The Legislative Council Secretariat ("the Secretariat") today (14 July) released a Research Brief on "Organ donation in Hong Kong". 

Organ transplant is a well-proven health intervention for patients suffering from organ failure, and the success rates of organ transplant are very high in Hong Kong.  However, some patients with organ failure died while waiting for organ transplant as a result of shortage of donor organs.  In 2015, Hong Kong's organ donation rate, at 5.8 donors per million people ("pmp"), is among the lowest in the world. 

Currently, Hong Kong adopts an opt-in system based on voluntary decisions of people to donate and the family consent to the donation after death.  The low organ donation rate has invited intense discussion in recent years about whether Hong Kong should switch from an opt-in to an opt-out system, in an effort to increase the number of potential donors.  Under the opt-out system, government considers everyone an organ donor unless they sign up to specifically opt out.  However, there is no conclusive evidence in opt-out countries suggesting that the adoption of opt-out system will directly result in higher donation rates.

As the adoption of opt-out system might not be a decisive factor to higher donation rates, there are other success factors that can be identified from the experience of high-donation places.  Spain and Australia experienced a marked increase in their organ donation rates after the implementation of reform measures in 1989 and 2009 respectively.  Both countries have established a dedicated authority that is specifically in charge of formulating strategies and allocating resources to facilitate coordinated organ donation and transplantation activities.  They also provide funding support to donation and transplant hospitals for the additional costs associated with organ donation and transplant events, such as expenses related to investment in transplant infrastructure and extra staffing required. 

In addition, Spain and Australia appoint hospital-based transplant coordinators who are mostly intensive care specialists trained to identify potential organ donors and approach donors' families for consent to organ donation.  As a result of the reform measures implemented, the organ donation rate in Spain had increased from 14 donors pmp to 39.7 donors pmp during 1989-2015 and likewise in Australia from 12.1 donors pmp to 18.3 donors pmp during 2008-2015.

In contrast to Spain and Australia, Hong Kong does not have a dedicated authority for coordinating organ donation, nor does it have a specific budget set aside for funding such activities.  There is also no dedicated team within hospitals to facilitate early identification of potential donors.  As to the job of seeking family consent to organ donation, it is undertaken by nine Organ Donation Coordinators who cover seven clusters of 41 public hospitals scattered across Hong Kong.

A key to cadaveric organ donation is the willingness of individuals to donate their organs after death and the acceptance of their family members to the donation decision.  In this connection, Australia has targeted its public education programmes at young people as well as promoting family discussions about donation wishes to ensure that every potential donor's decision is upheld.  In Hong Kong, the focus of promotion campaigns is on enhancing public awareness of organ donation and encouraging people to register as organ donors.  There is also a lack of measures to promote family discussions of donation wishes, although the Government has iterated its importance on a number of occasions. 

This is the fifth issue of the Research Brief for 2015-2016 prepared by the Secretariat's Research Office of the Information Services Division with a view to enhancing information support for Members.  It is a concise summary aiming at explaining a subject matter which may be of interest to Members and the general public.

The Research Brief is now available on the Legislative Council Website at http://www.legco.gov.hk/research-publications/english/1516rb05-organ-donation-in-hong-kong-20160714-e.pdf.

Ends/Thursday, 14 July 2016
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