BY DAVID MATAS
The Japanese Diet (Parliament), Dec 1, 2016
The Update
David Kilgour and I and Ethan Gutmann had engaged in research which led us independently to come to the conclusion that prisoners of conscience, primarily practitioners of the set of exercises Falun Gong, but also Uighurs, Tibetans and Eastern Lightning House Christians, were being killed for their organs to be sold to transplant patients. In doing so, we had taken official Chinese figures of transplant volumes at face value and focused on attempting to identify the sources for those asserted volumes.
However, Chinese government statistics for transplant volumes are not necessarily reliable. One effort which needed to be made and which we finally did make is to determine on our own what Chinese transplant volumes are.
The three of us together released in June an Update to our previous works on transplant abuse in China by looking primarily at transplant volumes. Our Update is posted on our joint website, endorganpillaging.org. The report is 680 pages and has almost 2,400 footnotes. The reason it is so bulky is that we came to our own conclusion on volumes by looking at and accumulating the data from the individual hospitals, hospital by hospital, where transplants occur.
For Communists, statistics are the pursuit of politics by other means. Statistics in China may be accurate, but only if the Party believes that their accuracy serves some political purpose.
For organ transplant statistics, the Communist system has had competing political considerations. One has been to show how advanced they were in transplant technology, a consideration which pushed them in the direction of large numbers. The other was not to create undue suspicion about sources, which pushed them in the direction of lower numbers.
The first tendency prevailed initially, leading to generation of inexplicably large number of transplants. The Party then realized that this manner of boasting was causing them a political problem, because it raised the question of the sources of all these organs, when they had no donation system and no national organ distribution system. They were stuck with the numbers they had produced. But, once they realized that those numbers were creating a problem for them, the numbers stopped increasing.
Individual hospitals are less concerned about accounting for sourcing since, at least to date, there has been no international focus on their numbers. The numbers we got for transplants from individual hospitals, when added up, far exceeded the totals coming from the national system.
We had to ask ourselves: How much of this is just touting, the fiddling with statistics at a local level, generated by different political considerations than operated nationally? We have answered this question by looking, for each hospital examined, at a wide variety of other factors besides what hospitals claim their transplant numbers to be.
We looked at bed numbers, staff numbers and capacity utilization rates. We looked also at grants and awards. Award citations or acceptances may mention a figure. Grants may mention a projected figure. We looked at publications, both newsletters and research studies. We looked too at the volume of use of anti-rejection drugs. We looked as well at potential patient groups, rate of growth, technological development, and media reports.
We did not rely on any one piece of evidence for any hospital to tell us what its transplant volume is. Rather, as we did for our previous research, we suspended coming to any conclusion until we looked at all the data. What that data tells us consistently looking at all factors in combination, is that transplant volumes in China are far larger than the official national figures.
We calculated totals both by addition and multiplication. For both, we focused on a subset of hospitals, those registered officially to do liver and kidney transplants.
On June 27, 2006, the Ministry of Health published a “Notice Regarding the Management and Regulation of Liver, Kidney, Heart, and Lung Transplantation Capabilities,” which imposed these requirements for medical institutions carrying out organ transplants:
• liver: 15 beds dedicated to liver transplants and no fewer than 10 intensive care unit beds, for a total of 25 beds.
• kidney: 20 beds dedicated to kidney transplants and no fewer than 10 intensive care unit beds for a total of 30 beds.
• liver and kidney: 35 beds dedicated to liver and kidney transplants and no fewer than 20 intensive care unit beds for a total of 55 beds.
There were 21 liver hospitals, 65 kidney hospitals and 60 combined liver and kidney hospitals given permits or a total of 146 hospitals. Our survey of hospitals indicate widespread facility constraints, including transplant centres that exceed 100% bed utilization and have a long line of patients waiting for transplants. The Government of China’s plan to expand the number of approved transplant hospitals from 169 to 300 suggests that the current system wide capacity cannot keep up with demand.
For the 146 hospitals, we calculated volumes by addition, hospital by hospital. We cross checked our volumes by multiplication, multiplying minimum bed and staff counts for each registered hospital, assuming full capacity and average stays for patients in hospital.
