Advances in China's Organ Transplantation Achieved with the Guidance of Law

Wang, Haibo; Zheng, Shusen; Liu, Yongfeng; Shi, Bingyi; Shen, Zhongyang; Hu, Shengshou; Ye, Qifa; Xue, Wei; He, Xiaoshun; Chen, Jingyu; Feng, Hao

doi:10.4103/0366-6999.149183

Cited by 18 publications

(11 citation statements)

References 6 publications

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“…Now, voluntary donation after cardiac death or living organ donation are the only means of organ transplantation in mainland China. 350 Since 2011, the China Organ Transplant Response System has begun to allocate donor livers, which is based only on urgency and compatibility. Until December, 2011, 20 877 liver transplantations done between 1980 and 2011 in 81 certified transplantation centres had been reported to China's Liver Transplant Registry.…”

Section: Workforce and Infrastructurementioning

confidence: 99%

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Sarin

Kumar

Eslam

et al. 2020

The Lancet Gastroenterology & Hepatology

392

303

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The Asia-Pacific region is home to more than half of the global population and accounted for 62·6% of global deaths due to liver diseases in 2015. 54·3% of global deaths due to cirrhosis, 72·7% of global deaths due to hepatocellular carcinoma, and more than two-thirds of the global burden of acute viral hepatitis occurred in this region in 2015. Chronic hepatitis B virus (HBV) infection caused more than half of the deaths due to cirrhosis in the region, followed by alcohol consumption (20·8%), non-alcoholic fatty liver disease (NAFLD; 12·1%), and chronic infection with hepatitis C virus (HCV; 15·7%). In 2015, HBV accounted for about half the cases of hepatocellular carcinoma in the region. Preventive strategies for viral hepatitis-related liver disease include increasing access to clean drinking water and sanitation. HBV vaccination programmes for neonates have been implemented by all countries, although birthdose coverage is extremely suboptimal in some. Availability of screening tests for blood and tissue, donor recall policies, and harm reduction strategies are in their initial stages in most countries. Many governments have put HBV and HCV drugs on their essential medicines lists and the availability of generic versions of these drugs has reduced costs. Efforts to eliminate viral hepatitis as a public health threat, together with the rapid increase in per-capita alcohol consumption in countries and the epidemic of obesity, are expected to change the spectrum of liver diseases in the Asia-Pacific region in the near future. The increasing burden of alcohol-related liver diseases can be contained through government policies to limit consumption and promote less harmful patterns of alcohol use, which are in place in some countries but need to be enforced more strictly. Steps are needed to control obesity and NAFLD, including policies to promote healthy lifestyles and regulate the food industry. Inadequate infrastructure and insufficient health-care personnel trained in liver diseases are issues that also need to be addressed in the Asia-Pacific region. The policy response of most governments to liver diseases has thus far been inadequate and poorly funded. There must be a renewed focus on prevention, early detection, timely referral, and research into the best means to introduce and improve health interventions to reduce the burden of liver diseases in the Asia-Pacific region. 168 www.thelancet.com/gastrohep Vol 5 February 2020The Lancet Gastroenterology & Hepatology Commission accounted for 108 276 (8·2%) of the total liver-related deaths in the region in 2015, compared with 929 (1·2%) of 72 437 in the USA and 4032 (0·3%) of 197 179 in Europe. Deaths in the Asia-Pacific region represented three-quarters of the global total number of deaths due to acute viral hepatitis. In 2015, the region accounted for three-quarters of the global total number of deaths related to acute HBV, almost two-thirds of those due to acute hepatitis A infection, and almost 80% of those due to acute hepatitis E infection. Of all deaths du...

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Section: Workforce and Infrastructurementioning

confidence: 99%

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Sarin

Kumar

Eslam

et al. 2020

The Lancet Gastroenterology & Hepatology

392

303

View full text Add to dashboard Cite

show abstract

“…This criminal law approach reflects the severity of the crimes involved. Setting aside the horrific practice of organ procurement from executed prisoners in China, which was a major source of transplants for foreign patients for some years, 40,41 and instances of HTOR that entail coercion or exploitation, transplant tourism commonly produces substantial negative effects including grave long-term physical and psychosocial harm to organ sellers and their communities. 12,[42][43][44][45] Further, the financial rewards of providing health care services to transplant tourists may divert resources from domestic patients, thus impairing the destination country's development of equitable organ donation and transplantation programs and increasing mortality among domestic transplant candidates.…”

Section: Objections To Ej Over Transplant-related Crimes Are Unconvinmentioning

confidence: 99%

Prevention of Transnational Transplant-Related Crimes—What More Can be Done?

et al. 2016

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States are encouraged to include provisions on extraterritorial jurisdiction in their laws on transplant-related crimes and to collaborate with professionals and international authorities in the development of a global registry of transnational transplant activities. These actions would assist in the identification and evaluation of illicit activities and provide information that would help in developing strategies to deter and prevent them.

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“…Due to the shortage of liver donors, transplantation from donors after brain death (DBD) has increased. From 2010 to 2014, there were 2,897 cases of voluntary post-mortem donations in China ( 4 ), the majority of which were DBD. However, compared with liver transplantation from a living donor, the DBD liver transplant has more grafting complications, and acute rejections of organs from DBD occur at a significantly higher rate compared with the organs of living donors 6–24 months following transplantation ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Peroxiredoxin 6 attenuates ischemia- and hypoxia-induced liver damage of brain-dead donors

Xiong

Fan

et al. 2015

Molecular Medicine Reports

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Oxidative stress induced by ischemia and hypoxia in the livers of donors after brain death (DBD) is associated with poor organ function and low patient survival rates in those receiving DBD liver transplants. Peroxiredoxin 6 (Prdx6) can defend cells against liver damage induced by oxidative stress. The present study aimed to investigate the role of Prdx6 in ischemia- and hypoxia-induced liver damage in DBD livers. Liver tissue samples from ten DBD patients were collected. The control group constituted of six liver samples from patients with liver hemangioma that had accepted tumor excision surgery. Protein expression levels were determined by western blotting, cell viability was assessed using a CCK-8 assay, intracellular reactive oxygen species (ROS) levels were measured using a ROS assay kit, and phospholipase A2 (PLA2) activity was measured using a PLA2 assay kit. In DBD liver samples, Prdx6 expression was downregulated and the nuclear factor-κB (NF-κB) signaling pathway was activated. Furthermore, when human liver L02 cells were exposed to ischemia and hypoxia, the expression of Prdx6 was reduced, causing an increase in reactive oxygen species (ROS); this in turn activated NF-κB signaling and lowered cell viability (P<0.01). In agreement, overexpression of Prdx6 reduced ROS levels and improved cell viability. It was also demonstrated that inhibition of NF-κB increased Prdx6 expression, while inhibition of Prdx6 limited PLA2 activity, exacerbating ischemia- and hypoxia-induced cell damage. This data suggests that Prdx6 and its PLA2 activity have a protective role in DBD livers, the expression of which is regulated by NF-κB. Thus, Prdx6 may be a novel target to alleviate liver damage in DBD.

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Advances in China's Organ Transplantation Achieved with the Guidance of Law

Cited by 18 publications

References 6 publications

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Prevention of Transnational Transplant-Related Crimes—What More Can be Done?

Peroxiredoxin 6 attenuates ischemia- and hypoxia-induced liver damage of brain-dead donors

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