. One company Liver4you.org, gave a do it or die approach. They wanted $60K before they even got you in the Philipines. Yeson.com were not pushy at all. They never hounded us like the other and no money exchanges hands until you are there and your medical records and pretest are done and checked out. Their contract was very reasonable. I you want more detail please leave us your email and we will contact you..hope this answers some of your questions.

www.yeson.com is the website we went through.

4/27/2006 12:15 AM  
Anonymous h westra said...

I find your action morally reprehensible. You are encouraging the Chinese government to prfit from the execution of condemned prisoners. Many of these are imprisoned for religious reasons whether Christians or Fulan Gulang

4/27/2006 7:28 AM  
Anonymous Anonymous said...

As a doctor in the UK, I don't blame you the patient, desperate people do desperate things. But this practice is repugnant, and China needs to be taken to task over this +++ It is no different to the experimentation of the Nazi doctors at Auschwitz (apart from being considerably more lucrative for the Chinese than it was for the Nazis), who firmly believed that experimenting on/killing inmates without consent was OK as it was providing medical information that was useful for the greater good of the wider society. Bear in mind that some of the 'excuses' for the death penalty in China include tax evasion amongst other offences...failing to put in a tax return is hardly a reason to remove ones vital organs! Good TV interview on this subject http://www.sky.com/skynews/article/0,,30000-13519519,00.html

Whether anyone will have the balls to take China to task over this is quite another matter, there is too much money involved when one is talking about the fastest growing economy, when this, in China, is merely seen as another way to make more cash.

Regards

David

4/27/2006 12:38 PM  
Anonymous Todd Smitherum said...

I read with much anger and complete confusion Debra J. Saunders opinion / article this past week in the "Wrongicle". I was completely shocked at how callous someone (especially someone who wasn't diagnosed with a life threating disease) could be.
While I had the luxury of knowing more about your situation than the average reader, I was shocked to find I apparently knew much more than someone who supposedly interviewed you.
Ms. Saunders is a complete hack, but that particular article wound up showcasing her complete ignorance. Maybe if the tables were turned and she was the one without "hope", she might consider alternatives like you did. I doubt anyone who faced your situation would just say, "Oh...I should find a treatment that pleases everyone, especially small minded Republican Stallwarts like Ms. Saunders."
I found it incredulous that she never happened to mention one of the main reasons that people have to go outside this country to find services and treatments like you did. Because we would rather bitch about our health care system and allow our "elected" politicians to finger point, rather than bite the bullet and overhaul a completely failed system.

I applaud your courage and convictions and am so happy that you will be able to be a participant in your children's lives.
Ms. Saunders has a cushy job with probably fantastic benefits and a well paid salary. How dare she comment on the affluency of others and their morals. She should take some of her earnings and buy a mirror, but I suspect she wouldn't like what she saw.
I hope this blog does not offend you, Sir. I have only the highest regard for someone who puts their family above all else. While I do not know you, I can only say you are a remarkabley courageous person for taking such a chance.

May all of the luck in the world flow your way!

Sincerely,
Todd Smitherum
(BTW: My Wife is Stefanie from WFB)

4/27/2006 5:05 PM  
Anonymous Puja said...

H westra and the annoymous dr from the UK seem to be stuck on this idea that the prisoners do not give consent. From everything we know, they do give consent. I encourage the practices to be examined more closely, but before go and make comparisons to Nazis and concentration camps, lets KNOW, not just throw around accusations.

4/28/2006 1:47 PM  
Anonymous Anonymous said...

You want evidence??

I (anonymous UK doctor) agree it needs investigation...here is a copy of the letter (with references) to my MP, I suggest others in the US write to their member of Congress on this.

Use of organs from prisoners in China for international transplant trade

I write regarding the recent revelation that the Chinese authorities are using the organs of prisoners on death row and from concentration camps to fuel both the international transplant trade and also the cosmetics industry. I fully appreciate that the previous statement is so abhorrent that it needs corroboration. However there is increasing evidence that this is exactly what is taking place:


1. A number of Chinese hospitals are offering organs to Western patients in under a week (suggesting that donors are being selected to order)1 Dr. Pang Yubin, a former researcher at the U.S. National Institutes of Health, explained why it must be that the prisoner who matches the patient would be executed to supply the patient requiring an organ. "I call it 'opposite matching.' Why is that? A patient will present with a certain need and in a few days a matching organ is found. As I said earlier, the chance of a match is around one percent. That is, only if there are one hundred live donors there waiting, could this match be possible so quickly”
2. China has the second biggest transplant programme in the World (after the USA) with between 80-99% of organs being provided from executed prisoners according to Chinese doctors2,3
3. China has steadfastly refused to publish accurate figures for the numbers of prisoners executed every year (in contravention of a number of international declarations on the use of the death penalty. Amnesty International, for 2005, estimated at least 1770 executions took place in China- more than the rest of the World combined, although most authorities believe the true figure to be much higher4. Based on these figures, this represents a multi-million dollar business just for the kidneys5. However, it would appear that all body organs are used, hearts, livers, corneas. It has been even alleged that the skin from executed prisoners is being used to supply the cosmetics industry1.
4. These practices have been robustly opposed as a breach of medical ethics and human rights by the British Transplantation Society6.
5. Several eye-witnesses have reported concentration camps in China where organs are being removed from prisoners alive for transplants without their consent7 Further it has been suggested that prisoners have been moved from camps prior to any independent investigation.
6. Sky news have confirmed with secret filming that organs are readily available from executed prisoners8.