Our calculation was that the total transplant volume was not 10,000 a year, the official Chinese figure. Rather, the range is between 60,000 to 100,000 a year, with an emphasis on the higher numbers.
Our conclusion had been that, even with volumes of 10,000 a year, the bulk of the organs had to be coming from prisoners of conscience, primarily practitioners of Falun Gong. For the figure of 10,000 a year, the Government of China now says that all organs are coming from donations, an implausible assertion, not backed by verifiable figures.
The volume of actual transplants in China, 60,000 to 100,000 a year, speaks for itself – that volume of organs must be coming from prisoners of conscience. Even the Government of China has no other explanation for this volume.
Of the 2,400 footnotes in our report, 2,200 come from official Chinese sources. The Government of China rejects our calculations. Yet, by rejecting our figures, they are rejecting their own.
Our research that hospitals are transplanting huge numbers does not have to be accepted. But they surely make ever more urgent the need to comply with the duties of transparency, openness to scrutiny and accountability imposed by the World Health Organization.
Japan
Our focus, in doing the Update, was transplant abuse in China and the global connection to that abuse. We did not focus on Japan specifically. Yet, in going into hospital details, we could see that Japan kept on popping up.
Our Update shows substantial connections between the Chinese transplant industry and Japan. There are several large Chinese transplant hospitals which cater to Japanese transplant tourists. Chinese transplant centre collaborate with Japanese institutions. There are many Chinese transplant surgeons who learned their transplant techniques in Japan. China has imported transplant related pharmaceuticals from Japan. There is even a Chinese hospital doing transplants partly funded by the Government of Japan.
Patients
First Affiliated Hospital of Sun YatSen University
The Update states:
“The First Affiliated Hospital of Sun YatSen University claims to have the most types of transplants and to rank second in total volume. … In addition to patients from China, it also provides kidney transplants to patients from over ten countries and regions, including … Japan ….”
Oriental Organ Transplant Centre
The Update states:
“The fifth edition of Phoenix Weekly in 2006 … stated that Oriental Organ Transplant Centre [in Tianjin] is the world’s largest transplant centre. … The article says that 85% of its patients came from over 20 countries and regions, including … Japan ….”
First Hospital of China Medical University
The Update also states:
“The First Hospital of China Medical University is located in Shenyang, Liaoning Province. It is the largest organ transplant centre in northeastern China … In 2003, the hospital established its China International Transplantation Network Assistance Centre (CITNAC), a transplant institution for foreigners, with customers mainly coming from Japan, South Korea, and other countries. The hospital ran a strong advertising campaign in Japan, promoting targeted services. The campaign stated, ‘The Organ Transplant Institute not only has several doctors and head nurses who studied in Japan and are familiar with Japanese culture, but most nurses can also speak Japanese, which is convenient for Japanese patients. …In an archived version of the website from September 2004, the Centre had emphasized, ‘In China we carry out living donor kidney transplants. It is completely different from the deceased body [corpse] kidney transplants you hear about in Japanese hospitals and dialysis centres – Compared to cadaver kidney transplants in Japan, what is offered here is much safer and more reliable.'”
The Update adds:
“The website of the China International Transplantation Network Assistance Centre (CITNAC) was shut down after live organ harvesting was publicized in 2006. The website http://zoukiishoku.com was previously available in Japanese, Russian, English, and Chinese.”
The First People’s Hospital of Changzhou (The Third Affiliated Hospital of Soochow University)
The Update states:
“Its urologic surgery department’s website states that it began performing kidney transplants in the 1980s, and that its strength traditionally has been in kidney transplantation. Its cumulative transplant volume is near the top nationwide. More than half of its patients come from Hong Kong, Macau, Taiwan, Japan, and other AsianPacific regions.”
Zhejiang Provincial People’s Hospital
The Update states:
“A Korean patient, who underwent a transplant operation in the hospital on June 3, 2006, stated that the hospital treated patients from all over the world. He saw … Japanese, etc. He stated that organs used for transplantation were obtained from prisons by doctors in military uniforms.”
