Chapter Nine: Findings from 164 Hospitals—Volume Drivers
I. DEMAND FOR ORGANS AND EXPANDED RECIPIENT POOL
China has 130 million hepatitis B carriers.1716 China also has 40~50% of the world’s liver cancer patients,1717 in addition to over half the world’s new liver cancer patients about 350,000 cases per year.1718 For the 8 million end-stage liver patients (including those with liver failure, cirrhosis, and liver cancer), the most effective treatment is transplantation. 1719
The establishment of the “Hangzhou Criteria”1720 and “Shanghai Fudan Criteria”1721 removed the previous restrictions from Milan and other international standards, which required an individual tumor’s diameter to be 5 centimetres or less for the patient to qualify for a liver transplant. This requirement has now been loosened to 8 centimetres under the Hangzhou criteria and 9 centimetres by the Fudan criteria, which has expanded the potential liver recipient population by about 40%. China does not have an effective national organ donation and allocation network. According to expert estimates in 2010, over 300,000 people are waiting for liver transplants. 1722
According to China’s official transplantation website, China has the largest number of people with liver disease of any country. The World Health Organization puts the figure at about 100 million. 1723 Chinese researchers say that nearly 400,000 people die every year from liver cancer in China, making up nearly half of all deaths from liver cancer worldwide. And these researchers say that about 300 million in China suffer one or another form of liver disease. 1724
In 2004, Chen Shi, chairman of the Chinese Medical Association’s Organ Transplantation Society and deputy director of Tongji Medical University’s Institute of Organ Transplantation, stated that there were millions of late-stage renal failure patients in mainland China, among whom about 500,000 were waiting to receive kidney transplants. This number would increase by 120,000 every year.1725 According to the current public data, over one million patients are waiting for kidney transplants in China each year. 1726
China currently has more than 10 million patients with heart failure. Each year, more than 2 million die from end-stage heart failure.1727
According to statistics from the World Transplant Games Federation, China has more than 4 million leukemia patients waiting for bone marrow transplants. 1728 The country also has four million people suffering cornea disease.1729 In 2012, Chen Jiaqi, founder of the Chinese Eye Bank and director of the Eye Bank of Guangdong Province, estimated that between 300,000 and 400,000 corneal transplants would be needed every year. 1730
Organ transplantation has assumed a high priority in national strategy and receives great emphasis as a future emerging industry. The Government has invested heavily in research, development, and personnel training in transplantation technology. Liver and kidney transplants have become routine surgery in clinical practice. New techniques are emerging and spreading throughout China’s provinces. Not only are the major hospitals engaging in transplants; but small hospitals are unwilling to miss the opportunity.
II. HOSPITAL FUNDING
Transition from Government Funding to Self-Reliance
The shift from socialism to capitalism in China meant withdrawal of government funding from the health system. Before the change, the Government owned, funded and ran all hospitals. All physicians were state employees.
With the transition to capitalism, this system was dismantled. From 1978 to 1999, the Beijing government’s share of national health care spending fell from 32 percent to 15 percent. Between 1990 and 2002, public funding as a proportion of local public health revenues went from almost 60 percent to 42 percent.
This led to privatization of most Chinese health care facilities. Hospitals were forced to rely on the sale of services to cover their expenses. David Blumenthal and William Hsiao wrote, “Public hospitals came to function much like for‑profit entities, focusing heavily on the bottom line.”1731
According to cardiovascular doctor Hu Weimin, the state funding for the hospital where he worked was not enough to cover even staff salaries for one month. He stated, “Under the current system, hospitals have to chase profit to survive.” Human Rights in China reported, “Rural hospitals [have had] to invent ways to make money to generate sufficient revenue.”1732
The Government, in addition to withdrawing funding, imposed price controls on basic health services. These price controls were not comprehensive and left new technologies and drugs untouched. In addition, hospital doctor salaries were changed to include a bonus component based on hospital revenue. Blumenthal and Hsiao wrote, “The result was an explosion in sales of expensive pharmaceuticals and high‑tech services.”
All these changes drove hospitals to transplants–a new technology not covered by price controls, which provided private revenue and which, afterwards, required anti-rejection drugs. Transplant surgery became a leading method for hospitals in China to make money. For example, the Organ Transplant Center of the Armed Police General Hospital in Beijing boldly stated, “Our Organ Transplant Center is our main department for making money. Its gross income in 2003 was 16,070,000 RMB. From January to June of 2004, income was 13,570,000 RMB. This year (2004) there is a chance to break through 30,000,000 RMB.”1733
A report by World Journal in March 2015 quoted Huang Jiefu as saying thatTranslate from: Chinese a liver transplant costs at least 600,000 RMB (about $96,000 USD) and more than 300,000 RMB (about $48,000 USD) for a kidney transplant.1734 At the end of 2006, Huang Jiefu stated to Caijing Magazine, “Organ transplantation has become a trend of being used as a tool for hospitals to make money.”1735
Because there were no guidelines for transplant fees in China, the prices for transplants ranged from tens of thousands to hundreds of thousands RMB. These included pharmaceuticals, surgery fees, organ acquisition, and preservation and transportation costs.1736 1737 Before the Kilgour-Matas report on organ harvesting in 2006, the website of the International Transplant Network Support Center of the First Affiliated Hospital of China Medical University listed transplant prices for foreigners. Kidney transplants cost more than $60,000 USD, liver transplants were $100,000, and lung and heart transplants each cost more than $150,000.1738
On February 26, 2013, Xinhua News published an article titled “China will officially launch three major principles for organ transplants and organ allocation to follow.” Huang Jiefu said, “A certain stimulus mechanism is to be introduced into China’s organ donation system by giving out certain humanitarian aid and economic compensation.”1739 The Guangzhou Southern Weekend reported in March 2010 that since 2000, the sale of organs for transplants has become “a mine of high-grade ore that can’t be exhausted.” 1740
On March 31, 2006, a senior military doctor of the General Logistics Department of the Shenyang Military Command wrote to the Epoch Times, “China is the center of international live organ trading, and has accounted for more than 85% of the total number of live organ transplants in the world since 2000. According to the data reported to the Central Military Commission, some people have been promoted and became Generals due to their ‘achievements’ in this field.”1741
He also said, “The military acts as the organ transplantation management system. This type of management and organizational core belongs to the military system. This is something that the local government cannot match, because once it becomes a military secret, no one can acquire the information. We all understand how the military system works. There is a huge source of living organs, many military hospitals report their transplants to their supervising authorities, at the same time, they also carry out organ transplants on a large scale in private. This leads to the fact that actual numbers are much higher than the official statistics.”
The People’s Liberation Army General Logistics Department is in charge of allocating organs source from prisoners in detention facilities. The Department receives cash (or foreign currency) when selling organs from hospitals, which pay for the organs. The bulk of the transplants are conducted in military hospitals, while the organs sold to civilian hospitals were just for extra profits. The purpose was to use these hospitals as shop windows and advertisements to overseas customers.1742
Ever since the Deng Xiaoping era, the Chinese military has been given a high degree of latitude to raise funds through entrepreneurial schemes using military resources and infrastructure. The military hospitals are no exception to this long-standing arrangement. While the system responsible for providing organs for military hospitals is maintained by military expense, transplant profits do not fall under military oversight. Accordingly, the trafficking of organs has become a method for military hospitals to make direct profits.
Kidney Transplant Cost
Below are the average costs of kidney transplants in different regions between 2000 and 2004, as reported in academic papers:1743
Table 9.2 Summary of kidney transplantation during 2000 to 2004
We found lower prices mentioned in various media reports:
The Qilu Evening News reported on July 28, 2003 that the General Hospital of Jinan Military Command charged 30,000 to 40,000 RMB for a kidney transplant and 20,000 to 40,000 RMB per year for immunosuppressive drugs thereafter.1744
It was reported in April 2006, patients paid only 50,000 RMB for kidney transplants at the Second Hospital of Dalian Medical University.1745
According to an archived webpage from 2008, Changhai Hospital of the Second Military Medical University advertised an average hospitalization fee of 50,000 RMB for kidney transplants.1746 The original page has since been removed.
According to a webpage dated in 2010, at the First People’s Hospital of Changde, the average cost for a kidney transplant between relatives was about 60,000 RMB with no complications, or about 80,000 RMB from a cadaveric donor.1747
It was reported that in early September 2014, a patient paid 600,000 RMB in cash to the First Affiliated Hospital of Zhengzhou University, which was able to find a matching kidney for him in one day. The transplant surgery was done the following day.1748
A people.cn report from November 16, 2015 indicated that that The First Affiliated Hospital of Xi’an Jiao Tong University Medical College requires “hundreds of thousands of RMB” for a kidney transplant.1749
Liver Transplant Cost
Between 1995 and 1999, liver transplant surgeries at Wuhan Tongji Hospital required 10 hours, and the cost averaged between 300,000 and 400,000 RMB and peaked at 800,000 RMB. By 2000, the cost had decreased to 190,000 RMB and surgery time to 7-8 hours.1750 By 2001, the institute could usually keep the liver transplant cost below 150,000 RMB; the surgery took 4 hours, which represented the best in the country. In August 2011, the institute performed a liver transplant for 110,000 RMB, the lowest nationwide.1751
In 2009, the cost of a liver transplant at Peking University First Hospital was around 160,000-200,000 RMB, including fees for surgery, monitoring, pharmaceutical, and examination fees for around three weeks after the operation.1752
Lu Shichun, director of the Beijing YouAnHospital transplant center, revealed in a media interview in 2011 that the fee for liver transplants differs among transplant centers and averages around 400,000 to 500,000 RMB.1753
In 2016, Wuhan Union Hospital, a sister institution of Tongji, advertised its liver transplant cost at around 150,000 RMB.1754
Heart and Lung Transplant Cost
At Fuwai Cardiovascular Disease Hospital, which is affiliated with the Chinese Academy of Medical Sciences, a heart transplant averages around 250,000 RMB. Fees for postoperative immunosuppressants average 3,000 to 5,000 RMB per month, as of 2016.1755
Shanghai Chest Hospital of Shanghai Jiaotong University charges between 200,000 and 300,000 RMB for a lung transplant, as of 2016.1756
Fees Paid by International Patients
Organ transplant prices for foreigners are not fixed. Although it should be taken with a grain of salt as it is a source twice removed, in 2014 and 2015, Yang Guang, a China expert who resides in Denmark, claimed that his friend’s two affiliated hospitals with a medical university in northeastern China would often charge $500,000 to $1 million USD for transplant, and in several cases, rich foreign patients desperate for an organ have been charged up to $2 million USD for a transplant and hospital stay. A Japanese woman received a young girl’s liver with serial number 020014 and was charged $5 million USD.1757
- In general, however, interviews with a group of international transplant recipients before 2006 reflected remarkably consistent prices:1758
- In 2001, a group of 7 patients who went to China together for organ transplants were individually told to bring $200,000 HKD (about $26,000 USD)
- In 2004, an Asian patient paid $27,000 USD for a kidney transplant at the Economic and Technical Development Hospital of Guangzhou
- In 2005, a patient from Taiwan paid $29,000 USD (including “red envelope” money, airline tickets, and other extras) for a kidney transplant at Guangdong Province Border Patrol Armed Police Central Hospital in Shenzhen
- In 2006, a patient from Asia paid $26,000 USD in cash for a kidney transplant at the Land Force General Hospital of WuhanOther sources suggest the cost of a kidney transplant in China runs to $66,500 USD and a liver up to $157,000 USD1759
- A heart transplant at the Zhongshan Hospital in Shanghai can be had for $119,000 USD, a fraction of the $860,000 USD such an operation would cost in North America1760
Trends and Factors in Transplant Costs
Different hospitals charge different fees for transplants but they tend to follow a common trend. From a few examples of the main players in China’s organ transplant industry, we can see a decline in medical and pharmaceutical costs coinciding with an overall increase transplant fees. The main factors driving transplant costs are the treatment itself (including surgery and hospitalization costs), pharmaceuticals (including the ongoing regimen of anti-rejection drugs), and the donor organ source.
