Organ transplantation in China has taken place since the 1960s, and by the early 2000s had become one of the world’s largest transplant programmes, with official figures reporting over 13,000 liver and kidney transplants in 2004. However, independent academic analyses have raised questions about the accuracy of these official figures and highlighted gaps in the transparency of China’s transplant data. Official registries are not fully accessible to outside researchers, making independent verification of transplant numbers and the sources of organs difficult. Involuntary organ harvesting was once legal on criminals, but outlawed in 2015. Growing concerns about possible ethical abuses arising from coerced consent and corruption led medical groups and human rights organizations, by the 1990s, to condemn the practice. These concerns resurfaced in 2001, when a Chinese asylum-seeking doctor testified that he had taken part in organ extraction operations. In 2006, allegations emerged that many Falun Gong practitioners had been killed to supply China's organ transplant industry. An initial investigation stated "the source of 41,500 transplants for the six year period 2000 to 2005 is unexplained" and concluded that "there has been and continues today to be large scale organ seizures from unwilling Falun Gong practitioners". In December 2005, China's Deputy Health Minister acknowledged that the practice of removing organs from executed prisoners for transplants was widespread. In 2007, China issued regulations banning the commercial trading of organs, and the Chinese Medical Association agreed that the organs of prisoners should not be used for transplantation, except for members of the immediate family of the deceased. In 2008, a liver-transplant registry system was established in Shanghai, along with a nationwide proposal to incorporate information on individual driving permits for those wishing to donate their organs. Despite these initiatives, China Daily reported in August 2009 that approximately 65% of transplanted organs still came from death row prisoners. The condemned prisoners have been described as "not a proper source for organ transplants" by Vice-Health Minister Huang Jiefu, and in March 2010, he announced the trial of China's first organ donation program starting after death, jointly run by the Red Cross Society and the Ministry of Health, in 10 pilot regions. In 2013, Huang Jiefu altered his position on utilizing prisoners' organs, stating that death row prisoners should be allowed to donate organs and should be integrated into the new computer-based organ allocation system. In 2014, China announced that it would stop using organs from executed prisoners for transplants starting January 1, 2015. However, critics described this as an "administrative trick," noting that prisoners including those on death row are reclassified as citizens, allowing their organs to continue being used in transplants. In 2018 and 2019, media investigations and academic analysis into these allegations increased. In August 2024, media outlets reported on the first known survivor of China’s forced organ harvesting.
Background Globally, pioneering experimental studies in the surgical technique of human organ transplantation were made in the early 1900s by the French surgeon Alexis Carrel, and successful transplants starting spreading worldwide after the Second World War. China itself began organ transplantation in the 1960s, which grew to an annual peak of over 13,000 transplants in 2004; and, despite some deaths from infection and hepatitis, the transplant programme has been successful in saving many lives. Though the number of transplants fell to under 11,000 annually by 2005, China still has one of the largest transplant programmes in the world. China explores innovative surgery, such as the world's first flesh and bone face transplant, performed by Professor Guo Shuzhong. Organ donation, however, has met resistance, and involuntary organ donation is illegal under Chinese law, as it is against Chinese tradition and culture, which attach symbolic life affirming importance to the kidney and heart. China is not alone in encountering donation difficulties; demand outstrips supply in most countries. The world-wide shortage has encouraged some countries—such as India—to trade in human organs. Reports of organs being removed from executed prisoners in China for sale internationally had been circulating since the mid-1980s, when a 1984 regulation made it legal to harvest organs from convicted criminals with the consent of the family or if the body goes unclaimed. Development of an immunosuppressant drug, cyclosporine A, made transplants a more viable option for patients.
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