Asia Times
The Update states:
“On April 4, 2006, Asia Times published a report entitled ‘Japanese flock to China for organ transplants.’ The report states that Mr. Suzuki, chairman of the Japan Transplant Recipients Organization, discovered that a hospital in a major city in China conducted 2,000 organ transplants last year [2005] alone. Among the recipients, 30 to 40 were Japanese, and 200 were Korean.”
Hokamura Kenichiro
Our Update states:
“When a native Japanese Hokamura Kenichiro’s kidneys failed, he waited over four years for a transplant before going online to check out rumors of organs for sale. He was astonished by just how easy it was. Ten days after contacting a Japanese broker in China in February, he was lying on an operating table in a Shanghai hospital receiving a new kidney. A doctor had only examined him that morning. ‘It was so fast I was scared,’ he says. The price was 6.8 million yen (about US $80,000). ‘It was cheap’, says Hokamura.
Hokamura is one of hundreds of well off Japanese who have recently made the trip to China for kidney, liver or heart transplants, drawn by the availability of cheap, healthy organs and rapidly improving medical facilities along the east coast of the mainland. …
His broker has helped more than 100 Japanese make the trip to China for transplants since 2004, and the trade is growing. Hokamura negotiated the deal through a Japanese broker in Shenyang that operates under the name of the China International Organ Transplant Center which maintains a professional website with detailed information about their services for donors in English, Japanese, Korean and Russian.”
A Japanese woman
The Update states:
“Organ transplant prices for foreigners are not fixed. … A Japanese woman received a young girl’s liver with serial number 020014 and was charged $5 million USD.”
Zhongshan Hospital of Shanghai Fudan University
The Update states:
“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. … It has attracted patients from more than 10 countries and regions, including … Japan.”
Training
Shen Zhongyang
The report states:
“Shen Zhongyang is known as the founder of China’s liver transplant field. From the time he graduated from China Medical University in 1984 until 1998, Shen twice studied in Japan.”
Liu Naibo
The Update states:
“Liu Naibo director of the urologic surgery department [of the China Japan Friendship Hospital], has rich experience in kidney transplant surgery and postoperative complications. He was one of the earliest in China to begin work on laparoscopic living donor nephrectomy and kidney transplantation. He has led multiple national and hospital level research programs. In 1989, he studied at Kyushu University in Japan.
Zhao Jianxun
The Update states:
“Professor Zhao Jianxun, deputy director of the transplant centre [of the Peking University First Hospital Urologic Surgery Research Institute] has studied hepatobiliary surgical techniques in Japan and participated in Peking University’s first liver transplant.”
Rui Jin Hospital
The Update states:
“The centre [Rui Jin Hospital of Shanghai Jiao Tong University School of Medicine Organ Transplant Centre] has 22 surgeons, including 16 chief and associate chief surgeons, 4 PhD advisors, and 5 master’s advisors. Each year, the department sends personnel to study in … Japan … and bring the latest knowledge and techniques back to China.”
Wei Li
The Update states:
“Deputy Director Wei Li of the Centre [Chest Tumor Diagnosis and Treatment Centre Henan Provincial People’s Hospital (People’s Hospital of Zhengzhou University)] studied lung transplant technique in Kyoto University in Japan from 2006 to 2008.”
Wang Yi
The Update states:
“Wang Yi MD [of the Second Hospital of University of South China, City of Hengyang, Hunan Province, Urologic Surgery Department, kidney transplant centre] is a chief physician, professor, master’s advisor, and member of the Hunan Province Organ Transplant Professional Committee. He studied urology at Hokkaido University in Japan …”
Shenzhen Sunyixian Cardiovascular Hospital
The Update states:
“This is the only hospital in southern China specializing in cardiovascular diseases and authorized to perform heart transplants. Its core professionals are from Beijing Fu Wai Hospital of the Chinese Academy of Medical Sciences, People’s Liberation Army No. 301 Hospital, and experts in cardiovascular disease who were trained overseas in … Japan.”
