7.1. Organ donation and transplantation supply and demand situation is still grim

At present, great progress has been made in organ donation and transplantation in our country. With the continued development of our society and economy, especially the improvement of the levels of medical service, it is still a huge challenge to solve the contradiction between the rapid growth of people's health needs and the overall shortage of service provision. About 300,000 end-stage organ failure patients in our country need organ transplantation each year, yet the number of organ transplants is less than 20,000 each year. From a global perspective, the number of organ donations in our country is at the forefront, but the donation rate per million population needs to be improved. How to improve the organ donation rate so that more patients receive prompt treatment is still the long-term goal of our work.

#### 7.2. Citizens lack the correct understanding of organ donation

First of all, under the influence of "maintaining the integrity of the body" and the wrong "death concept," Chinese citizens' willingness to organ donation is not strong, and due to the fact that the law relating to brain death is still lacking in our country, it also hinders the practice of "brain death" standard to a certain extent in our country. Secondly, the lack of social propaganda makes citizens lack the recognition of the donation process and give up donation. Coupled with the wrong public opinion, such as some exaggerated organ buying and selling speech, etc., also make citizens concern whether the use of donated organ is properly or not, which mislead citizens' cognition of organ donation, affecting their willingness to donate. At the same time, most medical workers have not been involved in organ donation and are not familiar with the criteria for determining brain death, the classification and conditions of organ donation and their reluctance to ask their patients' families' attitudes and wishes toward organ donation, which also hinder the discovery of potential organ donors.

#### 7.3. Organ donation and transplantation-related systems still need to be sound

China's organ donation worked from scratch, achieved by leaps and bounds. At present, we have initially established a donation and transplantation system for human organs in line with China's national conditions, culture and social ethics. However, all aspects of system design and legal norms still need to be explored and developed in practice. To establish a sound organ donation and transplantation system that is compatible with the level of social-economic development level, improve a more equitable and efficient organ distribution system and to scientifically plan the regional distribution of transplanted hospitals so as to ensure the equalization of organ transplant services for all citizens, we also need to keep it up.

registration of this system basically covers all the information and data above. The process is as

Real-time reporting, monitoring of implementation, data analysis and follow-up were conducted in every case of this organ donation database to ensure the regulation of DCD work and also accumulated a large amount of data and laid the foundation for the long-term

7.1. Organ donation and transplantation supply and demand situation is still grim

that more patients receive prompt treatment is still the long-term goal of our work.

7.2. Citizens lack the correct understanding of organ donation

donation, which also hinder the discovery of potential organ donors.

7.3. Organ donation and transplantation-related systems still need to be sound

China's organ donation worked from scratch, achieved by leaps and bounds. At present, we have initially established a donation and transplantation system for human organs in line with China's national conditions, culture and social ethics. However, all aspects of system design and legal norms still need to be explored and developed in practice. To establish a sound organ donation and transplantation system that is compatible with the level of social-economic

At present, great progress has been made in organ donation and transplantation in our country. With the continued development of our society and economy, especially the improvement of the levels of medical service, it is still a huge challenge to solve the contradiction between the rapid growth of people's health needs and the overall shortage of service provision. About 300,000 end-stage organ failure patients in our country need organ transplantation each year, yet the number of organ transplants is less than 20,000 each year. From a global perspective, the number of organ donations in our country is at the forefront, but the donation rate per million population needs to be improved. How to improve the organ donation rate so

First of all, under the influence of "maintaining the integrity of the body" and the wrong "death concept," Chinese citizens' willingness to organ donation is not strong, and due to the fact that the law relating to brain death is still lacking in our country, it also hinders the practice of "brain death" standard to a certain extent in our country. Secondly, the lack of social propaganda makes citizens lack the recognition of the donation process and give up donation. Coupled with the wrong public opinion, such as some exaggerated organ buying and selling speech, etc., also make citizens concern whether the use of donated organ is properly or not, which mislead citizens' cognition of organ donation, affecting their willingness to donate. At the same time, most medical workers have not been involved in organ donation and are not familiar with the criteria for determining brain death, the classification and conditions of organ donation and their reluctance to ask their patients' families' attitudes and wishes toward organ

follows (Figure 8):

development of DCD.

7. China's DCD organ donation problems

124 Organ Donation and Transplantation - Current Status and Future Challenges

For example, various provinces in China have formed an independent organ procurement organization (OPO) and delineated their corresponding service scope. Unlike other countries, most of the OPOs in China are composed of transplant medical teams in organ transplant hospitals. This form is advantageous in the initial stage of DCD work, but with the development of this work, some disadvantages are also exposed, such as the limitation of organ distribution and the irrational division of service areas, and so on, which all need to be constantly adjusted and improved in following-up work.

At present, there are two organ donation registration websites in China: organ donation administration center website by the Chinese Red Cross and "Shi and Suo" organ donation registration website administered by the National Health and Family Planning Commission. Current organ donation and transplantation network systems include the donor system, China organ transplant response system (CORTS). The use of websites is yet to be promoted, just as CORTS, a site that plays a major role in organ allocation, the number of patients who have registered on CORTS for transplantation has a large discrepancy from the actual number of 300,000 patients who are waiting for transplant. Compared with the UNOS website in the United States, the COTRS website in our country did not give full play to its functions, and lacked the legal effect and administrative system. Its authority and compulsion needed to be improved [36, 37].