Between 1995 and 1999, Wuhan Tongji Hospital charged an average of 300,000 to 400,000 RMB and a maximum of 800,000 RMB. In August 2001, surgery fees decreased significantly to around 150,000 RMB on average (the range was 110,000 to 190,000 RMB). The director of the hospital’s organ transplant research institute stated that the decrease in costs were due to the maturation of technology, decrease in operation times from 7-10 hours to 4-5 hours, reduced bleeding, lower cost of blood transfusions, shorter anesthesia times, fewer postoperative complications, and shorter hospitalization times. By 2002, Tongji Hospital had reduced its liver transplant operation time to 4 hours and the cost to below 150,000 RMB, the “lowest in the country.”1761
As we observe, at the early stage after 2000, transplant prices steadily declined due to technological development and abundant organ sources. The dramatic decline of surgery costs and treatments made it affordable for a wider range of patients. The maturation of technology and increase in both domestic and international patients led to an exceptional growth in China’s organ transplant industry.
The decrease in medical costs due to improvements in technology and techniques is also reflected at Shanghai General Hospital, which in 2002 eliminated the need for blood transfusions in one-third of its liver transplant surgeries. The entire operation time was reduced to four and a half hours, and the lowest cost was 142,000 RMB.1762
A 2003 investigation of liver transplant costs showed that early-stage recipients had an average pharmaceutical cost of 198,000 RMB every six months after surgery. The same cost for late-stage patients was more than 230,000 RMB. Recipients also need anti-rejection drugs, who cost more than 30,000 RMB per year.1763
As of 2003, the surgery fee at Jiangsu Provincial People’s Hospital was one-tenth to one-eighth that of the same surgery in other countries.1764
In 2004, Nanjing Drum Tower Hospital’s hepatobiliary department director Ding Yitao told a reporter that the hospital’s liver transplant fee averaged 150,000 RMB, the lowest in the country. Postoperative anti-rejection drugs cost around 3,000 RMB per month for domestically produced products and 5,000 RMB for imported drugs.1765
In the same year, the People’s Liberation Army No. 309 Hospital charged 200,000 RMB for liver transplants and 300 RMB per day for anti-rejection drugs.1766 Early in the same year, the Oriental Organ Transplant Center charged around $32,000 USD (~250,000 RMB) for liver transplants. By 2006, the fee had increased to 400,000 RMB for international patients but remained at around 200,000 RMB for domestic patients.1767
Since international patients are charged much more than domestic patients, organ tourism became a factor in driving up transplant prices. After the organ harvesting crimes were revealed in 2006, transplant prices generally stabilized due to the shrinking international market.
In recent years, along with the resurgence of the international market, both international and domestic demand have increased. According to a report by Jingchu Network in August 2015,1768 liver transplants in China cost around 600,000 RMB, and kidney transplants cost around 300,000 RMB. From these descriptions of costs for liver and kidney transplants from different channels, we can see that the fees in the past few years have been significantly higher than those before 2006. However, medical and pharmaceutical costs have trended downward. Thus, organ sources may be representing an increasingly large portion of transplant fees and one may naturally wonder if the increase in fees is due to a shortage in the organ supply. While he is hardly a reliable source it is interesting that Huang Jiefu threw cold water on that notion, stating in the same year that the limiting factors of organ transplantation in China lie primarily in medical costs and availability of transplant hospitals and doctors: “Only the third [reason] is that there are not that many donor bodies; even though donor bodies are abundant right now, there aren’t that many hospitals and that many doctors that can [perform transplants].”1769
Nevertheless, compared to the number of patients waiting for transplants, the transplant capacity of hospitals and organs available are still scarce resources. Despite an endless line of domestic patients in need of transplants, the profit-maximizing strategy for hospitals is to provide transplants to those most willing and able to pay. This can be seen in Huang Jiefu’s push to establish a platform to provide organ sources to Taiwan. Furthermore, we see international patients being charged more than domestic patients, to the tune of hundreds of thousands or even millions of USD–fees that are many times the treatment and pharmaceutical costs involved. This scheme takes advantage of the extremely inelastic nature of the market, given that these patients from other countries would otherwise have to wait years for a transplant.
The tissue type or HLA compatibility of the source and recipient impact the rate of rejection after a transplant operation. According to the U.S.-based National Marrow Donor Program (www.marrow.org), the compatibility ratio of recipient and source from a non-immediate family member is quite low—between 1% and 5%. In other words, it takes between 20 and 100 sources to find tissue type compatibility with a recipient; while media reports in China indicate a kidney tissue type matching percentage of between 20% and 30%.1770
Immunosuppressant drugs can lessen rejection responses from tissue type incompatibility. Globally, sources and patients with six out of ten matching points are considered tissue-type compatible. The number of matching points has a direct impact on the rejection rate and the amount of immunosuppressants needed. In China, however, 4 matching points, or sometimes even fewer, are acceptable. As a result, patients would have to rely on large doses of immunosuppressants after receiving transplants. Patients who develop severe rejection responses would require second or even multiple additional transplants. These pharmaceuticals also provide doctors a source of kickbacks, which contribute to some doctors’ aggressive pursuit of even marginal recipient prospects.
Dong Jiahong, director of the hepatobiliary surgery department at Beijing Tsinghua Chang Gung Hospital, revealed to Xinhua Net, “For a liver cancer patient, on average liver resection may cost 20,000 to 30,000 RMB. Liver transplantation may cost over 200,000 RMB, and there are follow-up costs. Most transplant patients will suffer from rejection issues and need to take immunosuppressants for life. Add in antiviral drugs preventing the recurrence of hepatitis B, and the cost is between 50,000 to 100,000 RMB a year.”1771
Because immunosuppressant regimens are individualized, they vary among hospitals and patients. Our hospital survey shows that the annual cost for post-transplant immunosuppressants range from 10,000 to 60,000 RMB. The cost decreased over time as domestic immunosuppressants gained market share. We discuss immunosuppressants in more detail later in this chapter.
Growth in Revenues
The experience and practice of the People’s Liberation Army No. 452 (Chengdu Air Force) hospital jumped from “township-scale” to that of a large-scale hospital in just a few years. Other military hospitals followed suit.
An article “Relying on the Market to Protect the Battlefield” by Xinhua Net and other domestic media in 20091772 reported that, when Zhang Cong became the hospital’s president in 2000, the troubled hospital had more than 6 million RMB in debt. Its kidney transplant division used to be the hospital’s best-known department. However, due to the lack of funds needed to update its equipment, its number of patients decreased day by day.
In 2002, Zhang decided to “borrow a hen to lay eggs” and found an entrepreneur who invested 8 million RMB in the hospital. The investor and the hospital together managed the renal transplant division. After the capital and equipment were in place, its kidney transplantation operation soon “came back to life.”
Five years later, the hospital bought back the facilities, equipment, and management rights from the investor and embarked on a new entrepreneurial path. Very soon, the number of kidney transplants performed by the PLA No. 452 Hospital ranked first among all hospitals in Sichuan Province. After the hospital grew from its original 210 beds to more than 1,000 beds, Zhang became the president of the PLA No. 309 Hospital in 2013.
At No. 309 Hospital, the PLA Organ Transplantation Center’s revenue rose from 30 million RMB in 2006 to 230 million RMB in 2010, an increase of nearly 8-fold in 4 years.1773
The annual income of Daping Hospital, affiliated with the Third Military Medical University, also increased from 36 million RMB at the end of the 1990s, when it began organ transplantation, to over 900 million RMB in 20091774—an increase of nearly 25-fold.
These examples show that the growth in organ transplantation continued after 2006.
Civilian hospitals have also profited from transplants. For example, the Second People’s Hospital of the Shanxi Occupational Disease Prevention and Control Center (in reality a kidney transplant center) charges around 100,000 RMB for a kidney transplant. Its revenue for 2005 was about 250 million RMB. There were at least 100 patients on its transplant waiting list.1775
III. A PARTY / GOVERNMENT-DRIVEN INDUSTRY
One aspect from our hospital survey that impressed us is that the vast majority of medical universities and their affiliated transplant centers, military and civilian, have received significant funding from all levels of government. The regime has prioritized organ transplantation in its national strategy and invested heavily in research, development, industrialization, and personnel training in transplantation technology.
