Replies to LegCo questions

LCQ19: Organ donation for transplant

Following is a question by the Hon Sin Chung-kai and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (March 5):

Question:

Regarding the donation of organs from deceased persons for transplant, will the Government inform this Council:

(a) whether it knows the criteria used by the Hospital Authority (HA) to determine if the above persons are suitable for donating organs;

(b) whether it knows the number of cases relating to the donation of organs last year in which transplant coordinators took the initiative to follow up and, among them, the respective numbers of cases in which the deceased persons had, while they were alive, expressed clearly their wish to donate their organs, and those in which the deceased persons involved were suitable for donating organs but their family members refused to donate the organs concerned; the number of cases last year in which the family members of deceased persons took the initiative to offer the donation of organs, and the procedures adopted by HA staff to follow up such cases;

(c) given that the authorities indicated in February last year that it was tentatively planned to complete by the end of last year the development of a centralised organ donation register for the registration, storage and retrieval, through a computer system, of the information on people who wish to donate their organs after death, whether the register has been established and in operation; if so, of the number of prospective organ donors whose information has already been stored in the system; if not, the reasons for that; and

(d) given that in Singapore and some European countries, people are presumed to consent to their organs being used for transplant after their death unless they have objected before their death to donating their organs, whether the authorities have conducted any study to see if such practice is acceptable to Hong Kong residents; if they have, of the outcome of the study; if such a study has not been conducted, whether the study will be conducted?

Reply:

Madam President,

(a) To ensure the safety of patients receiving organ transplant and a considerable chance of success for transplant operations, transplant coordinators of the Hospital Authority will assess each case referred to them (including those in which family members of the deceased take the initiative to offer the donation of organs) based on established medical protocols to ascertain that the organs are suitable for transplant. The assessment aims to exclude organs of patients suffering from malignant neoplasm (except primary brain cancer) or active infectious diseases, and to ensure that the organs for transplant functions properly.

(b) In 2007, transplant coordinators followed up a total of 224 cases referred to them, with 114 cases confirmed to be unsuitable for organ donation after medical assessment; 50 cases found suitable for organ donation but the donation could not be proceeded due to refusal by family members of the deceased; and 60 cases of successful organ donation. In 10 of these successful cases, the donors had expressed clearly their wish to donate their organs while they were alive and consent was successfully obtained from their family members.

Transplant coordinators are on call round-the-clock. Upon receipt of a case referred to them in which family members of the deceased took the initiative to offer the donation of the deceased's organs, transplant coordinators will immediately seek information on the medical history of the deceased from the medical officers and assess whether the organs of the deceased are suitable for transplant. If the organs are found not suitable for donation, transplant coordinators will explain the reasons to the family members together with an expression of gratitude. If the organs are found suitable for transplant upon assessment, they will explain the transplant procedures to the family members and ask them to sign a consent letter to donate the organs of the deceased. At the same time, they will also contact specialist doctors for conducting further examination on various organs of the deceased. If the organs are confirmed to be suitable for transplant, transplant coordinators and doctors from various transplantation units will coordinate to remove the organs from the deceased for transplant operation.

(c) The system development of the Centralised Organ Donation Register (CODR) was completed in January 2008. The Hong Kong Medical Association is now seeking consent from some 40 000 registered donors in its existing organ donation register for their data in the register to be transferred to the CODR. The Department of Health is carrying out an assessment on the personal privacy implications before the CODR comes into operation. Upon completion of this assessment, the CODR will be launched officially in the second quarter of 2008.

Establishing the CODR for facilitating the public to register as organ donors is part of our promotional efforts on organ donation. In general, our working priorities are to promote broader public awareness of the importance of organ donation, and nurture a social culture which embraces the notion of voluntary organ donation. With the setting up of the CODR, we have plans to step up the promotional efforts for organ donation.

(d) In view of the traditional social value in Hong Kong which respects the will of the deceased and their families, mandatory organ donation may not be widely accepted by the general public. As organ donation should be a voluntary act, we believe that a more effective way to encourage organ donation is to nurture a positive understanding and attitude towards organ donation through continuous publicity and education, thereby enhancing people's willingness to donate organs. We hope that Honourable Members of this Council can register as organ donors in support of organ donation upon the implementation of the CODR.


Ends/Wednesday, March 5, 2008
Issued at HKT 16:34

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