The Case
In September 2003, a 35-year-old male hemodialysis patient went to China for a kidney transplant. He had already completed tissue matching and other preoperative evaluations in Taiwan, and was informed that there was a HLA 3 matching kidney available. He was on his way to the First People’s Hospital affiliated with the Shanghai Jiaotong University in China. However, upon a final cross-matching test, it was discovered that the reaction was positive and the kidney was unsuitable. In order to avoid hyperacute rejection (an event that occurs minutes after transplantation and can result in organ failure within hours), he was asked to wait for a new organ. In the next two weeks, three matching kidneys were found and brought to hospital accompanied with a tube for cross-matching test, but they all tested positive. The three kidneys were discarded. At that time, the patient had to return to Taiwan as he only had three weeks sick leave from work.The Broker Who Introduced the Patient to a Hospital in Guangdong Province for Kidney Transplant
Between 2000 and 2006, the Chinese organ market witnessed an excess supply over demand. It rarely took more than a week to find a match. The doctor in that hospital is solely responsible for performing transplant surgeries. The transplant surgeon only needs to “place the order” and someone delivers the requested organ, or a hospital worker takes an ice bucket to get the organ. Before 2006, a doctor only needed to pay a “higher authority” 600 US dollars (not including bribe money) to obtain an organ. The broker for these transplant procedures was made to believe that this higher authority was the court. A broker told the following story: One time, a hospital worker transported eight kidneys by air. Because of a snowstorm and subsequent flight delays, he arrived late at the hospital. Upon examination, the doctors determined that the kidneys were not qualified for transplantation. They ordered the replacements and informed the eight patients that they had to hold off for a few more days for a new batch of kidneys. The broker knew that HLA 3 matching is a minimal requirement. He had seen detailed information about the donors in a doctor’s computer. He thought that China has a repository supply of organs from executed prisoners, and that the time of execution was in line with the need of organ transplantations. All brokers know that only military doctors have access to the organs. Patients would go to military hospitals or the transplant departments in domestic hospitals run by military doctors to receive transplantation surgeries. Although many foreigners come for organ transplantations, transplant recipients are mainly Chinese. The cost for a kidney transplant is only about 8,000 U.S. dollars. In addition to low cost for high-quality organs, the hospital, as we confirmed, boasts short waiting periods, with transplantations having a high success rate. China is a country that lacks comprehensive medical insurance. When organ transplantation is cheaper than dialysis, Chinese prefer organ transplantation over dialysis due to the lower cost. With regard to livers: In China, liver transplantations are in high demand due to a high incidence of hepatitis B.Hospitals in Mainland China
The Shenyang City International Transplant Network Support Center(1) was set up in the First Affiliated Hospital of the China Medical University in 2003 as an organ transplant website to attract foreigners. The hospital’s website reports that the Chinese government has made it possible to perform a large number of transplantation surgeries. The law jointly declared by the Chinese Communist Party’s (CCP) Supreme People’s Court of the People’sRepublic of China, Supreme People’s Procuratorate, Ministry of Public Security, Ministry of Justice, Ministry of Health and the Public Ministry,(2) states that organ supply is supported by the Chinese government. This is unheard of in any other countries. The question and answer section of the website promises that the quality of the organs is guaranteed by the use of “living organs,” rather than organs procured from brain-dead patients or from patients whose hearts have already stopped beating:“Question: Are pancreas transplant organs from brain- dead patients?
Answer: Our organs do not come from brain-dead patients, because the condition of these organs may not be good.
Question: Even if the transplant is successful, the postoperative survival time is no more than two to three years, right?
Answer: This type of question has been asked a lot. The short survival time refers to Japan where they took kidneys from the brain dead donors. In China, we have kidneys from living donors. It’s completely different from Japanese hospitals and dialysis centers because they conduct kidney transplants from dead donors.”
In addition, the hospital’s website clearly outlined the price for each organ:- $62,000 U.S. dollars for kidney transplantation
- $98,000 to $130,000 U.S. dollars for liver transplantation
- $130,000 to $160,000 U.S. dollars for heart transplantation
- $150,000 to $170,000 U.S. dollars for lung transplantation

