LCQ14: Organ donation and cross-boundary organ transplant mutual assistance mechanism
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Question:
The Department of Health has established a Centralised Organ Donation Register (CODR) to facilitate voluntary registration by those wishing to donate organs, so that their wish to donate organs after death can be duly recorded. In this connection, will the Government inform this Council:
(1) of the numbers of new registrations, deregistrations and cumulative total registrations on CODR in each of the past three years, with a tabulated breakdown by age group;
(2) according to the statistics from the Hospital Authority, as at March 31, 2026, there were over 3 000 patients awaiting organ transplants, whether the Government will review the effectiveness of its publicity efforts to promote organ donation and establish key performance indicators for this purpose, so as to help formulate corresponding promotional measures to raise public awareness and willingness to donate organs and increase the number of registrations on CODR; if so, of the details; if not, the reasons for that;
(3) whether it will consider changing the current "voluntary donation" mechanism for organ donation to an "opt-out" system; if so, of the details; if not, the reasons for that; and
(4) regarding the arrangements for cross-boundary organ donation and transplants with the Mainland, the Government has earlier on indicated that it needs to gradually accumulate successful cases to promote a cross-boundary organ transplant mutual assistance mechanism, of the expected timeframe for the regularisation of the mechanism; whether it has drawn up a specific work plan and timetable for this purpose; if so, the details; if not, the reasons for that?
Reply:
President,
In consultation with the Department of Health (DH) and the Hospital Authority (HA), the consolidated reply to the question raised by Reverend Canon the Hon Peter Douglas Koon is as follows:
(1) The numbers of registrations recorded in the Centralised Organ Donation Register (CODR) in the past three years are as follows:
| 2023 | 2024 | 2025 | |
| Number of new registrations | 25 968 | 24 809 | 24 662 |
| Cumulative total number of registrations (as at December 31 of the year) |
367 199 | 391 187 | 414 371 |
| Number of withdrawals of registration | 14 862 (Note) | 821 | 1 478 |
Note: During the period of May and June 2023, the spreading of quite a number of malicious remarks intending to mislead the public had led to an unusual surge in the number of withdrawals of registration from the CODR. Subsequently, with the Government's strengthened publicity efforts, the number of withdrawals of registration has returned to normal.
Since the age of the applicants is not recorded in the CODR, a tabulated breakdown by age group is not available.
(2) The Health Bureau (HHB), together with the DH and the HA, have been making continuous efforts to collaborate with community partners in promoting organ donation through different channels and on various fronts.
Since 2023, the DH has stepped up its publicity efforts on organ donation by (1) setting up organ donation promotion booths in different locations of the community and deploying the organ donation promotion vehicle to organise promotion activities, with a view to encouraging public registration in the CODR; (2) using various channels, such as television, radio, newspapers and the internet for publicity; (3) promoting e-engagement of the public through the dedicated social media page "Organ Donation at HK"; (4) educating the public through health talks; (5) producing publicity materials for distribution in various occasions and events; (6) establishing an institution-based network to promote organ donation in partnership with signatories and supporters of the Organ Donation Promotion Charter; and (7) staging large-scale publicity events to support the Organ Donation Day on the second Saturday of November every year.
In line with the Government's strategies and initiatives of promoting organ donation, the HA has organised various promotion activities, including (1) setting up a designated webpage, with publicity and education videos as well as e-posters hyperlinked to the CODR, in the HA's internet and intranet websites; (2) promoting organ donation on the HA's social media platform and posting promotional content on various media and platforms; (3) setting up promotion booths in various hospitals under the HA; (4) recruiting summer volunteers to participate in organ donation promotion activities; and (5) inviting and arranging for the DH to set up promotion booths in various hospitals under the HA and at large-scale events.
