Replies to LegCo questions

LCQ17: G Organ donation scheme

Following is a question by the Hon Chan Kwok-keung and a written reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (March 19):

Question:

The organ donation scheme has been in place for a number of years but the number of organs donated is far below that of patients waiting for organ transplant. In this connection, will the Government inform this Council:

(a) of the respective numbers of various organs donated, signed organ donation cards and patients waiting for organ transplant in Hong Kong each year over the last three years, as well as the corresponding figures in the neighbouring regions;

(b) how Hong Kong's laws and policies relating to organ donation compare with those of the neighbouring regions, and whether these regions have regulations or measures that can enhance people's willingness to donate organs;

(c) of the number of organ donation cards distributed in Hong Kong, the distribution channels and the amount of government subsidy involved; and

(d) of the current respective numbers of available organs stored in public and private hospitals in Hong Kong?

Reply:

(a)&(c) The numbers of various types of organ donations received by the Hospital Authority (HA) in the years 2000, 2001 and 2002 are at Annex.

Regarding the number of patients waiting for transplant in Hong Kong, since the number varies from time to time depending on the clinical conditions of the potential recipients, it is not possible to have a precise number of patients waiting for transplant over a period of one year. However, the approximate numbers of patients currently waiting for different types of transplants are at Annex.

The corresponding figures in the neighbouring regions are not available to us, since overseas countries do not usually release regularly figures on the number of organs donated and the number of patients waiting for organ transplant in their own countries.

In respect of organ donation cards, in the years 2000 to 2002, the Department of Health (DH) distributed over 850,000 organ donation cards through DH clinics and venues, other government departments and public amenities as well as non-governmental organizations. The annual New Life Campaign is another major drive to encourage the signing of the cards by the public. We do not have the number of signed organ donation cards since the public need not register with DH on their signing of the cards. The expenditure incurred was mainly for the printing of organ donation cards. The Government funds the printing of the organ donation cards. About $55,800 was spent on the printing of the organ donation cards distributed over the period of 2000 to 2002. There is no other significant Government expenditure incurred.

We do not have information on the use of organ donations cards in neighbouring regions.

(b) Organ donation in Hong Kong is governed by the Medical (Therapy, Education and Research) Ordinance (Cap 278) and the Human Organ Transplant Ordinance (Cap 465).

The Medical (Therapy, Education and Research) Ordinance provides that the body of a deceased person could be used for therapeutic purposes or for purposes of medical education or research, if the person has expressed a request of such donation before his death. The Human Organ Transplant Ordinance prohibits commercial dealings in human organs intended for transplanting, regardless of whether the organs are removed from dead or living persons. For organ transplants involving living donors, the Human Organ Transplant Ordinance also requires that the donor must have reached the age of 18 years; or have reached the age of 16 years and is married. The donor must be explained by a registered medical practitioner about the procedure, the risk involved, and his entitlement to withdraw consent to the organ removal at any time. His consent to the organ removal must be given under the condition without coercion or offer of inducement. The Ordinance also requires registered medical practitioners to submit proper documentation, with information about the donor (live or death), the recipient and the organ removed or transplanted, to the Human Organ Transplant Board within specified time limits. These principles of no commercial dealing and voluntarism are in line with the laws governing organ donation in other developed countries.

In respect of the donation of cadaveric organ, different countries adopt different approaches. In Hong Kong, a person who wishes to donate his organ(s) after his death could sign an organ donation card, or consent in writing or orally under the presence of two or more witnesses that his organ(s) be used for transplant after his death. Countries adopting similar approach as Hong Kong include Germany, the Netherlands, and Australia. In Singapore and some European countries such as Spain and Denmark, every person is presumed to consent to his organs being used for transplant after his death unless he has objected before his death to donate his organs. While the adoption such an "opt-out" approach would increase the number of organs available for transplants, we consider that organ donation should be a voluntary act and that enhancing people's willingness to donate organ would best be achieved by the nurture of a positive understanding and attitude towards organ donation through long-term publicity and education.

(d) Apart from skin, sclera and bone, all organs and tissues donated will be used for transplants soon after they are removed from the donors and will not be stored in organ or tissue bank.

Skin and sclera tissues from 32 and 3 donors respectively are currently stored in HA hospitals. Bones collected are usually stored as multiple bone fragments and a total of 336 bone fragments are kept in the bone banks of HA. Skin/sclera/bone tissues removed from a single donor can be used in more than one recipient, and a patient can at one time receive skin tissue from more than one donor source.

According to the information provided by private hospitals, no organs for transplant purpose are stored in their hospitals.

End/Wednesday, March 19, 2003
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