JUNE 22, 2005 may have been the turning point for Li Xinquan's family in Tingzhou City of East China's Shandong Province.

On that Wednesday morning, surgeons at Shanghai Zhongshan Hospital transplanted a kidney into 34-year-old Li Xinquan from his wife, Liu Zhaorong, 31.

"Actually, I didn't and couldn't think too much about donating one kidney," said Liu. "If I didn't give it, my husband would die and my son would have no dad in the future."

Li was diagnosed with acute uraemia on May 20, when doctors told him that he had only two months because both of his kidneys were failing.

The family was desperate. "Waiting for a possible donated kidney could take as long as one year, and the medical cost for dialysis is too huge for my family to afford - as high as 3,000 yuan (US$363) per week," said Li.

A kidney donated by relatives was the last recourse and fortunately, Liu's kidney matched that of her husband.

Gift for family members

Before Li's case occurred, Zhongshan Hospital had performed 10 living organ donations among close relatives this year.

"Low cost, short-term waiting, as well as a better match rate are some of the advantages of living organ donations among relatives," said Professor Zhu Tongyu of Zhongshan Hospital and director of the Organ Transplantation Centre of Fudan University.

"And more importantly, this can partially solve the severe organ shortage problem."

In China, there are 1.2 million ureamia patients like Li, at the terminal stage, half of whom can be saved by implanting a donated kidney. The fact is that less than 5,000 patients get a kidney each year, leaving the majority to die while waiting or relying on expensive dialysis.

Experts say that the liver shortage will turn more serious in the near future, because China has 1.2 people carrying the hepatitis B virus and quite a number of patients will develop liver cancer. From 1994 to 1998, the number of patients on the waiting list for livers increased 168 per cent, but the supply only increased 18 per cent, according to Professor Fan Jia at Zhongshan Hospital.

Statistics show that in 2004, a total of 2,000 liver transplants were performed in China, almost double the figure in 2003.

"Awareness about donating organs for relatives has increased among the public in recent years, especially after the first Organ Recipients Sports Game held in 2004," said Professor Zhonghua Klaus Chen, director of the Wuhan-based Institute of Organ Transplantation of Tongji Medical College.

Up to May 2005, the institute had carried out 85 living kidney donations among relatives - four per cent of all kidney transplant cases but the highest of all hospitals on the Chinese mainland.

The figure is still very low when compared with that in Western countries. For example, in the US, living organ donation among relatives accounts for over 50 per cent of all cases.

Along with medical experts, the media, business and other groups have started to promote the concept among the public.

In 2004, 39-year-old Tian Shiguo from Shangdong was selected as one of "Ten Persons Who Moved China", because he donated a kidney to his elderly mother.

Beijing Novartis Pharma Ltd established a fund to assist the families who donate an organ for a family member. The fund has helped 50 families with 5,000 yuan (US$605) for each donor whose medical cost had not been covered by social medical insurance.

Problems remain

The most difficult obstacle facing Chinese transplant surgeons is slow legislative progress. China has yet to draft laws on organ transplantation and donation, brain death and living organ donation among relatives.

Insiders say that such laws have not yet been listed on the agendas of relevant authorities.

"Personally, I believed legislation is quite urgent. Legislators should establish one and then undertake continuous revisions during practice," said Chen, who has actively advocated such laws in China.

Chen said Chinese transplant surgeons now follow international practices, but these would be risky without legal support.

"A doctor from Luzhou volunteered to donate a kidney to help anyone who needed it, but I can't arrange such charitable giving without legal support," said Zhu.

Meanwhile, experts have called on health authorities to strictly supervise organ transplantation. In China, there are more than 300 hospitals conducting organ transplants, but no national organ supply network has been established.

Driven by profit, hospitals will scramble for the limited organ supply and pay money to secure transplantable organs, which leads to high prices for the operation and almost ensures that poor patients aren't treated equally and fairly.

"The organs should be collectively distributed by the network to better use resources. And health authorities should approve only big hospitals with considerable experience in conducting transplants to ensure technical quality," said Zhu.