In the paper for discussion of the Legislative Council Panel on Health Services on the policy initiatives of the HHB in the 2022 Policy Address, the HHB set a key performance indicator (KPI) for organ donation promotion, which was to increase the total number of registrations in the CODR by 15 per cent (i.e. to approximately 410 000) by the end of 2027. This KPI was achieved ahead of schedule in 2025. As at April 30, 2026, the number of registrations in the CODR exceeded 418 000, demonstrating that the Government's organ donation publicity efforts have been effective. Moving forward, the Government and the HA will continue to adopt a multi-pronged approach, strengthening collaboration with various sectors through different channels to jointly promote organ donation.
(3) Hong Kong has been adopting an "opt-in" system for cadaveric organ donations. Members of the public can carry signed Organ Donation Cards as an expression of wish to donate organs after death, but what is more important is that such wish should be made known to the family members. Under the existing mechanism, even if a deceased person has indicated his/her wish to donate organs after death, organ donation co-ordinators would seek the consent of the family members of the deceased. Should there be any objection from the family members of the deceased, the relevant transplant surgery will not be performed.
Apart from Organ Donation Cards, the DH launched the CODR computer system in 2008 to provide members of the public with an additional convenient means to clearly indicate one's wish for organ donation so that family members and medical staff are aware of the expressed wish. Whenever the HA encounters cases concerning patients with potential brain death, organ donation co-ordinators of the HA would ascertain if the deceased has expressed a wish for organ donation on the CODR, and would approach his/her family members after declaration of brain death. Organ donation co-ordinators would then explain the details of organ donation to the family members and convey to them the deceased's wish so as to seek their consent to the donation of the deceased's organs as soon as possible, thereby saving lives of patients who are in need of organ transplant. Experience shows that most people, upon learning their beloved family member's wish to donate organs after death, are more willing to respect and honour such wishes. The record on the CODR is merely an expression of wish and does not bear any legal effect or binding force.
An "opt-out" mechanism is very different from the existing organ donation regime. Organ donation is a selfless and generous act of benevolence. The Government is of the view that organ donation should be promoted through strengthening education and publicity. At this stage, it is not appropriate to consider changing the cadaveric organ donation regime through legislative means. As a matter of fact, regarding such a controversial issue, mandating an "opt-out" system for organ donation through legislative means without sufficient consensus in society may be counterproductive, as it could deter individuals from expressing their willingness to donate. This is a matter that requires careful consideration.
(4) With the strong support and assistance of the Central Government and relevant Mainland authorities, there were two cases of successful cross-boundary organ donation from the Mainland to Hong Kong in December 2022 and February 2025. On the basis of the two successful cases, Hong Kong and the Mainland have currently established standing channels and standardised co-operation procedures for handling emergency cross-boundary organ transplant. When a patient in moribund condition is confirmed to be in need of urgent organ transplantation to extend his/her life and no suitable organ is available in Hong Kong, subject to the fulfilment of relevant clinical criteria as assessed by the medical team and the consent of his/her family members, the Government will seek assistance from the country. The operational procedures for handling emergency cross-boundary organ transplant adopt a second-tier allocation mechanism, which will be activated only when local matching is unsuccessful for a donated cadaveric organ. Each case will be notified to the relevant government departments and an application will be made. The relevant departments will then vet the application and implement the arrangements in accordance with the established mechanism to ensure that the transportation and transplant processes are in compliance with the laws and regulations of both places.
In addition, the HA has formulated and implemented a set of standardised clinical protocols in terms of technical requirements, criteria and procedures for handling emergency cross-boundary organ transplant cases in a consistent approach. This is to ensure that organ donation is conducted in a legal, fair, equitable and safe manner to benefit patients with the greatest need. The Government will continue to seek assistance from the country for patients in urgent need of organ transplant in accordance with the mechanism, and improve the cross-boundary organ transplant mutual assistance mechanism based on the experience gained from handling more successful cases.
Ends/Wednesday, May 27, 2026
Issued at HKT 15:00
Issued at HKT 15:00
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