National Strategic Plans
There have been twelve Five-Year Plans, with the first beginning in 1953. Although they are called Five-Year Plans, most of them are nothing more than long-term projects. Through macro environmental transformations every five years, these plans can be sustained and implemented. Since the advent of the persecution campaign against Falun Gong, the Government of China has continuously incorporated organ transplantation into its Five-Year Plans for multiple ministries–a rare occurrence.
In 2001, establishing organ transplantation regulations was listed as part of the Tenth Five-Year Plan for the Ministry of Health.1778
In 2004, organ transplantation technology was added as a major research area and key technology in the Tenth Five-Year Plan for National Health, Science and Technology Development of the People’s Republic of China.1779 In 2008, organ transplantation was included once again as a key project in the Eleventh Five-Year National Key Technology Research and Development Program.1780
Since 2011, organ transplantation has been included again in the Twelfth Five-Year National Key Technology Research and Development Program and a number of other national special plans within that Twelfth Five-Year Plan.1781 1782
China’s National Program on Key Basic Research Projects (973 Program) is a foundational research and major development project guided by national strategic demands. It is meant to be progressive, advanced, comprehensive, and to assume a leading role in China’s future development and advancement in scientific technology. Its orientation is to support significant scientific research.1783
The High Technology Research and Development Program (863 Program) aims to address high-tech issues of national long-term development and national security; it is meant to be strategic, cutting-edge, and forward-looking. This program is intended to help develop high technology with independent intellectual property rights, to coordinate the integration and application of high technology, and to develop future emerging industries.1784
Since 2000, these national plans and programs and other national funds have incorporated a large number of projects related to organ transplantation, one of the “comprehensive, leading future emerging industries” that is meant to drive China’s future global development.
The military and central and local governments have invested heavily in domestic medical institutions to carry out basic research and development in the organ transplant field and promote its industrialization. These strategies are illustrated by the following examples:
The largest transplant center in Asia is located in Tianjin. The director of the Oriental Organ Transplant Center of Tianjin First Hospital, Shen Zhongyang (also director of the Institute of Organ Transplantation of the Chinese People’s Armed Police General Hospital), was named the “father of Chinese liver transplantation.” He was appointed as the chief expert of the organ transplant program under the national “863 Program” and an expert in biological and medical technology under the same program. 1785 He claimed that organ transplantation is gospel in medicine and will change the world, that China has 130 million Hepatitis B carriers whose conditions are irreversible, and that the only solution is liver transplantation.
The First Affiliated Hospital of Zhejiang University has the largest transplant center in eastern China. The hepatobiliary and pancreatic surgery center and its affiliated liver transplant center have a team of 134 medical professionals, including Zhen Shusen, a member of the Chinese Academy of Engineering, and nearly 40 senior transplant experts. Among them, 60% have doctoral degrees. The center has 340 beds.
In recent years, the liver transplant center has completed over 40 national projects. Some of the projects have provided over ten million RMB in funding. It took the chief scientific position in leading two projects of the 973 Program: Foundational research in the application of immunological mechanisms of chronic graft dysfunction (2003~2008) and basic research on the application of organ transplantation immunology (2009~2013).1786 In addition, it took the lead in three projects of the 863 Program, three projects under the national Eleventh Five-Year National Key Technology Research and Development Program, and two projects supported by National Natural Science Foundation. Furthermore, the center had a project funded by Changjiang Scholars and Innovative Development Team Program, and another project supported by the Ministry of Health’s Professional Specialization Fund.1787
The Organ Transplant Center of the First Affiliated Hospital of Guangzhou Sun Yat-sen University has engaged in more than 50 research projects, including the national “863 Program “, “Twelfth Five-Year National Key Technology Research and Development Program”, and a National Natural Science Foundation project during three recent years.
The academic leader of the center He Xiaoshun has presided over 17 research projects with funding of more than thirteen million yuan in total. From 1996 to 1998, he only got 80,000 RMB from the National Natural Science Foundation after he had worked in this area for over 10 years. During the seven years from 2001 to 2008, he received research funding of 850,000 RMB, a 10-fold increase from earlier. Since 2008, his team has obtained more projects of amounting to 12 million RMB, a 14-fold increase in 7 years, including a national 863 Program on key technology of organ transplant (2.88 million RMB, from 2012 to 2015). 1788
Liberation Daily, the official newspaper of the People’s Liberation Army, reported in 2004 that the Shanghai Municipal Science and Technology Commission established a major multiple organ transplantation research project in 2002. It invested 8 million RMB in five hospitals to conduct clinical research in heart, liver, and lung transplants. These five hospitals include Zhongshan Hospital of Fudan University, Ruijin Hospital and Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University, Shanghai First People’s Hospital, and Shanghai Lung Hospital. In 2003, the total number of organ transplants in Shanghai was more than 10 times that of 2001, and the hospitals achieved a few “national and even international first” titles in organ transplantation.1789
People’s Daily Online reported in June 2014 that Renji Hospital’s liver transplant center at Shanghai Jiaotong University has become a key clinical specialization of a number of science and health programs under the National Health and Family Planning Commission, National “Project 211,” National Clinical Pharmacology Institute of Organ Transplantation, and the most important clinical key discipline of the Shanghai Health and Family Planning Commission. In recent years, the center received funding for seven projects by the National Natural Science Foundation of China; one project supported by the National Health and Family Planning Commission, a joint research project on major diseases supported by the Shanghai Health and Family Planning Commission, more than ten general programs, and key programs supported by the Shanghai Municipal Science and Technology Commission. The total research funding amounted to over 20 million RMB.1790
We list here a few more organ transplant centers which have embarked on vast projects in recent years and their projects:
Dou Kefeng, the director of the PLA Institute of Organ Transplantation of Xijing Hospital, Affiliated to the Fourth Military Medical University, has taken the lead in the following projects: two sub-projects of national “863 Program”, one project in “Eleventh Five-Year National Key Technology Research and Development Program”, one major project and three projects in the National Natural Science Foundation, one military clinical high-tech major project, the military “Eleventh five-Year scientific and technological research disciplines, three military “2110” projects, and a special military discipline. The total ongoing research project funds reached over 20 million RMB; 1791
Recently, the Institute of Organ Transplantation Research of Xi’an Jiaotong University has taken the lead in 46 national and key department projects, including those under the “973 Program,” the “Eleventh Five-Year National Key Technology Research and Development Program,” “National Natural Science Funds,” and a provincial Key Discipline.1792
The Liver Transplant Center of West China Hospital at Sichuan University is a teaching hospital, as well as a research and development institute. It has undertaken more than 30 projects supported by the National Natural Science Foundation of China, National Education Commission, the “973 Program” of the Ministry of Science, the Eleventh Five-Year National Key Technology Research and Development Program, the Ministry of Health, the Sichuan Province Health Department, and a provincial Key Discipline.1793
The Organ Transplantation Research Institute of Wuhan Tongji Hospital affiliated with Huazhong University of Science and Technology, in the past decade, has undertaken over 30 science and technology research projects, including the national “863 Program “, “973 Program “, major projects funded by the National Natural Science Foundation of China, clinical key projects supported by the Ministry of Health, major projects by Hubei Province Natural Science Foundation, and other research projects commissioned by the Ministry of Health. In recent five years, this institute has published 410 papers, including 78 SCI papers and 11 books.1794
In addition, other prestigious universities and affiliated hospitals, as well as almost all military and civilian medical universities and their affiliated hospitals, are rapidly developing their organ transplant research and receiving a large amount of national funding. These institutions include Tsinghua University, Peking University, Renmin University, Shanghai Tongji University, Wuhan University, Central South University, Jilin University, and Lanzhou University, etc.
These examples reflect that the Chinese Government has made organ transplantation a high priority in its national strategy, and have been stimulating and driving its development.
Involvement of Party Officials in Developing Transplant Hospitals
Many Communist Party and government officials at all levels have supported the hospitals’ transplant activities, by helping to remove the obstacles of development, providing financial aid, or playing a matchmaking role in establishing collaborative relationships between transplant centers. We give a few cases below as examples.
Vice Chairman of Standing Committee of National People’s Congress Guides Establishment of Peking University Organ Transplant Center
In October 2001, the Peking University Organ Transplant Center was established under the guidance of Han Qide, Vice Chairman of the Standing Committee of the National People’s Congress.1795 It incorporated related departments from five medical institutions, including Peking University First Hospital, Peking University People’s Hospital, and Peking University Third Hospital. The center specializes in transplantation of liver, kidney, pancreas, heart, cornea, bone marrow, and other organs. It claims to be the largest and most academically advanced in China, with its liver transplant capabilities in a leading position in the Beijing region. 1796 The Peking University Organ Transplant Center was the predecessor of the Peking University Organ Transplantation Research Institute. In 2013, Zhu Jiye, director of the Institute, revealed to the media that it conducted 4,000 liver and kidney transplants within a particular year. 1797
The First Affiliated Hospital of Nanchang University is the only hospital in Jiangxi Province with an independent organ transplant center. It is also the best equipped in the province. In 1991, this hospital became the first in the province to perform kidney transplants, followed by heart, liver, combined liver-kidney, combined pancreas-kidney, bone marrow, and corneal transplants. Within the first four months since its official opening, the center was able to perform 6 vital-organ transplants in one day.1798
Meng Jianzhu, former Jiangxi Provincial Party Secretary and current Party Secretary of the CCP Central Political and Legal Affairs Committee, has historically supported this hospital’s transplantation activity. He personally played a matchmaking role in establishing a collaborative relationship between this hospital and the Shanghai Organ Transplant Center (Shanghai General Hospital).1799
Since December 2007, Li Hongzhong has sequentially held the roles of governor of Hubei Province and provincial Party Secretary. On February 25, 2014, he attended the “2013 Hubei Province Science and Technology Awards Conference” held in Wuhan. He gave Tongji Hospital a “special award for scientific and technological progress” for its research program in “new technology for combined transplants and treatment of major diseases.” Since then, these capabilities have been propagated to organ transplant centers at ten 3A hospitals in Beijing, Shanghai, Guangzhou, and other regions. 1800
Prior to the above, Li Xiansheng, the Deputy Party Secretary of Wuhan and mayor of Wuhan between April 2002 and December 2007, enthusiastically supported and promoted the city’s development in organ transplantation. In mid-November 2003, after listening to a report by the city’s science and technology bureau, he raised the need to advance the city’s transplantation technical base and facilities.1801
According to a Sina Global News report dated in November 2011, Wuhan, the capital of Hubei Province, is said to be China’s largest organ transplant center. Among its hospitals, Tongji Hospital of Huazhong University of Science & Technology is the best known; it is also one of China’s first and most authoritative hospitals for living kidney transplants. It conducts thousands of kidney transplants each year and has China’s largest pool of kidney recipients.1802
Organ transplantation in Shenzhen grew extremely quickly between June 2003 and November 2007, when Li Hongzhong was the city’s mayor and Party Secretary. In July 2006, authorities in Shenzhen became the first in the country to add heart and liver transplants to local subsidized health insurance programs. This reflects the speed at which the organ transplant industry developed in Shenzhen. 1803
Industrialization of Organ Transplantation
Organ transplantation in China began when Wu Jieping, a member of Chinese Academy of Sciences and Chinese Academy of Engineering, completed the country’s first kidney transplant in March 1960.1804 Kidney transplantation experiments were expanded nationwide in the 1970s. Since 1990, more than 1,000 kidney transplants were being performed each year. By the late 1990s, around 80 kidney transplant facilities had been opened nationwide, each averaging less than 20 annual operations.
