The Surge in Withdrawals From Hong Kong’s Organ Donor Registry

A human liver between a woman's two palms.
Many Hongkongers have chosen to remove themselves from the organ donor registry in Hong Kong. (Image: Anton Skavronskiy via Dreamstime)

Many Hongkongers have chosen to remove themselves from the organ donor registry in Hong Kong. This act appears to be a way to express their disagreement and discontent with plans to establish closer medical connections between Hong Kong and Mainland China.

Historically, Hong Kong has maintained a separate legal and political system from mainland China under “One Country, Two Systems.” But in recent years, there have been concerns among Hongkongers about the growing autonomy and influence of the other country.

Hong Kong’s medical ties with Mainland China

In December 2022, a critical operation in Hong Kong involved a 4-month-old baby girl who urgently required a heart transplant. Unfortunately, no suitable donor match was available locally. As a result, a heart was sourced from a child in mainland China who had experienced brain stem death.

This incident marked a rare occurrence of cross-border organ donor donations between Hong Kong and mainland China. Hong Kong, a special administrative region of China, had been under British rule until 1997. The collaboration between these two regions for organ transplantation is not common, but it proved essential in this life-saving operation.

Following the successful heart transplant of the infant, authorities have engaged in discussions regarding the possibility of establishing a mutual assistance registry with mainland China. The purpose of such a registry would be to facilitate and simplify future organ donor donations.  

By working together and sharing resources, both regions can increase the chances of finding suitable organ matches, mainly where local options are limited. This collaboration is driven by the understanding that organ transplantation is a time-sensitive and life-saving procedure, and by leveraging the resources of both regions, more lives can be saved.

The surge of withdrawals of potential organ donors amounted to 5,700 applications between December 2022 and April 2023 and has been regarded as a silent protest against plans to establish medical connections with mainland China.
The surge of withdrawals of potential organ donors amounted to 5,700 applications between December 2022 and April 2023 and has been regarded as a silent protest against plans to establish medical connections with mainland China. (Image: Hanohiki via Dreamstime)

The decline of potential organ donors

As authorities of Hong Kong see the light in this medical partnership, it is not the case for most of its people. Recent data released by the government indicated a significant increase in the number of Hongkogers choosing to withdraw from the city’s organ donor registry.

This surge of withdrawals amounted to 5,700 applications between December 2022 and April 2023 and has been regarded as a silent protest against plans to establish medical connections with mainland China. Opting out of the organ donor registry is seen as expressing dissent among the population. In addition, this serves as a means for individuals to voice their concerns about the proposals.

Organ transplantation is a critical procedure that saves lives and improves the quality of life. The decline of organ donors in Hong Kong could have severe consequences for patients needing life-saving transplants, as the demand for organs far exceeds the available supply. This highlights how the population’s perception of government decisions can impact their willingness to participate.

Distrust of China’s organ procurement practices

Many Hongkongers harbor a sense of distrust toward the healthcare system in mainland China. This doubt stems from various factors, but the most prominent concern is organ procurement practices, particularly those related to using organs harvested from prisoners.

The fear of organs being sourced from criminal and political prisoners such as Falun Gong practitioners, Uyghurs, and other prosecuted groups has become a widespread issue contributing to mistrust. Hongkongers express worries about the ethical implications and potential human rights violations associated with such practices. The belief that prisoners’ organs are being used without proper consent raises serious moral concerns among the population.

In response to these concerns, China announced in 2014 stating its intention to cease using executed prisoners as a source for organ transplants. This commitment was intended to address the extensive unease and encourage greater transparency within organ transplantation in the country.

However, despite this official statement, the fears and uncertainty among Hongkongers persist. The historical context and past reports of organ harvesting from prisoners have left a lasting impact on public perception. Worse, the credibility of the implementation and enforcement of China’s act may still be questioned, leading to continued doubts regarding the reliability and integrity of their healthcare system.

A Chinese surgeon harvesting an organ.
Doubt among Hong Kongers about being organ donors stems from various factors, but the most prominent concern is organ procurement practices, particularly those related to using organs harvested from prisoners. (Image: via Pixabay)

‘Hong Kong Organs for Hong Kong Use!’

The slogan ‘Hong Kong Organs for Hong Kong Use!’ has gained popularity among those advocating for the prioritization of organ transplantation within the country. This concept emerged as a response to concerns about the potential rise of mainland Chinese patients seeking organ transplants in Hong Kong.

Supporters argue that Hong Kong’s limited healthcare resources should be primarily allocated to local patients in need rather than being extended to patients from mainland China. They believe that the healthcare system in Hong Kong should prioritize its citizens, ensuring they receive timely and adequate access to organ transplantation services.

The slogan also reflects the anxieties of Hongkongers who fear their healthcare system could become overwhelmed and strained. Hong Kong’s healthcare system is already under significant pressure, with long waiting lists for transplants and a shortage of organs. The concern is that if resources are diverted to cater to patients outside Hong Kong, it could worsen local patients’ challenges.

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