Chen Tienan
The Update states:
“Chen Tienan, chief physician of the heart surgery department, joined TEDA [Tianjin Economic Technological Development Area International Cardiovascular Hospital, Cardiovascular Disease Clinical College of Tianjin Medical University] in 2003. Since 2005, he has fully participated in heart and heart kidney transplants, as well as perioperative management. … He studied in … Japan in 2014.”
Meng Xingkai
The Update states:
“Hospital president Meng Xingkai [of the First Hospital of Shanxi Medical University] is a well known expert in the hepatobiliary surgery department. Between 1997 and 2006, he studied abdominal surgery at the … Pharmaceutical University (now University of Toyama) in Japan …. “
Yan Yehong
Our Update states:
“Professor Yan Yehong, director of the organ transplant department, [of the First Affiliated Hospital of Nanchang University, Jiangxi Province] received training in living donor liver transplantation at Kyoto University of Japan.”
Du Chengyou
The Update states:
“The department’s director, [of the First Affiliated Hospital of Chongqing Medical University hepatobiliary surgery department which serves as the Chongqing Organ Transplant Centre] Du Chengyou, is very knowledgeable in liver transplantation and other areas, and has superb surgical skills. … He also studied liver transplantation at … the Affiliated Hospital of Kyoto University in Japan.”
Collaboration
Xijing Hospital Organ Transplant Center
The Update states:
“Established in 2000, Xijing Hospital Organ Transplant Center has become the largest organ transplant center in Northwestern China. … In 2005 it became the Military Organ Transplant Center with the approval of People’s Liberation Army Department of General Logistics, and then became the Military Organ Transplant Research Institute in 2012. It claims to lead the country in transplantations of liver, kidney and heart. …
The Research Institute has long term partnerships and regular collaboration with internationally acclaimed organ transplant centers, including … the Organ Transplant Department of Kyoto University in Japan … “
China Japan Friendship Hospital
The Update states:
“The hospital has a nationally ranked thoracic surgery department, which performed the first two lung transplants in China in the 1970s. … All of its physicians have research or study experience overseas. Some of its professors serve as visiting professors at overseas institutions and have longterm academic exchanges. The department has named honorary professors from … Japan”
The First Affiliated Hospital of Soochow University
The Update states:
“The Urologic Surgery Department has a kidney transplant centre with 55 beds, 130 monthly admissions/ discharges, and a 101% turnover rate…. The department is a key clinical specialist centre of Suzhou City and Jiangsu Province and offers master’s and PhD degree programs. … It has established academic exchange and collaborative relationships with … Japan ….”
Chen Yuxin
Our Update states:
“Professor Chen Yuxin [of Qilu Hospital of Shandong University] is a doctoral advisor and an expert in liver transplantation. He has engaged in academic research and exchange in Japan ….”
Chen Guoyong
The Update states:
“The hospital [Zhengzhou People’s Hospital in Henan Province] also carries out liver and multiorgan transplants. At present, the hospital’s website shows that Chen Guoyong, the hospital’s vice president and director of its Liver Transplant Surgery Department, had completed over 500 combined multiorgan procurement operations, over 500 kidney transplants, over 300 liver transplants, and dozens of combined liverkidney and pancreaskidney transplants. He had been a visiting scholar in Japan ….
First Hospital of Shanxi Medical University
The Update states:
“The hospital’s 48bed hepatobiliary surgery department is subordinate to its transplant surgery department and has 7 chief physicians, 3 associate chief physicians, one doctoral advisor, 3 master’s advisors, 9 PhDs, 2 master’s degree holders, and 3 visiting scholars in Japan.”
Jinzhou
The Update states:
“According to the Chinese Ministry of Commerce website, Jinzhou Public Security Bureau’s OnSite Psychological Research Center [Wang Lijun’s transplant research and experimentation centre] … collaborated with universities in more than ten countries in joint research and academic exchanges, including … Japan …”
Funding
The Update states:
“China-Japan Friendship Hospital
This hospital was established collaboratively by the Chinese and Japanese governments and receives subsidies from the Japanese government. … The hospital’s urologic surgery department operates a kidney transplant centre.”
