Hong Kong will greatly benefit from a proposed organ donation scheme with mainland China, transplant experts have said, after a surge in requests to withdraw from the existing programme sparked a blistering condemnation by the city’s leader.
Chief Executive John Lee Ka-chiu on Tuesday said police had launched an investigation into the suspected abuse of the organ donation system, calling it “shameful and disgraceful” behaviour.
“Some withdrew their applications without even registering. This is a very suspicious act,” Lee told the press before his weekly meeting with the key decision-making body the Executive Council.
Health Bureau figures showed 5,785 residents applied to withdraw from the Centralised Organ Donation Register between last December and April, but more than half, or 2,905, involved people who had never signed up or made repeated attempts to withdraw.
In February alone, the percentage of bogus withdrawal applications was as high as 74 per cent. From 2018 to 2022, the number of withdrawals annually ranged from 266 to 1,068. As of April, there were 357,668 registrations in the system.
“I severely condemn those who attempt to sabotage the system – which has a noble cause of saving lives through organ donations – for their shameful and disgraceful behaviour,” Lee said. “We will also continue to push forward with the collaboration of organ donation with mainland China, as past cooperation proved successful in saving the lives of Hong Kong residents.”
The Health Bureau on Monday said it could not rule out that a small group of people had intentionally made withdrawal attempts to disrupt the register. Police said the cybersecurity and technology crime bureau was investigating and officers would continue to monitor related online activities for any possible illegal acts.
The Department of Health said the government was reviewing the process for registration and withdrawing permission. Factors such as personal privacy and identity verification would be considered when updating the system, it added.
It revealed the hotline for requesting access to personal data had recently received many inquiries and the department would allocate more resources to cope with the increased demand.
In December, a Hong Kong baby girl suffering from heart failure received a donated organ from the mainland, in the first arrangement of its kind. Health authorities later said they hoped to establish a cross-border donation scheme and this past weekend a delegation travelled to Guangdong province to learn about the mainland’s organ transplant procedures.
The government said some internet users had recently promoted the idea that organ donors should scrutinise the identity of recipients and urged others to withdraw from the register.
Under international practice, donors or their family members cannot designate specific recipients or ask for any identity screening. The identity of recipients will also not be made known to family members of donors beforehand.
Professor Philip Li Kam-tao, a consultant at Prince of Wales Hospital’s department of medicine and therapeutics, and a member of the delegation, said the number of organ donations has been unsatisfactory in recent years.
Close to 2,600 patients were waiting for transplants, with kidneys needed the most, but only 27 organ donations have been made this year. Between 2019 and 2022, only about 80 to 100 livers, kidneys, hearts and lungs were donated each year.
“It’s very disheartening to see Hong Kong’s organ donation system being improperly disrupted,” Li said. “The wrong messages being disseminated will affect public willingness to donate organs.”
He also expressed concerns that Hong Kong people were becoming less altruistic, noting blood supplies were also running low.
“With so many local patients waiting for transplants, and so few organs being donated, the chance of us donating organs to the mainland is very low,” he said. “However, the chance of Hong Kong’s patients benefiting from organs coming from over the border is way higher.”
Under the proposed collaboration, health authorities would closely follow the international practice of not telling recipients the identity of the donor, and vice-versa.
“Organ donation is entirely out of one’s good will, and the race, gender, age, nationality of the recipients should not be a matter of concern.”
Professor Albert Chan Chi-yan, a consultant at Queen Mary Hospital’s Liver Transplant Centre and another delegation member, said about 1,100 donated organs on the mainland could not be matched with any patients in the China Organ Transplant Response System.
“Under the proposed mechanism, whenever there is an organ that cannot match on the mainland, authorities will alert us and we will try to match the organ with the patients on the waiting list,” he said.
All the necessary details to help make the clinical judgment, including the donor’s age, health condition, the organ’s cold ischemia time, and more, would be shared with Hong Kong medical personnel, Chan added.
“The frontline medics in Hong Kong will have the final say on whether the organ is suitable for our patients, and we will stick to the relevant assessment standards,” he said.
But the mainland and Hong Kong would continue to maintain separate systems for allocating organs, he said.
Reports have emerged over the years about a lack of transparency in how donations are arranged over the border, and Chan said mainland authorities shared the same concerns and had worked hard to eradicate any illegalities.
He said the mainland’s centralised computer system could detect any suspicious activities and make reports to police.