LCQ8: Promoting organ donation and cross-boundary matching

     Following is a question by the Hon Elizabeth Quat and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (January 11):
     It has been reported that Hong Kong is one of the places in the world with lowest deceased organ donation rates. On the other hand, since 1999, there have only been three successful cases of cross-boundary organ donation, including a recent case of a four-month-old baby girl who received a heart donation from the Mainland for transplant. There are quite a number of views that as organ donation can give people a second life and is an embodiment of selfless love, the Government should establish with the Mainland a regular cross-boundary organ donation and matching mechanism. In this connection, will the Government inform this Council:
(1) as it is learnt that the Mainland has the well-developed China Organ Transplant Response System which, by means of big data, analyses the information of voluntary organ donors across the country who are on its records, as well as ranks and matches patients in accordance with internationally recognised medical principles such as urgency of patients' conditions and donor-recipient organ compatibility, whether the Government will expeditiously work with the Mainland to commence (i) exploration on the technical and procedural matters relating to organ donation, matching, transportation, certification, etc, and (ii) discussion on the legal framework for co-operation in organ donation and matching; if so, of the details; if not, the reasons for that;
(2) given that currently Hong Kong and the Mainland have not yet established a regular cross-boundary organ donation and matching mechanism, resulting in the Hospital Authority having to liaise with the authorities on the Mainland to search for a suitable organ for each case, whether the authorities will consider co-ordinating with the Mainland to regularise the co-operation between the two places in organ donation and matching; if so, of the details; if not, the reasons for that; and
(3) given that at present there are nearly 3 000 people awaiting organ transplants in Hong Kong every day, of the new measures put in place by the Government to promote organ donation and dispel related myths, so as to encourage members of the public to sign up for organ donation?
     Despite ongoing advances in medicine, organ transplant remains an important hope for some patients with organ failure to live on. At present, human organ transplant services are mainly provided by the Hospital Authority (HA). The HA has established a rigorous mechanism for allocating human organs, under which patients in need of transplant are placed on a waiting list and prioritised according to their clinical conditions and medical urgency. Clinical considerations vary for transplanting different organs or tissues. If transplant is needed, matching of the clinical conditions between the potential recipient on the waiting list and the donor is required in advance. After matching, the donated organ/tissue will be transplanted to the patient most in need.
     The consolidated reply, in consultation with the Department of Health (DH) and the HA, to the various parts of the question raised by the Hon Elizabeth Quat is as follows:
(1) and (2) Import of human organs into Hong Kong for transplant purposes is regulated by Sections 4 and 7 of the Human Organ Transplant Ordinance (Ordinance) (Cap. 465) and Section 4 of the Human Organ Transplant Regulation (Cap. 465A). According to the Ordinance, any such organ, when imported into Hong Kong, must be accompanied by a relevant imported organ certificate which contains all statutorily required information, including statements confirming that all applicable laws of the importing place were complied with when obtaining the organ, and that no person made or received a payment for supplying the organ, etc.
     Currently, Hong Kong does not have any standing mechanisms to share cadaveric organs with medical institutions outside Hong Kong (including those in the Mainland). Nonetheless, cross-border organ import and transplant have all along been permitted on a case-by-case basis under the laws of Hong Kong as the situation warrants, and there had indeed been cases involving cross-border organ donation and transplant between Hong Kong and other regions in the past. With regard to Hong Kong and the Mainland, while the two places follow different regulations, allocation systems and clinical treatment of patients in terms of organ donation and transplant, they are both subject to their stringent requirements adhering to international standards for organ acquisition, allocation, cross-border transportation, etc.
     It is noted that some Hong Kong citizens have in fact chosen to receive organ transplant in the Mainland through its organ allocation mechanism, i.e. the China Organ Transplant Response System (COTRS) according to national requirements. Relevant registration procedures, organ allocation and transplant surgeries are performed in accordance with the regulations of the Mainland.
     In considering whether to establish a standing mechanism to share cadaveric organs between the medical institutions of Hong Kong and the Mainland, the Government has to review a basket of factors, including but not limited to the donation, acquisition, allocation, transplant, import and export laws and arrangements, safety of organ transportation (e.g. transportation modes and time constraints) and alignment with the local organ allocation system and the organ transplant waiting list, etc. for cadaveric organs of the two places, so as to ensure that the donated organs, regardless of being donated from Hong Kong or the Mainland, will be transplanted to patients most in need in the two places in a safe, legal, fair and equitable manner through a proper mechanism and appropriate arrangements.
     In view of the case concerning a heart donated from Mainland for transplant to a baby girl in Hong Kong last December, the Government is actively open to exploring the setting-up of a standing mechanism for sharing cadaveric organ with Mainland medical institutions. The Government will continue to deliberate on the matter with the relevant parties responsible for COTRS, closely monitor the development of organ transplant around the world including the Mainland, accord priority to patients' welfare, and consider all the aforesaid factors in a holistic manner when exploring the mechanism for sharing cadaveric organs with other places including the Mainland.
(3) Over the years, the Government has been committed to building a culture that is supportive of organ donation with a view to reducing individuals' and their family members' reluctance or hesitation in this regard. The DH and the HA have been working with various professional community partners, such as the fact that the HA assigns Organ Donation Coordinators who play a supportive and co-ordinating role, in order to promote the trend of organ donation in society.
     The DH launched the Centralised Organ Donation Register in 2008 to encourage members of the public to register their wish to donate their organs after death by providing a convenient registration means for them. It also provides a reliable and effective means for the HA's Organ Donation Coordinators to ascertain, upon patients' death, their previously expressed wish to donate organs, so that they may approach the patients' families as soon as possible to seek their consent for donation of the deceased's organs. As at early January 2023, over 350 000 persons have registered their wish in the Register.
     The DH has been promoting organ donation in many ways, such as publicity via various media channels, celebration on the Organ Donation Day in November every year, and setting up promotion booths at different events and venues. The DH revamped the organ donation thematic website in 2022 and launched a promotion campaign for the Organ Donation Day 2022 in November in the same year, including arranging the organ donation promotion vehicle to visit multiple locations, setting up promotion booths in various districts, holding prize quizzes on social media platforms, and appealing to the public for their support of organ donation through online platforms, advertisements on public transport and outdoor banners, with a view to building a culture of accepting and advocating organ donation in society.
     All in all, the Government will closely monitor the development of organ transplant and continue to promote organ donation with utmost effort to assist the patients in need to rekindle their lives.

Ends/Wednesday, January 11, 2023
Issued at HKT 15:30