Implementing the Regulation on Human Organ Donation and Transplantation and its accompanying policies through practical projects in China: Lessons from the Life Relay Hundred City Tour Project and the National Organ Donation Systematic Multi-Disciplinary Collaborative Project in 2024
Jie Zhao1, Lu Liu2, Dehua Liu4, Qiu Tao5, Yonghua Feng6, Lianzheng Wang7, Weikun Qu8, Man Xia9, Xianduo Li10, Feng Jiang11, Feng Gu12, Guozhen Chen13, Huibo Shi14, Xin Wang15, Dasheng Sun16, Zhenhua Tu17, Wu Zhang18, Guohui Li19, Xiuyu Yang20, Miao Pu3.
1External Relations Department, China Organ Transplantation Development Foundation, Beijing, People's Republic of China; 2Publicity Department, China Organ Transplantation Development Foundation, Beijing, People's Republic of China; 3Organ Procurement Organization, Xiamen University Xiang'an Hospital, Xiamen, People's Republic of China; 4Organ Procurement Organization, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China; 5Organ Procurement Organization, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China; 6Organ Procurement Organization, 5 The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, People's Republic of China; 7Organ Procurement Organization, Dalian Medical University Second Affiliated Hospital, Dalian, People's Republic of China; 8Publicity Department, Shanxi Provincial Organ Procurement and Allocation Center, Taiyuan, People's Republic of China; 9Medical Affairs Department, Hebei University Affiliated Hospital, Baoding, People's Republic of China; 10 Organ Procurement Organization, Yantai Yuhuangding Hospital, Yantai, People's Republic of China; 11Organ Procurement Organization, The First Affiliated Hospital of Shandong First Medical University, Jinan, People's Republic of China; 12Organ Procurement Organization, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China; 13Organ Procurement Organization, Tongji Hospital, Tongji Medical College of HUST , Wuhan, People's Republic of China; 14Organ Procurement Organization, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China; 15Organ Procurement Organization, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, People's Republic of China; 16Organ Procurement Organization, The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China; 17Organ Procurement Organization, Shulan(Hangzhou) Hospital, Hangzhou, People's Republic of China; 18Transplantation Center, The Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China; 19Organ Procurement Organization, The Affiliated Hospital of Qinghai University, Xining, People's Republic of China; 20Secretary-General, China Organ Transplantation Development Foundation, Beijing, People's Republic of China
Introduction: Organ donation and transplantation reform entered a new phase in China in 2024. The Regulation on Human Organ Donation and Transplantation (the Regulation), effective from May 1st, 2024, was enforced by several policies. Notably, the Opinions on Promoting the High-Quality Development of Organ Donation (the Opinions),jointly issued by 14 ministries, was the first policy solely targeting organ donation. It clarifies government sectors' roles and the need for a collaborative mechanism to promote organ donation. In response, the China Organ Transplantation Development Foundation (COTDF) initiated the Life Relay Hundred City Tour Project, which assists municipal governments in enhancing organ donation through interdepartmental collaboration; as well as the National Organ Donation Systematic Multi-Disciplinary Collaborative (SMDC) Project, which targets the healthcare sector, helping Organ Procurement Organizations (OPOs) establish systematic collaboration mechanisms for donor detection, family approach, referral, and maintenance through professional training programs.
Methods: To understand the projects' effects, the COTDF conducted a survey at the end of 2024, focusing on participants' attitudes, working mechanisms, and daily practices related to organ donation using random sampling. Participants were divided into three groups: those who attended both projects (Group A), who attended only training courses (Group B), and who attended neither (Group C). The 1-way ANOVA test was employed to analyze differences among the 3 groups.
Results: The survey collected 532 responses from 13 provinces. Participants included 49.43% from ICUs, 19.55% from Emergency Departments, 17.48% from neurology departments, 4.89% from administration departments, 6.20% from OPOs or transplant centers, and 2.44% from other sectors. Among them, 12.22% attended both projects (Group A), 41.65% attended only training courses (Group B), and 46.62% attended neither (Group C). Significant differences were found among the groups in attitudes toward organ donation, potential donor reporting, systematic multi-disciplinary collaboration, familiarity with OPO contact information, organ donation processes, clinical triggers, confidence in initial family approach and donor maintenance, and OPO contact frequency(P<0.01). Groups A and B showed higher levels in these aspects compared to Group C (Table 1). Participants rated government involvement as the most important factor influencing organ donation in China (Figure 1).
Conclusion: Legislative, sustainable, and high-quality development is crucial for organ donation in China. The projects effectively enhanced healthcare professionals' awareness and knowledge of organ donation. At the same time, given the low overall organ donation level in China, there is a high expectation for government involvement in raising public awareness.
[1] Organ Donation
[2] Systematic Multi-Disciplinary Collaboration
[3] Life Relay Hundred City Tour Project
[4] High Quality Development in China