According to Zheng Shusen in March 2006, liver transplantation in China went through three stages of development.1805 The 1970s was a period of experimental and clinical exploration: Tongji Hospital in Wuhan and Ruijin Hospital in Shanghai first carried out clinical liver transplants in 1977. Liver transplantation soon peaked before declining and coming to a standstill in the mid-to-late 1980s. It rose to 78 cases between 1990 and 1998, reaching 16 in 1997 and 27 in 1998. The volume then jumped to 115 cases in 1999 before surging. Each facility has also gradually matured in its clinical experience.
Since 2000, a large number of national and military transplantation medical technology research centers and key research laboratories have been established, incubated new transplant technologies, and led the rapid development of the transplant industry. After nearly 40 years of preparation and then relying on a living organ bank, transplantation in China saw a unique explosive growth from sporadic cases to the large-scale transplant industry it has now.
Shen Zhongyang, the director of both Tianjin Oriental Organ Transplant Center and the Liver Transplant Institute of the Armed Police General Hospital, is known as the founder of China’s modern clinical liver transplantation. He is the first in China to establish a multidisciplinary liver transplant standard and procedures. With surgery as the central link, he standardized a process for liver transplantation with multidisciplinary collaboration. As a result, liver transplants have become part of routine clinical practice in China.
According to the 2009 edition of the Tianjin Medical Journal, between January 2004 and August 2008, Shen participated in 1,600 liver graft procurements.1806 The now-standard procedure for excising the liver from a donor lowered the time necessary for the organ to remain at body temperature to under five minutes and reduced the time for procurement operations to thirty minutes.1807
Shen pioneered and improved a variety of liver transplant surgical procedures. He developed an integrated prevention system that reduced the recurrence rate of the hepatitis B virus (HBV) after liver transplants from over 80% to under 5%.1808 This advancement resolved a major obstacle in liver transplantation in China.
He wrote books including Clinical Liver Transplantation, Modern Clinical Liver Transplantation, China Liver Transplantation, and Liver Transplantation Manual to address continuously emerging theories and technologies.
He helped 66 medical facilities in 22 regions to carry out clinical liver transplants, training 200 transplant professional personal and spreading the “pinnacle of transplantation technology.” In July 2006, the center was sponsored by the China Medical Board (CMB, a private foundation based in the U.S.) and became a “National Liver Transplant Training Center.” It has trained 385 doctors, who have become the backbone of organ transplant departments in other hospitals, where huge numbers of transplants are performed on the front lines.
The Third Xiangya Hospital of Central South University is a national research base in central and southern China for transplantation technologies on organ, tissue and cellular levels. The hospital has the capacity to conduct major organ transplants on a large scale and now leads the country in the total number of solid organ transplants performed, including liver, kidney, combined liver-kidney, combined heart-lung, and intestinal transplants.1809 1810
In August 2001, the hospital invested nearly one billion RMB to build the Hunan Transplant Medical Center, including laboratories, laminar flow operating rooms, an ICU ward, and 150 transplantation beds.1811
In 2005, the Transplant Medicine Engineering and Technology Research Center affiliated with the Ministry of Health was officially established in this hospital. Its mission was to build an important national base specializing in clinical transplantation medical research and related industry development. The center also collaborated with the World Health Organization and the International Xenotransplantation Association to develop xenograft international norms (the Changsha Standard). 1812
The center received funding from the National Natural Science Foundation and other key projects in clinical disciplines from the Ministry of Health. The hospital also concentrated manpower, material, and financial resources to industrialize related research results.
The center has carried out liver, kidney, small intestine, spleen, heart, nerve, ovarian, testicular, and multi-organ transplantation. Its clinical work includes transplantation of islet cells, bone tissue, bone marrow, stem cells, liver cells, and spleen cells. The center also cooperated with the Human Disease Genes Research Center of Peking University under the national 863 Program’s Human Genome Study to research immunosuppressant drugs, pharmacogenomics, and its personalized medicine.1813
The hospital experienced tremendous growth. Its new 1,000-bed, 98-metre-tall surgery building became operational on April 9, 2008 and represented 600 million RMB in investment.1814
Spread of Organ Transplantation
The Ministry of Health guides some military and civilian medical institutions with strong technical capability, as well as large organ transplant centers, to conduct clinical teaching and practice, establish technical training bases for transplantation, and promote new transplantation technologies. A large number of transplant doctors have been trained in a short time to meet the rapid growth of China’s transplant industry.
Mobile Heart Transplant Hospital
Zhongshan Hospital of Xiamen University’s Heart Center was established in 2001 and began to operate independently on April 28, 2011.1815 In 2014, it became the Xiamen Cardiovascular Hospital. Its new site has 600 beds.1816
Liao Chongxian, the founder of the heart center, has been named “China’s top person in heart transplantation.”1817 On August 21, 1995, he performed the first heart transplant in Fujian Province and the first pediatric heart transplant and first heart-kidney transplant in China.
Based on his experience in the United States, Liao created the “mobile heart transplant hospital” model and travelled around the country to instruct and personally participate in heart transplants.1818
In 2001, he established the Xiamen Heart Center Cardiovascular Surgery Department at Zhongshan Hospital and started his mobile heart transplant hospital model.1819 Its website says that the department performs heart transplants on a large scale and has helped more than 20 Class 3 Grade A hospitals to perform heart transplants in the past 10 years.
Liao revealed to the media that as of 2004, more than 75 heart transplant recipients had received their transplants from his hospital. 1820
A “New Era” of Lung Transplants
The lung transplant center at Wuxi People’s Hospital claims to be among the top three in the world,1821 and claims to have completed more than half of all lung transplant surgeries in the country.1822 Its founder, Chen Jingyu, is thus renowned as the “No. 1 Lung Transplant Surgeon in China.” As reported in July 2014, Chen’s team often completed four or five lung transplants a day.
He led his team to spread its advanced techniques to more than thirty 3A hospitals in more than ten cities and provinces, including Beijing, Guangzhou, Nanjing, Hangzhou, Wuhan, and Jilin.1823 A new era of lung transplantation in China has begun, and Chen’s team has filled in many gaps in this area.1824
Spreading Advances in Liver Transplantation
Zheng Shusen served as the academic lead of the transplant center at the First Affiliated Hospital of Medical School of Zhejiang University. He was one of the pioneers of liver and multi-organ transplantation. The hospital has helped develop transplantation at Peking Union Medical College Hospital, Huashan Hospital of Fudan University, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, the First Affiliated Hospital of Xinjiang Medical University, Zhongshan Hospital of Xiamen University, and other institutions.
It has also established remote diagnostic systems with the First Hospital of Zhejiang Province and other hospitals in Zhejiang, Fujian, Guizhou, Xinjiang, and other areas. Its transplant capabilities radiate to more than 20 provinces and cities in China and have propelled the development of the country’s organ transplant industry.
Zheng was among the first in China to use a non-venous bypass technique to reduce bleeding, transfusions, surgery time, ICU time, and cost. His award-winning innovations in liver and multi-organ transplants have been put into use all over the country.1825
Building a Remote Medical Network Through Military Satellites
No. 181 Hospital of Guangzhou Military Command serves as the organ transplant center for Guangzhou Military Command. It has a number of PLA medical centers, clinical bases, research institutes, and key specialties under the Guangzhou Military Command.
In early 2005, it spent 250,000 RMB to build a remote medical network through military satellites, connecting over 200 military hospitals and more than 1,000 experts. This remote treatment model provides patients with a platform for accessing high-end medical resources.1826
Its PLA Kidney Transplant Center performed 8 transplant surgeries on December 30, 2012, including heart, lung, kidney, liver, corneal, and islet cell transplants. Although this hospital is not qualified to conduct heart transplants, conducted experiments and clinical research in heart transplantation using a “partially continuous beating technique”, a technique that is internationally advanced and has been applied in other hospitals.1827
On August 12, 2003, the Xiamen Evening News published a report titled “New Breakthrough at Xiamen First Hospital: Two Liver Transplants in One Day:” In the morning of August 12, the hospital simultaneously completed liver transplants for two patients. Li Bin, director of the vascular hepatopancreatobiliary surgery department, revealed that if there are sufficient organ sources and recipients, they can perform three liver transplants in one day. However, the fact that the First Xiamen hospital’s newly detached vascular hepatobiliary surgery department can perform three liver transplants per day was beyond one’s expectation.