The Chinese government of course denies these allegations, however the weight of these allegations, the number of independent witness statements demand that an immediate investigation is instituted into these barbaric practices by the international community. I await your reply.


Regards

David












1. UK transplant patients go to China for organs from executed prisoners The Guardian April 20, 2006
2. South China Morning Post 1/4/06

“a survey of medical centres revealed Mainland surgeons transplanted 3,741 livers, 8,103 kidneys and 80 hearts last year, according to industry sources, said but a lack of records on follow-up care made survival rates – believed to be 3-5 years - difficult to calculate.
China’s use of organs from executed prisoners will continue to hold back its transplant industry as long as authorities fail to enact laws regulating how and when the body parts can be used, according to but a leading mainland transplant surgeon says fewer than 20 people have voluntarily donated organs on the mainland since 2000.
Professor Chen Zhonghua from Wuhan’s Tongji Hospital estimates that more than 99 per cent organ transplants in China come from executed prisoners.
But sources say the mainland will have to consider other donor sources as the number of executions declines and demand for transplants increases.
China is second only to the United States in the number of transplants it performs and the number of surgeries is on the rise.
“It’s impossible for anybody or organisation to get accurate statistics in the absence of a registration system to monitor organ sources, surgery processes and recipients on the mainland,” one source said.
“But you have to include the possibility that some commercial centres have omitted mentioning surgery on foreign patients due to the sensitive source of organs and other hospitals may have exaggerated the number of surgeries they have performed as a way of inflating their reputation.”
Professor Chen said the number of liver transplants performed in China doubled in the past two years, while the number of kidney transplants jumped from 5,000 to more than 8,000.
And without a brain death definition rule and organ donation and transplant laws, fewer than 20 voluntary donors had contributed transplants in China since 2000.
Professor Chen said each top-level hospital in every major city had an organ transplant centre, and each year, at least 1,000 transplant surgeons took part in the annual meeting of the Chinese Society of Transplantation.
He said a lack of regulation meant that prices for surgery varied from tens of thousands of yuan to hundreds of thousands of yuan.
Professor Chen said the main cost involved was in organ procurement, particularly the expense of going through court and police channels.
“Many hospitals have PR staff and their targets are the local courts because without judicial approval and assistance, hospitals cannot approach prisoners or get blood tests,” he said.
Driven by the huge profits, a number of large commercial transplant centres have emerged in recent years and have advertised their services overseas.
Due to the relative ease of getting organs in Chinese hospitals, more and more foreign patients who would otherwise have to wait for years to get a replacement organ are coming to China for operations, a practice that has attracted harsh criticism from the Word Health Organisation.
Authorities were silent on the issue until November when Vice Health Minister Huang Jiefu told a WHO meeting in Manila that China would regulate organ procurement from executed prisoners.
An industry source said a commercial transplant hospital in northern China paid 20 million yuan to reserve the procurement of organs from all the executed prisoners in the area.
“But you cannot confirm this rumour, because nobody in the industry will break the rule of silence, even though everybody knows the procurement of organs from executed prisoners is almost the only way to get organs in China,” the source said.
Before the Ministry of Health issued a rule this week to ban on any kind of organ sales and raise the entry threshold for institutes wishing to carry out the procedures, there was only a temporary rule issued by the Ministry of Public Security, the Supreme Court and several other state departments in October, 1984.
That rule stipulated that the organs of executed prisoners could be procured for medical use on the condition the donations were voluntary or they came from the bodies of unclaimed prisoners.
But with the high demand for organs and lax administration, hospitals have tried to increase the number of organ donors by appealing to court and police officials.
“Once a court agrees, the doctors can go to the execution field, wait in a sterile van, and harvest the organ right after the execution,” a transplant surgeon said.
“Such experiences are a severe moral and mental shock to many surgeons, because the prisoners do not usually die immediately after they are shot. But surgeons have to take quick action to get the organs due to freshness requirements.
“To some extent, the doctors are part of the execution. That is too much for many young doctors to accept … but that is the fact, and if you want to do the transplants you have to admit to reality.”
Professor Chen said: “Transplant surgeons are not to be blamed. It’s the malfeasance of the government. Because as the doctors would say, ‘if the police and government don’t regulate, why should we worry? And After all, we are rescuing patients’.”
Despite the failures of the existing situation, Professor Chen was optimistic about the future of organ transplants on the mainland, with more open discussion of legislation and greater social awareness of the issue.
“China has to change the current model, to encourage voluntary donation and accelerate the legislation in the field,” he said. "

3. British Medical Journal 8/4/2006.

Chinese rules on transplantation do not go far enough, expert says
Hong Kong
Jane Parry

New guidelines covering organ transplantations in China fail to address basic issues such as brain death and the source of organs, one of the country’s leading transplantation surgeons has said.

