1. Introduction

Organ transplantation in China began in the 1960s and has gone through semicentennial of hard work and development [1]. With the continuous development of the technology in transplantation, we have made great progress in organ transplantation and have gradually improved and completed in aspects of operation technology, long-term patient maintenance, transplantation-related scientific research and transplant-related management. At the same time, more and more patients with end-stage organ failure get prompt treatment

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and eproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

and long-term survival. The curative effect has been recognized by the public. At present, it has become a routine treatment in our country.

needs to establish a sustainable organ donation and transplantation system in line with social ethics and China's national conditions. In August 2009, the Red Cross of China and the former Ministry of Health held a conference for human organ donation work in Shanghai to jointly announce the establishment of a human organ donation system and promote DCD across the

Current Situation of Organ Donation in China http://dx.doi.org/10.5772/intechopen.74711 107

After a long period of deliberation and discussion by health authorities and scholars of transplantation and law, China started pilot work of organ donation and procurement in 2010, that is, donation of cardiac death (DCD). Chinese Red Cross, entrusted by the ministry of health, hosted the pilot work. Since then, China's organ transplantation has entered a new

In March 2010, the Ministry of Health (now the China Health and Family Planning Commission) and the Red Cross Society issued a document to carry out organ donation pilot work in 10 provinces and cities in China. The 10 provinces and cities are Tianjin, Liaoning, Shanghai, Jiangsu, Zhejiang, Fujian, Jiangxi, Shandong, Hubei and Guangdong [11]. Since Hunan Province had begun organ donation work and made some achievements before that, in June 2010, the Ministry of Health and the Red Cross General Union jointly approved Hunan Province to join the pilot provinces for organ donation [12]. At the same time, a document was issued on the "Organ Donation Pilot Work Program." Several requirements were put forward in the work of the 11 provinces and cities: (1) to establish the organization structure and team of organ donation work; (2) do a good job of personnel training; (3) to ensure the start of this work and ensure the work funding; (4) attach great importance to propaganda work; (5) explore the establishment of compensation and relief mechanism and incentive mechanism to ensure the sustainable and healthy development of donations; and (6) on the basis of common goals and principles, explore the formulation of implementation rules in line with the actual conditions in the region. In July 2010, the "Guidance to Chinese Organ Donation after Cardiac Death pilot work," which was written by the former Ministry of Health and the Red Cross of China together with related experts, was published in "Chinese Journal of Organ Transplantation" and initiated the DCD pilot work in China [13]. At the same time, the "Organ Donation Pilot Work Program" has also been formulated, which specified the duties and institutional framework of organ donation system and preliminary scheme of donation work process

International classification of cardiac death organ donation is mainly based on the Maastricht standard established in 1995. In view of the immature conditions of legislation on brain death in our country, our country has formulated the DCD classification standard of China according to China's national conditions so that the combination of "brain death" and "cardiac death" is well applied, in which way can also avoid the misunderstanding in our country's cultural identity and make the donation procedure comply with the law. In 2011, the Ministry of Health issued

2. The gradual processing of DCD work in China

country [9].

stage [10].

(Figures 1 and 2).

2.1. The determination and classification of DCD

However, from the 1960s to 2006, organ transplantation in China lacks supporting and supervision of specialized regulatory and law [2]. Due to the specificity of organ transplantation, which involves various of parts and links, it requires strict and orderly management of the identification, assessment, procurement, preservation, function maintenance, registration, distribution of organ resources and selection, evaluation, postoperative maintenance of recipient and other aspects. All these need to establish a scientific donation system at the national level to ensure the legal operation of organ transplantation, to guarantee the legal rights and benefits of the donor and the recipient, to ensure the quality of transplanted organs and the fair distribution and rational use of organs. The selection of recipient should also be based on the severity of illness rather than the other requirements. Meanwhile, strict control indications to ensure the quality of medical care and safety of recipients.

In 2007, our country promulgated "the Regulations on Human Organ Transplantation" (hereinafter referred to as "the Regulations") [3], which marks that our organ transplantation has embarked on a legal track [4]. After the relevant departments took a series of positive measures, initial results were obtained. The objective of implementing the "the Regulations" is to establish an ethical and sustainable organ transplant system. In the past, there were some serious problems in organ transplantation in our country, such as organ trading, tourism transplanting, opaque distribution, and so on. In the meantime, due to the lack of voluntary organ donation, there had been a history of reliance on organs of deceased prisoners [5]. These are all serious mismatches with the development of our country's modernization and seriously restrict the sustainable development of organ transplantation [6]. It is not only difficult to guarantee the quality and safety of transplantation but also undermine the image of our civilized power. With the rapid and steady development of all walks of life in our country, the firm establishment of legal system, the increasing emphasis on health of people and the increasing demands on the quality of life, the medical industry in our country has become the industry which needs more improvement. The development of organ transplantation in our country has entered a crucial stage.

Since the 1980s, China began to try organ donation-related work in the light of international advanced experience. In June 1986, experts from various disciplines in China drafted the first draft "Brain death criteria," and in 1995 and 2003, they repeatedly modified and improved the draft. In July 1997, the first brain-dead organ was donated in Shanghai, and two cases of kidney transplantation were successfully performed. In February 2001, the second case of brain-dead organ donation and the first DBD liver transplantation were performed in Nanjing, China. In July 2005, the first case of donation after cardiac death (DCD) was successfully performed in Guangzhou, China. The first case of DBD heart transplantation in China was successfully performed in July 2006. The first DBD lung transplantation in China was obtained in March 2007. The successes of these attempts have also inspired our continued search [7].

In view of the declining source of cadaver donation in our country, living donors are in violation of the international principle of "no injury" to healthy people. In order to avoid the trade of organs, our country strictly investigates and limits the donor's status and relatives' scope [8]. Living donors cannot be the major source of organ transplantation. China urgently needs to establish a sustainable organ donation and transplantation system in line with social ethics and China's national conditions. In August 2009, the Red Cross of China and the former Ministry of Health held a conference for human organ donation work in Shanghai to jointly announce the establishment of a human organ donation system and promote DCD across the country [9].