How had they achieved that? The hospital obtained two donors at the same time from the largest organ transplant center in eastern China–the affiliated hospital of Zhejiang University. It also received technical support from academician Zheng Shusen. According to the report, the department had reached an organ sourcing and technology sharing agreement with the affiliated hospital of Zhejiang University. The affiliated Zhejiang hospital has a nationwide system of organ sources and basic research in key laboratories, both of which could be borrowed by the First Xiamen hospital.1828
The First People’s Hospital of Yueyang collaborated with Tongji Hospital and many other hospitals to provide remote consultation for patients with complicated diseases. Meanwhile, the hospital has set up an organ information sharing network with many hospitals inside and outside the province, enabling the sharing of organ resources and complementing of transplant capabilities. 1829
Similarly, Rui Jin Hospital in Shanghai has equipped its transplantation pathology laboratory with a remote consultation system connected to the University of Pittsburgh Thomas E. Starzl Transplantation Institute, enhancing the diagnosis of difficult cases.1830
The Second Hospital of Dalian Medical University collaborated with the Hepatobiliary and Pancreatic (HPB) Surgery Department of the First Affiliated Hospital of Zhejiang Medical University to conduct remote medical consultation. It established a communication platform with University of Heidelberg in Germany to further develop the discipline.1831
A media report in 2005 stated that the Second Xiangya Hospital of Central South University’s “…donor organ network has gradually extended to the north and south, and has established resource sharing relationships with more than 10 domestic organ transplant centers.”1832
We found that many leading institutions have been selected by the Ministry of Health to train a large number of transplant specialists for hospitals nationwide, allowing the industry’s work force to better keep up with demand.
In June 2006, Huang Jiefu cooperated with the China Medical Board (CMB) in New York to provide one million USD to assist in the establishment of transplant standard and registration systems, domestic laws and regulations regarding transplantation in China, strengthening professional training, and expanding liver transplant-related research achievements. The project established three liver transplant training centers in China, at the Peking Union Medical College Hospital, the First Affiliated Hospital of Sun Yat-sen University, and Tianjin First Center Hospital.1833
Two doctors from the Department of Kidney Transplantation at Nanfang Hospital of Guangzhou’s First Military Medical University wrote in a published paper, Experience of Guiding Graduate Internship in renal transplant clinical work, in November 2003:
“With the growing number of kidney transplants in recent years, our department attracted many young military and civilian medical students attending Master’s and Doctoral programs in renal transplantation. These intern students stayed with our department for 6 to 8 months … Donor nephrectomy technique is an important part of kidney transplantation … the requirement is to minimize warm ischemia time, to avoid damage during excision in complicated environments…Graduate students increasingly participated in nephrectomies under the guidance of teachers … from initially inexperienced in renal transplant to the end of the internship, these students became more skilled specialists in renal transplantation. Most graduates are assigned to various work units after training, where they become the backbone of their renal transplantation teams.”1834
On these hospitals’ websites, a large number of young “associate experts” claim to have “skilled donor organ excision techniques and rich experience in handling donor organs.”
The Department of Hepatobiliary Surgery at Southwest Hospital, which is affiliated with the Third Military Medical University, was the first major liver transplant laboratory and transplant center in the military. With world-class equipment and many functional laboratories, it is one of the largest hepatobiliary and pancreatic surgery departments, both domestically and internationally. It guided 21 medical institutions to carry out liver transplants in Jiangsu, Shandong, Guangdong, Shaanxi, Henan, Yunnan, Sichuan, Xinjiang, Guizhou, Fujian provinces, etc. It has graduated 50 PhD students, 75 Master’s students, and 762 internship doctors in the major of Hepatopancreaticobiliary Surgery. These graduates have become the backbone and academic leaders in their facilities all over the country and in the military. 1835
The First Affiliated Hospital of Zhejiang University has a multi-organ transplantation research laboratory under the Ministry of Health. It claims to be the largest transplant center in the east of China and one of largest transplant centers in the whole country. It assisted Peking Union Medical College Hospital, Huashan Hospital of Fudan University, First Affiliated Hospital of Xinjiang Medical University, and other domestic and international hospitals in carrying out liver transplants, and extending technical support to more than 20 provinces and cities nationwide.1836
The organ transplantation center of the First Affiliated Hospital of Sun Yat-sen University claimed to offer the most variety of transplants nationwide and is among the top in transplant volume.1837 The hospital performed China’s first successful kidney transplant in 1972. Since Huang Jiefu in 1993 successfully implemented China’s first liver transplant in vitro blood bypass, the hospital is known as the birthplace of the second peak in China’s liver transplantation. In 2006, this center was approved by the Ministry of Health as a national kidney transplant technical training base. It has also become one of the three largest liver transplantation training centers sponsored by the China Medical Board (a private foundation based in the U.S.).
“The Institute of Organ Transplantation Research at Xi’an Jiaotong University is one of the largest transplant centers in the country and includes all functions of medicine, teaching, and research. Its researchers include 9 professors in their doctoral program, and has trained 85 PhD graduates, and 156 Master’s degree holders.”1838
In 2003, it incorporated with Terasaki laboratory of the United States and jointly established the Organ Transplants Tissue Typing Technology Training Center in Northwest China. By December 2012, this center had guided more than 10,000 kidney transplants for 23 hospitals in 13 provinces. It guided other hospitals in liver, kidney, heart, lung, and small intestine transplants in western China.1839 It trained more than 500 medical professionals for other domestic institutions, with some of them having become academic leaders. Since 2000, this center has held annual programs for continued education in kidney transplantation, with students from large general hospitals from 14 provinces and autonomous regions. “After learning from this program, the students started or carried out a greater number of high quality clinical kidney transplants and achieved a remarkable degree of continuing medical education.
IV. KEY TECHNOLOGY RESEARCH AND DEVELOPMENT
Unccessful research and trials that proved the feasibility of transplant technology were followed by a nationwide effort to make the technology readily accessible throughout China.
In the past decade, these hospitals and individuals have achieved many innovations that enabled the growth of the transplant industry and made it possible to achieve its present-day scale. These achievements include lower rejection rates, shortened operation times, increased collaboration, and other advances.
Reducing Rejection Responses
According to Chinese state media, former president Jiang Zemin has met Wu Mengchao, “the father of Chinese hepatobiliary surgery,” four times. 1840 Wu is the president of the Eastern Hepatobiliary Hospital of the Second Military Medical University and the chief advisor of the PLA Organ Transplant Conference. At a special ceremony held by the Central Military Commission, Jiang personally conferred upon Wu the honor of “Leading Model Medical Expert” and awarded him a “First-Class Heroes Medal.”
In 2005, Wu Mengchao was given the 2005 Annual National Supreme Science and Technology Award for solving several key issues surrounding rejection of liver transplants.1841 On January 17, 2006, Sun Dafa, political commissar of the People’s Liberation Army General Logistics Department, awarded Wu a prize of 1 million RMB.1842
As of 2010, among his 14,000+ liver surgeries, Wu had performed at least 9,300 tumor removals,1843 while the remaining 4,000+ were unaccounted for and likely to be transplant cases. As of April 2011, even at the age of 89, he continued to perform 200 surgeries per year. 1844
On October 10, 2011, the Central Propaganda Ministry, the Ministry of Health, the General Political Department, the People’s Liberation Army General Logistics Department, and the Shanghai Municipal Committee jointly held a report session on “Wu Mengchao’s chronology of achievements” in the Great Hall of the People. Those in attendance included Xu Caihou (former Vice Chairman of CCP Central Military Commission), Li Jinai (then-director of the General Political Department), and Liao Xilong (director of People’s Liberation Army General Logistics Department).1845
Shi Bingyi, from People’s Liberation Army No. 309 Hospital and director of its PLA Organ Transplantation Research Institute, also established an early warning system and a non-invasive diagnostic system for rejection responses. It has become an important method of diagnosing acute rejection responses and established a low-dosage immunosuppressive system and a method integrating Chinese medicine to prevent and treat rejection responses.1846
When interviewed by Xinhua in February 2012, Shi Bingyi said that the most important issue concerning transplants is preserving the organ’s function and long-term survival. He explained, “There are two ways: one is a stem cell transplant; another is to improve the regulation of the immune system, such as T cells. The latter has a good effect on the long-term survival of transplanted organs and immune tolerance. This is one of world’s leading technological research topics that we’re carrying on in our center.” 1847
Many other transplant hospitals have also explored this field.