Chen Zhonghua, director of the Institute of Organ Transplantation at Tongji Medical College, Wuhan, who helped to draw up the rules, said last week that China’s lack of a legal definition of brain death was a major obstacle to promoting an organ supply that was in line with international ethical standards. The guidelines are due to come into effect in July.

"There are not even any guidelines on the medical criteria for brain death. China is 30 to 40 years behind Western countries in using the brain death method of determining the source for donation," he said.

"People in China are more accepting of the concept of organs donated from executed prisoners, [which is] seen as a way for them to repay their debt to society," said Professor Chen. The new rules ban the sale and purchase of organs but fail to address many other matters.

In 2003 the transplantation centre at Tongji Medical College conducted the country’s first organ transplantation from a donor who had been declared brain dead according to the criteria commonly used in the West. And to date the centre has performed more than 30 transplantations using organs from 10 brain dead donors, as well as more than 100 renal transplantations from living donors. However, these operations still account for less than 20% of the total done at the centre.

Executed prisoners are the source of most of the transplants in China, which conducts the second largest number of organ transplantations in the world after the United States.

An estimated 8000 kidneys and 3700 liver and 80 hearts were transplanted in China in 2005, and these included transplants for patients from overseas, in a growing market for "transplant tourism."

In time the use of organs from executed prisoners will decline, said Professor Chen, not least because of the recent reduction in the number of crimes for which the death sentence can be handed out.

In addition, overseas trained surgeons such as Professor Chen—who trained at Cambridge University with the transplant surgeon Roy Calne for 10 years before returning to China in 2000—are bringing international standards of ethics to the country.

But clear regulation by the government was needed to ensure that the "dark side" of organ transplantation was eradicated, Professor Chen said.

"This [the new regulations] is really a solid if small step that we have been awaiting for a long time. However, any regulation on organ transplantation has to start with the source, what type of sources can be used, how they can be used, and the criteria for determining who is at the top of the waiting list. These new rules are starting at the end of the [transplantation] process, not the beginning."


4. BBC http://news.bbc.co.uk/1/hi/world/4926224.stm '20,000' on death row worldwide
5. Friedman EA & Friedman AL. Payment for donor kidneys:pros and cons. Kidney International (2006) 69, 960–962.
6. BBC http://news.bbc.co.uk/1/hi/world/asia-pacific/4921116.stm China ‘selling prisoners organs’

7. Epoch Times http://www.theepochtimes.com/211,111,,1.html Organ harvesting in China’s Labour camps

8. Sky News http://www.sky.com/skynews/article/0,,30000-13519519,00.html April 19th, 2006.

4/29/2006 7:20 AM  
Anonymous Andy said...

More power to you! My wife is a pancreas-kidney receipient (2 seportate transplants and donors). We had a living kidney donor and were only on the panc list for 3 days (no antegons). We would totally have done that had it come to it. Organ donation should be an opt-out system not an opt-in system. IMO

Check out our transplant blog @ Kaley.SnarkyAvenger.com.

BTW... have you heard of Life Sharers? Check it out!

4/29/2006 10:38 AM  
Anonymous Anonymous said...

If you thought the US medical system treated you UNFAIRLY because you couldn't get a transplant in the US, had you given ANY MOMENT to think about how even MORE UNFAIR your action were to hundreds of thousands (perhaps many millions) of even more desperate patients in China!?

In essence, you utilized your economic/financial superiority to murder a human being in order to save your own life. You have just displayed another example of Westerner's exploitation of the developing countries! How SAD and UNFAIR that such IMMORAL "trade" is still going on after the end of colonization!! Do you believe in GOD??

Further, you are taking advantage of your celebrity status to write book and stuff to profit even MORE!? Besides helping to pay back your loan (PLUS MUCH MORE), your writings will surely "teach" more Westerners how to more quickly kill the less-fortunate!! HOW INSANE!! MAY GOD XXXX YOU!!

4/29/2006 3:59 PM  
Anonymous Anonymous said...

Hi Eric and Lori-
I am a producer at CNN's Anderson Cooper 360 and while I know you have talked to CNN international we would be very interested in talking to you about your story for a piece in a series about organ dontaions that we are working on for our program. I would very much like to speak with you about your experiences. Could you please get in touch with me at 212 275-8144.
Thank you-
Audrey Gruber

5/02/2006 8:31 AM  
Anonymous Anonymous said...

http://www.viceland.com/issues/v13n2/htdocs/black.php

Interesting little read, although not *specifically* about China, it documents the westerner *demand* and the international black market *supply*

5/02/2006 8:47 PM  
Anonymous Anonymous said...

I'm not surprised by the poll. Americnans are greedy byatches!

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