LCQ5: Organ donation
********************
Question:
The Department of Health launched the Centralised Organ Donation Register (CODR) in November 2008 for members of the public to register their wishes to donate organs after death so that, upon their death, the relevant medical personnel can learn of such wishes from CODR. However, members of the public may continue to express such wishes by signing and carrying an organ donation card. On the other hand, the recent successive calls for organ donation from members of the public whose family members are in urgent need of organ transplants have aroused public concern about the current situation of organ donation in Hong Kong. In this connection, will the Government inform this Council:
(1) whether it has estimated the current number of members of the public who have signed and carry an organ donation card; given that there are inadequacies by means of using organ donation cards to express the wish to donate organs (e.g. it is easy for members of the public to lose or forget to carry their organ donation cards), why the authorities have retained this arrangement after establishing CODR; whether they have urged members of the public who have signed an organ donation card to register with CODR so that medical personnel can learn of the wish of such persons upon their death;
(2) of the respective numbers of registrations and deregistrations with CODR last year; whether the authorities have regularly reviewed CODR so as to remove the registrations of those who have passed away or permanently left Hong Kong; if so, of the details; if not, the reasons for that;
(3) whether it knows (i) the respective numbers of patients who passed away last year while waiting for a liver, heart and lung transplant, and (ii) the number of the following cases in each of the past five years: it had been confirmed that the organ(s) of the deceased who had registered with CODR/carried an organ donation card was/were suitable for transplant, but the relevant transplant operations could not proceed due to objection from the deceased's family members;
(4) given that the Hospital Authority (HA) increased the establishment of Organ Donation Coordinators from seven to nine in the 2015-2016 financial year, whether the Government knows (i) the main duties of such personnel, (ii) the effectiveness in promoting organ donation with the increased manpower, and (iii) whether HA will further increase the manpower to step up its efforts in promoting organ donation;
(5) as the Government has indicated earlier that it is seeking public views on the establishment of an opt-out system for organ donation, of the progress of that work; whether it has explored other feasible measures to promote organ donation; and
(6) whether, among the organs of the deceased, only organs of brain-dead persons are suitable for transplant; of (i) the number of brain-dead persons, (ii) the number of those, among them, whose family members were willing to donate their organs and (iii) the number of patients who received transplant of those organs, in each of the past five years?
Reply:
President,
To impress upon the general public the importance of organ donation and to gradually inculcate a culture that is receptive to and appreciative of organ donation, the Department of Health (DH) has been making promotional efforts on different fronts in collaboration with the Hospital Authority (HA) and community partners.
(1) The DH established the Centralised Organ Donation Register (CODR) in 2008 to provide members of the public with a convenient channel to register their wish to donate organs after death. The CODR also provides a reliable and effective means for Organ Donation Coordinators to ascertain, upon patients' death, their previously expressed wish to donate organs, so that they may approach the patients' families as soon as possible to seek their consent for donation of the deceased's organs to save patients in urgent need of organ transplant.
As an alternative, members of the public may sign an organ donation card. In fact, some people prefer carrying signed organ donation cards to registering with the CODR. However, the DH still encourages people who have signed an organ donation card to register with the CODR, so that Organ Donation Coordinators of the HA can identify their wish to donate organs more effectively and make arrangements as appropriate.
Since members of the public who have signed the organ donation cards do not need to report to the DH, we do not have the number of people who have signed the cards.
In support of the large-scale territory-wide organ donation promotion campaign co-ordinated by the Food and Health Bureau, the HA has been implementing the "Scan me to support organ donation!" campaign in all public hospitals and the community since June 2016 to disseminate three key messages, namely "Sign-up", "Register" and "Spread-out". The second message, "Register", seeks to encourage those who have signed the organ donation cards to register with the CODR.
(2) There were 52 550 new registrations and 859 deregistrations with the CODR in 2016. Under the existing system, Organ Donation Coordinators are allowed to check the wishes of organ donation of deceased patients where necessary. Under the established mode of operation, the Government would not review regularly whether the registrants on the CODR have passed away or permanently left Hong Kong.
(3) The breakdown of the number of patients who passed away last year while waiting for a liver, heart or lung transplant is as follows:
| Organ | Number of patients who passed away in 2016 while waiting for a transplant |
| Liver | 20 |
| Heart | 6 |
| Lung | 1 |
The following table sets out the number of cases in each of the past five years where the organ(s) of the deceased who had registered with the CODR/carried an organ donation card was/were confirmed to be suitable for transplant, but the transplant operation(s) could not proceed due to objection from the family members of the deceased.
| Year | Signed an organ donation card/ registered online (no. of cases) |
Donation failing to proceed due to objection from family members (no. of cases) |
| 2012 | 3 | 0 |
| 2013 | 4 | 1 |
| 2014 | 1 | 0 |
| 2015 | 3 | 0 |
| 2016 | 7 | 1 |
(4) The duties of Organ Donation Coordinators of the HA include the following three main areas:
1. Approach families of brain stem dead patients who may be potential donors and explain to them the details of organ donation in the hope that they will give consent to donate organs of their family members;
2. promote organ donation among healthcare staff so as to raise their awareness of it; and
3. provide support and co-ordination for external organ donation promotional activities.
At present, the HA has nine Organ Donation Coordinators (the number of Organ Donation Coordinators increased from seven to nine in 2015-16). Regarding the work of approaching families of brain stem dead patients and promoting organ donation among healthcare staff mentioned in items (1) and (2) above, effective contacts have generally been made and promotional efforts have been strengthened.
As for item (3), given that the work of external promotion of organ donation virtually requires collaboration among various professional community partners (including the DH and other interested community and professional groups), Organ Donation Coordinators play a supportive and co-ordinating role. The HA will review the manpower of Organ Donation Coordinators as appropriate.
(5) The adoption of a legislative approach, such as drawing on overseas experience to introduce mechanisms like the opt-out system is very different from the existing organ donation regime. Regarding the establishment of a new mechanism, we should ensure that the relevant proposals are acceptable to the public, and a fair, transparent and widely acceptable mechanism will be developed, so that wishes of members of the public will be respected.
The Government is assessing the latest development regarding the public understanding and acceptance of organ donation, including the establishment of an opt-out system, via the Census and Statistics Department's Thematic Household Survey. A report on the subject is expected to be published in early 2018. We will assess the situation based on the survey findings and duly consult the public before making any substantial changes.
The Government will meet with medical professionals and patients' group in June to gauge their views on the several topics related to organ donation.
(6) Deceased organs for transplant purpose currently come from donations from persons who have been medically certified brain-dead. The breakdown is as follows:
| Year | Brain-dead persons (no. of cases) |
Consent given by family members for donating deceased organs (no. of cases) |
Patients receiving organ transplant (no. of persons) |
| 2012 | 126 | 56 | 149 |
| 2013 | 91 | 50 | 123 |
| 2014 | 96 | 43 | 112 |
| 2015 | 110 | 43 | 129 |
| 2016 | 123 | 51 | 118 |
Ends/Wednesday, May 10, 2017
Issued at HKT 14:23
Issued at HKT 14:23
NNNN