Beijing Anzhen Hospital performed the world’s first four combined heart, bone marrow, and stem cell transplants as an innovation in the knowledge and techniques of improving immune tolerance. Heart recipients experienced lower rejection rates while maintaining resistance against viruses and bacteria. Thus, lesser quantities of immunological drugs were needed. This result can potentially be extended to the fields of lung and other actual organ transplants.1848
The kidney transplant department at the First Affiliated Hospital of Henan University of Traditional Chinese Medicine combines traditional Chinese and Western treatment methods to minimize the incidence of chronic allograft nephropathy to a large extent. Its advanced follow-up system improves long-term graft survival.1849
Fujian Medical University Union Hospital has recently made breakthroughs in immunosuppressive treatments and post-operative management. Its heart transplant recipients are able to walk within one to two days after surgery, leave the isolation ward after two weeks, and be discharged within two to three weeks, fully recovered. 1850
With the rapid development of organ transplantation, China’s market in immunosuppressants has seen unprecedented growth. Our investigation of the over 160 transplant hospitals showed that the Government has incorporated organ transplantation into its national strategy. Below are examples of national programs that fund key research and development projects in transplantation technology and immunosuppressants:
- National High-Tech R&D Program of China (863 Program)
- National Program on Key Basic Research Project of China (973 Program)
- National Key Technology Research and Development Program
- National Natural Science Foundation of China (NSFC)
- “985 Project” (aims to build world-class universities)
- “211 Project” (aims to raise the research standards of 100 high-level universities)
These programs and funded projects have achieved fruitful results. For example, Li Leishi, an academician at the Chinese Academy of Engineering and director of the Institute of Nephrology Research at Nanjing Military General Hospital, found that Triptolide (monomer), the herbal extract of Tripterygium, has a distinct immunosuppression effect. His discovery has achieved positive outcomes for the treatment of acute rejection responses following kidney transplants.1851
The research was conducted by Li Yantang and his student Qian Yeyong, using Chinese medicine’s Tripterygium Glycosides as an anti-rejection drug for kidney transplants. Li is the director of the Division of Urology at the People’s Liberation Army General Hospital and has received support from the National Natural Science Foundation.1852 Qian Yeyong was the first to succeed in using this drug as an immunosuppressant for clinical organ transplantation.1853
More examples include:
- “A novel immunosuppressant Fingolimod: research advances” 1854 and “Research advances in the application of immunosuppressant in organ transplantation” published by the Institute of Basic Medical Sciences, Academy of Military Medical Sciences1855
- a project on research and development of organ transplant immunosuppressant series products undertaken by the Lunan Pharmaceutical Group
- research in immunosuppressant withdrawal after liver transplantation by the Guangdong Provincial Organ Transplant Center, Sun Yat-sen University Institute of Organ Transplantation1856
- studies in basic immunology for organ transplantation conducted by the Fudan University Organ Transplant Center1857
Ample funding promoted the rapid development of domestic immunosuppressant drugs. By 2004, domestic drugs began to catch up and shared almost half of the market with imported and joint-stock drugs. This development greatly lowered the cost of immunosuppressants and lifted a barrier for many patients who otherwise could not afford to receive organ transplants. It thereby contributed to a rapid growth in transplant volume in China before 2004. 1858
The first domestic immunosuppressant was Ciclosporin made by the North China Pharmaceutical Group. In 2004, Professor Zhang Yuhai, director of the Urology Department of the Beijing Friendship Hospital, said that over half of kidney transplant patients chose to use domestic immunosuppressants, including not only self-funded patients but also many with free medical service or insurance.1859
The 2011 China Science and Technology Development Report published by the Ministry of Science and Technology claimed in its section on the prevention of major diseases and practical health technology that the completion of a pilot production demonstration base for a series of immunosuppressive drugs and active pharmaceutical ingredients and preparations. It said that this has improved China’s research, development, and production capacity for immunosuppressive drugs. Domestically produced immunosuppressants reduce medical costs for transplant recipients and are exported to bring profit and enhance international competitiveness for China’s transplant immunosuppressant industry.1860
According to data from the Southern Medical Economic Institute, domestic immunosuppressants had grown into a $10 billion RMB market by 2006.1861 The market grew by an average of 13% every year between 2008 and 2014.1862
As the patents of several major imported drugs expired, China began to produce a large volume of imitation products in addition to domestically developed drugs. These producers have achieved the same efficacy as imported immunosuppressants but at much lower prices. This increased the market share of domestic drugs. Major producers include Huadong Medicine Co., Ltd, North China Pharmaceutical Group Corporation, and Zhejiang Hisun Pharmaceutical Co., Ltd.1863
Improved Organ Matching
Professor Tan Jianmin at Fuzhou General Hospital of Nanjing Military Command pioneered HLA and amino acid residue matching technology in China, enabling donors and recipients to be genetically matched before transplantation and significantly improving transplant quality. He won second prize of the 2001 National Science and Technology Advancement Award.1864
Tan also established an anti-HLA antibody screening method, significantly reducing acute rejection responses. This technique has since been applied all over the country; Fuzhou General Hospital has established collaborative relationships more than 100 hospitals in 19 provinces and cities and organ sharing relationships with 15 transplant centers.
The Second Hospital of Shandong University started researching DNA microarray tissue matching technology in 2003, achieving strict gene pairing between donor and recipient prior to transplantation. As a result, its transplant quality has increased substantially.
Prolonged Organ Preservation
Among hundreds of transplant-related patents in China, about half are related to anti-rejection drugs and organ preservation solutions.
Shanghai Changzheng Hospital of the Second Military Medical University was one of the first in China to perform kidney transplants. Zhu and his team completed research on kidney and multi-organ preservation solutions. After 20 years of clinical application, this product is propelling China to the forefront in the field internationally.1865 An archived webpage of Changzheng Hospital stated, “98% of hospitals in China use the organ preservation solution we developed.” 1866
In addition to military institutions, civilian medical universities and hospitals are also involved in these areas. We give some examples:
The Organ Transplantation Institute of China Medical University has also taken part in the Research and Development of organ preservation solutions; a kidney preservation solution they developed leads in the domestic market.1867
Zhongshan Hospital of Shanghai Fudan University’s heart surgery department, which claims to account for approximately half of all heart transplants in China, innovated in the field of heart preservation technology and set a record for safely preserving a heart for 10 hours. It has developed a complete set of standard procedures for heart transplantation. All of its heart transplant patients achieve ambulation within 3 days. It also presides over China’s heart transplantation access ordinance. 1868
Chen Jingyu, the director of the lung transplant center at Wuxi People’s Hospital, developed pulmonary perfusion preservation solutions, which prolong lung retention time from four to six hours to nearly eight hours, reaching an internationally advanced level and taking the lead in China.1869
Transplant centers have also developed alternative solutions for prolonging organ life.
For example, the No. 181 Hospital of Guangzhou Military Command, in collaboration with cardiothoracic experts from the People’s Hospital of Guangxi, conducted experiments and clinical research in heart transplantation using a partially continuous beating technique (extending the heartbeat while excising the heart from the donor, in order to keep the organ fresh for a longer period of time).1870 This technique is advanced internationally and has been applied in other hospitals.1871
Shortened Operation and Hospitalization Durations
At No. 107 Hospital of Jinan Military Command, deputy director Du Yingdong of the liver transplant center claimed, “Over 10 years ago, it took us over 10 hours to complete a liver transplant surgery. Now our technology has matured, and a liver transplant only takes 4 to 5 hours. Sometimes, 3 to 4 surgeries can be completed in one day. The speed of development has caught up to that of high-speed rail.”1872 In April 2012, the hospital opened a new ward building, increasing its bed count from 600 to over 1,000.1873
Shen Zhongyang, the director of Tianjin Oriental Organ Transplant Center, set a world record for the fastest liver transplant surgery in 2003, taking 2 hours and 4 minutes between making the incision and closing the abdomen. No blood transfusions were used during the operation. The previous record was 3 hours.1874
Zhongshan Hospital of Shanghai Fudan University performed its first liver transplant in 1978. Since 2001, liver transplantation at this hospital has seen rapid development, with increased variety, more innovations, shorter operating times (4 to 6 hours on average), less bleeding, and fewer complications. Some patients are discharged 9 days after their operation. Transplant recipients extend from patients of liver cancer to other end-stage liver diseases. The hospital’s quantity and success rate of liver transplantation lead both the Shanghai region and the country.1875 Its liver surgery department recently started immediate outpatient follow-up treatments with its liver transplant patients, such that a patient receives their operation immediately after an exam and hospital admission, accelerating the treatment cycle. It has attracted patients from more than 10 countries and regions, including the U.S., U.K., Japan, Canada, South Korea, Hong Kong, Macau, and Taiwan. Even with a conservative two-week hospitalization period, its annual surgery volume can reach 5,000.
At Beijing YouAn Hospital, patients who recover quickly from liver transplants can be discharged in two weeks.1876
Fuwai Cardiovascular Disease Hospital’s website states that it has refined a set of conventions for heart transplantation. Most patients successfully recover after surgery, can begin walking after 2~3 days, and can be discharged after 2~3 weeks.1877
In 2002, Shanghai Zhongshan Hospital eliminated the need for blood transfusions in one-third of its liver transplant surgeries. The entire operation time has been reduced to four and a half hours, and the lowest cost was 142,000 RMB.1878
Shanghai Changzheng Hospital’s liver surgery department adopted an inferior vena cava (IVC) graft procedure on the basis of its traditional and piggyback liver transplants, reducing its surgery duration from 9 hours to 5 hours.1879
The Third Affiliated Hospital of Sun Yat-sen University established a procedure for in vitro blood bypass orthotopic liver transplants to overcome limitations in piggyback liver transplants. The simplified procedure reduced anhepatic time to 20-40 minutes, the shortest reported in China. The hospital received a second-prize national science and technology advancement award for this procedure.1880
1716 Dilemma and Resolution Strategy for Sources of Liver Transplantation in China
Journal of Medicine and Philosophy May 2010, Volume 31, No. 5
Authors: Puchao Yu, Chen Hong, Armed Police General Hospital
《我国肝移植肝源的困局及其化解方略》- 作者：武警总医院 蒲朝煜，陈虹
1717 China liver transplant Situation and outlook
Source:wjgnet.com, dated:2006-04-108, author: Chen Zhishui
陈知水：中国肝癌肝移植的现状与展望 《世界华人消化杂志》 2006-04-8
1718 China liver transplant Situation and Challenges
Surgical Rennovtion Forum Net 2015-08-13
郑树森：中国肝移植现状与挑战 来源：外科創新論壇網 2015-08-13
1719 “Gentlemen accumulate knowledge through studying, but hands-on experience is fundamental”
High Level Feast of Transplantation in China
Source: The First Affiliated Hospital, Zhejiang University August 11th , 2015
《“学以聚，行为本” 中国“移植”路上的高端盛宴》 【发布时间： 2015-08-11】 浙大附一院
1720 Hangzhou Standard of Liver Transplantation
Today Morning Express January 14, 2009
《肝移植有了“杭州标准”》 [日期：2009-01-14] 【来源：今日早报】
1721 Winner of the State Science and Technology Prizes: Fan Jia Established the Shanghai Fudan Standard for Liver Transplant
Source: CancerGuangdong Science Center January 22nd, 2013
《国家科技奖获得者樊嘉:建立肝癌”上海复旦标准”》 【时间：2013年1月22日】 来源：广东科技中心
1722 Source: China Youth Daily July 18th , 2010
1723 “Rainbow Club” for liver transplant recipients was established in the Armed Police General Hospital
Source: Armed Police General Hospital dated: 2005-09-05
肝移植受者“彩虹俱乐部” 在武警总医院成立 日期：2005-09-05 来源：武警总医院
1724 SPECIALARTICLE: The Global Burden of Liver Disease: The Major Impact of China
Source: Hepatology, the official Journal of the American Association for the study of Liver Discease
Authors: Fu-Sheng Wang, Jian-Gao Fan, etc. Dated: December, 2014
1725 Aproximately 500,000 Patients on Waiting List for Kidney Transplant Every Year in China, Only 5,000 Wishes Fulfilled
Source: China News Service, Dated:June 5, 2004
《中国每年约50万患者等待肾移植 仅5000名如愿》 中新社2004年6月5日
1726 Solution to the gap between the supply and demand of human organs Source: news.163.com
1727 The Union Hospital “reinstalled” 4 hearts within 22 minutes, Wuhan Evening, June 25, 2013
协和医院22分钟内“重装”4颗心 武汉晚报， 2015年6月25日
1728 The Long Wait for a Transplant The World Transplant Games Federation
1729 Earnest Aspiration? First Eye Bank Alliance in China Almost Certain china.com June 3, 2014
望眼欲穿?全国首个眼库联盟呼之欲出 《中华网》 2014-06-03
1730 Corneal Donations Severely Inadequate
Source: People’s Daily June 7, 2012
角膜捐献严重不足《 人民日报 》2012年06月07日
1731. “Privatization and Its Discontents – The Evolving Chinese Health Care System”
David Blumenthal, M.D., M.P.P., and William Hsiao, Ph.D. N Engl J Med 2005;
353:1165‑1170 September 15, 2005 DOI: 10.1056/NEJMhpr051133
1732 “Implementation of the International Covenant on Economic Social and Cultural Rights in the People’s Republic of China”, April 14, 2005, paragraph 69, page 24.
