31st August 2018, Volume 131 Number 1481

Phillipa Malpas

I would like to thank Professor Stephen Munn for his considered response1 to my paper.2

One of the central challenges facing researchers seeking to clarify ‘accurate data about current practices within China1 is the shifting landscape regarding the number of transplant surgeries undertaken in China. The China Organ Harvest Research Centre’s Report published last month notes that, ‘... after forced organ harvesting first gained international scrutiny in 2006… transplant data and relevant online information have been either removed or deflated, often by an order of magnitude.3 They detail the deletion of hospital websites, cases of under -reporting, and the falsification of transplant data from a number of named institutions. They conclude that the true number of transplant surgeries carried out in China ‘may forever remain unknown.’3 Their conclusions are consistent with the findings of David Kilgour, David Matas and Ethan Gutmann.4

In my paper I refer to Liver International’s retraction of the paper by Yu et al.5 The editorial team states that unless the authors provide ‘indisputable, detailed and exhaustive evidence6 that their institution (First Affiliated Hospital of Zhejiang University’s School of Medicine) did not use the organs of executed prisoners in their research the ‘authors will be subjected to a life-long embargo from submitting their work to Liver International.6 The retraction is a further example of verified unethical (reporting) practice from China.

I am in agreement with Professor Munn that banning transplant patients from overseas travel to procure an organ exceeds the role of transplant physicians, however I reiterate my point that physicians should strongly dissuade their patients from traveling to China for the purpose of receiving an organ transplant.2

This is justified because of ‘evidence that such black market organs do not perform as well in transplant recipients’,1 and because of the compelling likelihood that such organs are taken from women and men who were murdered for their organs.

Sustained and ongoing efforts to increase New Zealand’s organ donation rate is to be applauded. Our position internationally regarding deceased donation rates however is nothing to be proud of.7 Organ Donation NZ8 acknowledges that some New Zealanders waiting for an organ will die waiting and others will be limited in their quality of life for need of an organ. One way for New Zealanders to play their part in increasing the availability of organs for those individuals living with organ failure, is to seriously consider becoming an organ donor; either upon death, or as a living donor. Ensuring that one’s informed decision to donate is clearly articulated to others would go some way in mitigating the demand for overseas organs.

Author Information

Phillipa Malpas, Associate Professor in Clinical Medical Ethics, Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland.


Phillipa Malpas, Associate Professor in Clinical Medical Ethics, Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland.

Correspondence Email


Competing Interests

Phillipa Malpas is a member of the group, the International Coalition to End Transplant Abuse in China (ETAC).


  1. Munn S. Transplant ethical considerations: response from the trenches. N Z Med J. 2018; 131(1478):8–9.
  2. Malpas PJ. New Zealand transplant patients and organ transplantation in China: some ethical considerations. N Z Med J. 2018; 131(1478):55–61.
  3. China Organ Harvest Research Center (COHRC). Transplant abuse in China continues despite claims of reform. Available on-line at: http://www.chinaorganharvest.org/app/uploads/2018/06/COHRC-2018-Report.pdf: COHRC; June 2018: See Chapter 5, pages 82–95.
  4. Kilgour. D, Gutmann. E, Matas. D. Bloody Harvest / The Slaughter: an update. Available at: http://endtransplantabuse.org/wp-content/uploads/2017/05/Bloody_Harvest-The_Slaughter-2016-Update-V3-and-Addendum-20170430.pdf; 2016.
  5. Yu Z, Sun Z, Yu S, Zhang L, Feng X, Zhang M, et al. Safety limitations of fatty liver transplantation can be extended to 40%: experiences of a single centre in China. Liver international. 2016; 37(5):767.
  6. Mondelli M, Zobair Younossi, Francesco Negro. Editor’s Note. Liver International. 2017. Available at: http://onlinelibrary.wiley.com/doi/10.1111/liv.13400
  7. International Registry in Organ Donation and Transplantation (IRODaT). Available at: http://www.irodat.org/?p=database#data
  8. Organ Donation NZ. Available at: http://www.donor.co.nz/