Its website states:
“Since it began to perform kidney transplant in 1986, it has accumulated rich clinical experience, standardized perioperative management practices, a high long term survival rate, and low medical costs. It has achieved a leading position nationally and received good reviews from domestic and international patients.”
Export of pharmaceuticals
The Update states:
“In September 2004, Sanlian Life Weekly contained an article titled ‘Tianjin Survey: Asia’s Number One in Organ Transplantation,’ in which the head medical resident at Tianjin Oriental Organ Transplant Center, Zhang Yamin, said that donor organ procurement is costly, that a single organ perfusion preservation solution is not a small expenditure, and that every major organ requires four bags of preservation solution at 5,000 RMB each. At the beginning, there were no domestic manufacturers of perfusion solutions, so they had to use preservation solutions brought back from Japan, bag by bag, by Shen Zhongyang.”
Some questions
How many Japanese patients are going to China for transplants? Japanese Member of Parliament Takashi Nagao asked the Minister of Health that question. The answer he received back was “We do not know”.
What is Japan doing to prevent or even discourage transplant tourism into China? As far as I can tell, Japan is doing nothing.
How many Chinese health professionals have been trained and are being trained in Japan in transplantation surgery techniques? What undertakings are requested before training these professionals, to prevent them from using the techniques they learn for organ transplant abuse? I am not aware of any.
What restrictions are placed on the funding that the Government of Japan gives to the China Japan Friendship Hospital to prevent the funds being used to support organ transplant abuse? There is not, to my knowledge, any such restriction.
What prohibitions are in place to prevent Japanese collaboration with China on transplantation and transplantation research from relying on organs from improper sources? There are not, as far as I know, any such prohibitions.
When a Chinese transplant professional comes to Japan as a visiting scholar, what efforts are made to determine whether the visitor has engaged in transplants using organs from improper sources? What efforts are made to attempt to ensure that what the visitor learns in Japan about transplantation is not used for transplantation from improper sources in China? To my knowledge, there are no such efforts.
When a Japanese transplant professional, scholar or researcher is given an honorary position at a Chinese health institution, what effort is made, before accepting the position, whether the institution has been and is engaged in organ transplant abuse? Again, as far as I know, there are no such efforts.
What volume and what value of pharmaceuticals are exported from Japan to China for transplantation? What precautions are in place to prevent these pharmaceuticals from being used in organ transplant abuse? To my knowledge, there are none.
Conclusion
The report that David Kilgour and I wrote on the killing of Falun Gong for their organs in China was released in July 2006. In the ten years and more which has passed since the release of that report, Japan has done, to all appearances, nothing to avoid complicity in Chinese transplant abuse.
Japan is a global technological leader. Finding out the answers to these questions I just asked should be, for Japan, child’s play. Doing something about Japanese complicity in Chinese organ transplant abuse should be equally easy.
Japanese officials and the Japanese health system seems to know nothing and do nothing. When that happens, when Japan says nothing, does nothing and claims to know nothing, the reason is not inability or incompetence. Japan is one of the last countries, if not the last, to able to justify plausibly inaction by inability.
The reason for inaction in Japan to find out about and combat complicity in transplant abuse in China is, I would suggest, a conspiracy of silence, wilful blindness. None are so blind as those who will not see. Japan is blind to its own complicity in organ transplant abuse in China because Japan has turned a blind eye to that abuse.
For outsiders to impact on Chinese Communist behaviour is difficult at the best of times. Transplantation in China is a multi – billion dollar business. Stopping the killing of prisoners of conscience for their organs in China would be financially devastating to the Chinese health sector.
Yet, at least, outsiders can avoid complicity with what happens in China. What outsiders do to avoid complicity is entirely in their own hands.
Japan, on this matter, regrettably, has fallen far behind and is making no apparent effort to catch up. Japan should not just be catching up. It is perfectly capable of leading the world in informing itself about and avoiding complicity in Chinese organ transplant abuse. That is what it should do.