1733 The Organ Transplant Center of People’s Liberation Army No. 309 Hospital
1734 The Fall of Zhou Yongkang Broke the Trade Chain of organs from executed prisoners
WorldJournal.com March 17, 2015
周永康落馬 摧毀死囚器官交易鏈 世界新闻网 March 17, 2015
1735 The Difficulty of Legislation in Organ Transplantation Life Week，2006 Issue 13 / April 17, 2006 Guo Na
器官移植立法之难 三联生活周刊2006年第13期 作者：郭娜 2006-04-17
1736 Standardization of Human Organ Transplantation
Beijing Public Health Information Online October 26th, 2007
《北京公共卫生信息网》 人体器官移植亟待规范 时间：2007-10-26
1738 Published Price List from China’s International Transplantation Network
1739 China will officially launch organ transplant organ allocation and follow three major principles Xinhua News Agency
1740 The Maze of Organ Donation
Source: infzm.com / Southern Weekend March 26th , 2010
器官捐献迷宫 《南方周末》 2010年3月26日
1741 Military Doctor Discloses the CCP’s Official Process of Stealing and Selling Falun Gong Organs
Source: The Epoch Times
1742 General Logistics Department of People’s Liberation Army is the core of organ harvesting mechanism
Minghui Net, author: Jun Chen, Dated: November 11, 2009
解放军总后勤部是活摘器官的核心机构（图） 明慧网 作者：甄钧 2009年11月11日
1743 Strategies and Consideration for Organ Transplantation and Brain Death Legislation in Mainland China
Chinese Journal of Evidence-Based Medicine, 2009 Vol. 9, Issue 4, p.400-407 Publisher: Rao Wei
1744 The continuation of wonderfulness of life through organ transplant
器官移植 延续生命的精彩 2003-7-28 文章来源：大众网－齐鲁晚报
1745 Labor Camps and Detention Centers Around Expose Shady Deal-Organ Plotting
《各地劳教所看守所黑幕曝光（图谋器官）》 【明慧网】Apr 18, 2006
1746 The medical specialties of Changhai Hospital: kidney transplant
1747 Changde City First People’s Hospital – Urology Surgery Department – 2nd Ward – specialist – Zhou Jianhui
1748 Investigation Leads: Waiting Time for Matched Organs Still Very Short in China
1749 The difficult rebirth of a kidney transplant acceptor
换肾人的艰难重生 《 健康时报 》 记者 刘子晨（2015年11月16日
1750 Liver Transplant Surgery Self-Lowers “Social Status”,
Source: Chutian Metropolis Daily, Dated: August 14, 2001
1751 Wuhan Liver Transplantation created the low price record
1752 Liver transplant hospitals Introduction: Peking University First Hospital – Surgical Department – liver transplant
Source: GoodDoctor.com Dated: Feburary 25, 2009
介绍一些肝移植医院 – 北京大学第一医院外科 – 肝脏移植简介 来源： 好医生 2009年02月25日
1753 Exclusive Interview: Professor Lu Shichun talking about liver transplantation
1754 Department of Gallbladder Surgery at Union Hospital of Tongji Medical College of Huazhong University of Science & Technology, Source: Union Hospital of Tongji Medical College of Huazhong University of Science & Technology
1755 Transplant cost- The Fu Wai Cardiovascular Disease Center
1756 The Lung Transplant Center of Shanghai Chest Hospital
1758 Appendix 5. The Recipient Experience
BLOODY HARVEST— Revised Report into Allegations of Organ Harvesting of Falun Gong Practitioners in China
by David Matas, Esq. and Hon. David Kilgour, Esq., 31 January 2007
1759 ‘Japanese Flock to China for Organ Transplants’, The Asia-Pacific Journal, Japan Focus-Clifford Coonan, David McNeill, Vol. 4, Issue 4, No. 0, April 2, 2006,
1760 ‘Japanese Flock to China for Organ Transplants’, The Asia-Pacific Journal, Japan Focus-Clifford Coonan, David McNeill, Vol. 4, Issue 4, No. 0, April 2, 2006,
1761 Liver Transplantation took 4 hours, Tongji Hospital created national record low price
4小时换个肝费用跌破15万 同济医院创全国纪录 2002-12-20 作者：田巧萍 文章来源：武汉晚报
1762 Shanghai Transplantation technology at leading level all over the world
上海器官移植多项技术居世界领先地位 2003-2-2 文章来源：新华网
1763 Shanghai Transplantation technology at leading level all over the world
肝移植如果四处“开花” 更新时间：2003-2-7 作者：金永红 文章来源：健康报
1764 Jiangsu Pronvince People’s Hospital makes liver transplantation “big”
江苏省人民医院肝移植做“大”了 2003-7-5 文章来源：扬子晚报
新生后的沉重：肝移植成功却申请安乐死 更新时间：2004-12-3 文章来源：健康报
无力承担术后昂贵费用 肝移植大学生面临停药 更新时间：2004-11-12 文章来源：沈阳晚报
解读卫生部严限为外国人实施器官移植背后 2009-2-6 作者：姚忆江 徐 文章来源：南方周末
1768 Hubei Ranked the Country’s Second Place in Organ Donation Amount Experts called for incorporating
Organ Transplantation into Health Insurance Source: Sports Network Dated: August 8, 2015
湖北器官捐献量全国第二 专家呼吁器官移植纳入大病医保 来源：荆楚网 2015-08-08
1769 Huang Jiefu recalled for the first time to participate in transplant organs from executed prisoners,
disclose the truth, supported by CCP Central Committee
Source: Phoenix TV January 12th, 2015
《凤凰卫视》：黄洁夫回忆首次参与死囚器官移植披露真相, 获中央支持 2015年1月12日
1770 Legal Loophole Facilitates Market for Human Kidneys, Illegal Sales Rampant in Shanghai Source: Xin’an Evening News
上海非法卖肾猖獗 法律漏洞“成就”卖肾市场 来源：新浪网
1771 Prevention and treatment of hepatitis B and liver cancer – Interview to Dong Jiahong reprint of Xinhua.Net
乙肝和肝癌的防治-董家鸿访谈 清华长庚医院肝胆胰外科网页 转自新华网
1773 Brief Introduction of the Organ Transplantation Center of the No. 309 Hospital of the People’s Liberation Army 2010-11-17
1774 Changes of Daping Hospital During 30 years: Annual Income Increased from A Few Million to 900 Million
Source: xyxy.net Dated: May 11, 2009
从年收入百万到9个亿 看大坪医院30年变迁 《寻医问药网》 2009年5月11日
1775 11 Kidney Transplants in One Day at Second People’s Hospital of Shanxi Province on August 15 (2006) Minghui.net
1776 Five-Year Plan – China Internet Information Center china.com.cn
1777 Five-year plans of China
1778 The notice on the Ministry of Health issued health Tenth Five-Year Plan
Source: 110.com, source: The Ministry of Health, Dated: 2001-07-23， Status: valid
卫生部关于印发卫生事业第十个五年计划纲要的通知 法律法规网/来源：卫生部 状态:有效 发布日期:2001-07-23
1779 The Tenth Five-Year Plan on Chinese Health Technology Development and 2010 Vision Plan
The National Health and Family Planning Commission of the People’s Republic of China 2004-06-03
中国卫生科技发展第十个五年计划及2010年远景规划纲要 中华人民共和国国家卫生和计划生育委员会 2004-06-03
1780 Ministry of Health issued the National Key Technology Research and Development Program of the Eleventh Five-Year Plan to support four projects Guidelines for application
1781 Meeting Minutes on the 12th Five-year Plan Strategy Study Workshop – National High-tech R&D Program of China (863 Program) on StemCells and Tissue Engineering
863计划干细胞与组织工程 – “十二五”战略研讨会会议纪要
1782 The project start meeting of 863 Program on the field of biology and modern medical was held in Beijing 2012-07-31
1783 National Key Basic Research and Development Program (973 Program).
1784 National High Technology Research and Development Program (863 Program).
1787 Liver Transplantation Innovation Team of the First Affiliated Hospital of Zhejiang University
Science Technology Department of Zhejiang Province
1788 Introduction of He Xiaoshun
Source: Good Doctors Online
1789 Organ Transplantation Techniques in Shanghai Have Great Value, Last Year’s Transplant Quantity Near 1,000 cases ,
Source: Liberation Daily Dated: February 24, 2004
1790 Xia Qiang’s Model Achievements
Source: Health and Hygiene Channel of People’s Daily Online 2014-06-09
1791 Dou Kefeng: Open and Sincere
Science and Technology Digest March 18, 2014 Hou Jie
窦科峰：披肝沥胆献真情 《科技文摘报》 March 18, 2014 侯洁
1792 Introduction of Department of Kidney Transplantation, Xi’an Jiaotong University
西安交通大学附一院 – 肾移植科科室简介
1793 Introduction of Liver Transplantation Center of West China Hospital of Sichuan University
1794 Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology – Department of Organ Transplantation
1795 Peking University People’s Hospital Undertakes Second Human Organ Procurement Organization Training
and Human Organ Transplantation Policy Training Conference
Source: Peking University Health Science Center Information Weekly, 2013, Issue 21, December 3, 2013.
1796 Peking University Organ Transplant Center was established
Source: PeopleNet, BioSino.org dated: October 10, 2001
北大器官移植中心成立 中国生物信息网/来源：人民网 日期：2001年10月10日
1797 Sharing System Moves Chinese Organ Transplantation into the Public Welfare Era
Source: China Economic Weekly, 2013, Issue 34 Athor: Liu, Yanqing
共享系统推动中国器官移植进入公益化时代 来源：《中国经济周刊》2013年第34期 作者： 刘砚青
1798 The First Affiliated Hospital of Nanchang University Department of Organ Transplantation
1799 The First Affiliated Hospital of Nanchang University Department of Organ Transplantation
1800 Science and Technology Awards Conference Highlights Creative Force in Hubei
China Economic News. February 26, 2014.
1801 Wuhan Municipal Government to Open Entrepreneurial Employment Opportunities
Eastday.com November 20, 2003.
1802 Kidney Harvesting Gang Runs Wild in Wuhan, Female University Student Killed and Dumped,
Family Members of Victims Beaten While Appealing to College
Source: SINA Global News November 30, 2011
割肾党横行武汉 女大学生遇害弃尸 家属大学请愿被殴 《新浪全球新闻》 2011年11月30日
1803 “Shenzhen Cancer Patient Enjoyed Health Insured in Guangzhou,”
Source: Shenzhen Jing News, Edition. July 21, 2006.
深圳参保肿瘤患者广州看病可享医保 来源：深圳晶报 2006年07月21日
1805 China Education and Research Network – Introduction of Zheng Shuseng
1806 Precautions and Related Issues Analysis of Quick Liver Extraction Tianjin Medical Journal p.793-794, Issue 9,
Volume 37, 2009 Cheng Litian, Shen Zhongyang, Zhu Zhijun, Zheng Hong, Deng Yonglin, Pan Cheng, Zang Yunjin
224-5 “供肝快速切取术中应注意的相关问题分析”《天津医药》2009年37卷09期 793-794页
作者：陈立天, 沈中阳, 朱志军, 郑虹, 邓永林, 潘澄, 臧运金
1807 Shen Zhongyang Source: Ho Leung Ho Lee Foundation
1808 Shen Zhongyang – Ho Leung Ho Lee Foundation
1809 Introduction to the Specialist Transplantation Department of the Third Xiangya Hospital, Central South University
1810 Introduction of Xiangya Organ Transplant Institute of Central South University
1816 Brief Introduction to Xiamen Cardiovascular Hospital
1817 Introduction to Renowned cardiovascular surgeon – Professor Liao Chongxian
Source: China Review Academic Publishers Limited
1818 Cardiovascular Surgeon Liao Chongxian’s successful story in heart and combined transplantation
Source: China Review Academic Publishers Limited
1820 The Famous Cardiovascular Surgeon and Organ Transplant Specialists – Liao Chongxian
Source: Chongqing Liao Clan
1821 Chen Jingyu: Ten Years of Tempering Creates a Mythic Story in Transplant Field, Healthcare Media
1822 Brief Introduction to the Diagnostic and Treatment Center for Lung Transplant Treatment at Wuxi People’s Hospital
1823 Chen Jingyu: Ten Years of Tempering Creates a Mythic Story in Transplant Field, Healthcare Media
1824 Brief Introduction to the Diagnostic and Treatment Center for Lung Transplant Treatment at Wuxi People’s Hospital
1826 Introduction to People’s Liberation Army No. 181 Hospital
1827 The Project of Experimental and Clinical Application Research of Heart Transplantation Reached the International Advanced Level
1828 Xiamen First Hospital Breakthrough: two cases of liver transplantation in one day
厦门第一医院新突破:一天两例肝移植 来源：厦门晚报 2003-8-12
1829 Brief Introduction to The Organ Transplant Department at the First People’s Hospital of YueYang alyisheng.com
1830 “Rui Jin Hospital (Organ Transplant Center).” Guangdong Province Medical and Health Information Site.
1831 The Second Hospital of Dalian Medical University carried out deep cooperation, speed up diversified development
Source: official web site of the Second Hospital of Dalian Medical University, Oct. 31st, 2012
大医二院开展深度合作，提速多元化发展 来源： 大医二院文化建设部 2012年10月31日
1832 Time of Dragons Soaring and Tigers Leaping – Kidney Transplantation Department of Organ Transplantation Center,
Second Xiangya Hospital of Central South University Hunan Online – Public Health Edition October 21, 2005
1833 Introduction to the liver surgery departmental – Peking Union Medical College Hospital
1834 My Experience of Guiding Postgraduates in Practicing During Kidney Transplant Clinical Work Chinese Journal of Medicine
November 2003, Volume 3, Issue 11 Fu Shaojie, Yu Lixin
《在肾移植临床工作中指导研究生实习的体会作者》《中华医药杂志》2003年11月第3卷第11期 付绍杰 于立新
1835 A ‘Panacea’ for Treating End-Stage Liver Disease”
Hbver.com, Source: Health News December 30, 2004
“对付终末期肝病这里有‘金刚钻’” 文章来源：健康报 《战胜乙肝网》更新时间：2004-12-30
1836 Department of Hepatopancreatobiliary Surgery and Liver and Pancreas Transplantation,
The First Affiliated Hospital of Zhejiang University – Zheng Shusen
1838 Introduction of Kidney Transplantation Institute, Xi’an Jiaotong University
1839 Introduction of Department of Kidney Transplantation, Xi’an Jiaotong University
西安交通大学附一院 – 肾移植科科室简介
1840 Zemin Jiang Met Four Times with Wu Mengchao CCP.people.com.cn – News of the Chinese Communist Party
1841 Wu Mengchao Wins State Supreme Science and Technology Award
National Office for Science & Technology Awards — Official Website
1842 Sun Dafa Presents Award to Wu Mengchao
gov.cn The Central People’s Government of the People’s Republic of China – Official Website
1843 Wu Mengchao’s Model Deeds
Baotou Medical College First Hospital Affiliated with Inner Mongolia University of Science and Technology
《吴孟超同志先进事迹 》 内蒙古科技大学包头医学院第一附属医院网站转载
1844 Medical Soul – dedicated to Wu Meng Chao, people’s physician
Source: People’s Daily 2011-04-26
医魂——献给人民医学家吴孟超 来源：《人民日报》 2011-04-26
1845 Seminar of Wu Mengchao’s Model Deeds Held in Beijing People’s Daily
1846 Exclusive Interview of Bingyi Shi, Dean of Organ Transplantation Center of PLA No. 309 Hospital: There Should Be
Constant Innovation in Organ Transplantation Xinhua News Agency February 6, 2012
1847 Exclusive Interview of Bingyi Shi, Dean of Organ Transplantation Center of PLA No. 309 Hospital: There Should Be
Constant Innovation in Organ Transplantation Xinhua News Agency February 6, 2012
1848 Introduction to the 9th Cardiac Surgery Department at Affiliated Beijing Anzhen Hospital of Capital Medical University
1850 Orthotopic Heart Transplantation—-Top One In Nation
1851 Li Leishi – Model Deeds of the Vice President of Nanjing General Hospital of Nanjing Military Command
Chinese Medical Doctor Association
1852 PLA General Hospital Specialist — Li Yantang
1854 A novel immunosuppressant fingolimod: research advances
1855 Research progress of the application of immunosuppressants in organ transplantation
1856 Research progress of immunosuppressant withdrawing after liver transplantation
1858 Imported products are no longer the only dominant
1859 Imported products are no longer the only dominant
1860 China Science and Technology Development Report: Development of organ transplant immunosuppressant products
1861 Organ transplant stimulating immunosuppressant market
1864 Winner of the Ninth Chinese Physician Prize – Tan Jianming
1866 Introduction of Shanghai Changzheng Hospital-Department of Organ Transplantation
1867 Explore and innovation Cast brilliance – on Organ Transplantation department of the First Clinical College
China Medical University Paper, 2005 Edition 126 December 27, 2005
1868 Key Laboratory of Organ Transplant Medical Planning and Research Office at Fudan University
1869 Brief Introduction to the Diagnostic and Treatment Center for Lung Transplant Treatment at Wuxi People’s Hospital
1870 The Project of Experimental and Clinical Application Research of Heart Transplantation Reached the International Advanced Level
1871 Fujian Province’s Science Achievements
1872 Giving Patients New Lives–Du Yingdong, Deputy Director of Department of Hepatobiliary Surgery at No. 107 Hospital
Source: Jiaodong.net March 28, 2015
生命在这重新崛起-107医院肝胆外科副主任杜英东 胶东在线 March 28, 2015
1873 The new hospital ward building was put into use in No. 107 Hospital Souhu.net/ Qilu Evening News Apr 22, 2012
107医院新病房大楼启用 搜狐网 齐鲁晚报 2012年4月22日
1874 “Tianjin First Central Hospital Sets Record, Uses 2 Hours to Complete a Liver Transplant Surgery”
Source: Sohu, December 26, 2003.
天津一中心医院创纪录 仅用2小时完成肝移植手术 来源：新华网
1875 Introduction to Fudan University Organ Transplant Center
1876 A special interview with Professor Lu shichun on Liver transplantation Date: Aug 27, 2012
1877 Introduction to heart transplant — The Fu Wai Cardiovascular Disease Center
1878 Shanghai Transplantation technology at leading level all over the world
上海器官移植多项技术居世界领先地位 2003-2-2 文章来源：新华网
1879 “Liver transplant” master – Fu Zhiren from Shanghai Changzheng Hospital
“换肝”高手—上海长征医院傅志仁 2003-11-21 作者：严志明 文章来源：人民网
1880 “Liver Transplant Entering a New Era.” Hbver.com. / Source: Health News, May 10, 2005.
肝移植走向新时代 2005-5-10 战胜乙肝网/来源：健康报