Zheng takes a last look at her brain-dead husband on June 27 before a transplant operation at a hospital in Quanzhou, Fujian Province. The family agreed to donate the man's organs. Photo: CFP

At midnight on June 22, Gao Min received a phone call from a relative of a man who had suffered from a brain hemorrhage, saying that the family was considering allowing his organs to be transplanted.

Gao, a volunteer organ donation coordinator in Shenzhen, Guangdong Province recruited by the local Red Cross Society, rushed to the hospital the next morning and waited for five hours until the 20 relatives reached a consensus.

When the family finally filed the necessary paperwork to allow the man's organs to be given to someone else, the patient had suffered multiple organ failure, meaning he was no longer an eligible donor.

More and more Chinese people have become willing to donate their or their family members' organs since 2014, before China officially abolished the practice of harvesting organs from executed prisoners in 2015 and launched a voluntary-only donation system. 

"I received up to 100 calls every day asking about donations and last year I assisted more than 30 organ donations," Gao, 48, told the Global Times. "But a few years ago, I could not secure even one donation every three or four months."

China saw 34 voluntary organ donations in 2010, and that number rose to 1,648 by the end of 2014. The number of people who volunteered to donate their organs also rose from 1,087 in 2010 to 14,636 to 2014, according to statistics from the China Organ Donation Administrative Center (CODAC) under the Red Cross Society of China.

However, the number of donors is still relatively small compared with the huge demand.

Experts believe that donation coordinators often find out too late that someone's organs are available, due to doctors' reluctance to raise the sensible topic to the patient's family. "If the doctors had told me earlier and mentioned organ donation to more families, my latest case would not have failed," Gao said.

Poor donors 

Gao has been an organ donation volunteer for eight years, and has helped with over 100 transplants.

She contacts the families of possible donors to secure organs, then asks doctors to assess, obtain and transport the organs before witnessing the transplant operation. She also provides psychological support to the families of donors after operations.

By the end of 2014, China had a total of 1,151 coordinators helping to facilitate organ donations, according to the CODAC.

Cao Yanfang, who became the first such coordinator in Zhejiang Province in 2010, said that her original goal was a 1 percent success rate.

In the beginning, she received many rejections and even threats, Cao told the Global Times. It took her three years to find 100 sources of organs. But she only took 10 months to find the next 100. 

Luo Zhigang, director at the No.2 Hospital of the University of South China in Hengyang, Hunan Province, told the Global Times that the hospital has made efforts to publicize organ donation such as hanging posters outside operation rooms to make more people aware of the practice.

"But most families who inquire about organ donations are either farmers or poor migrant workers from other provinces," Gao added.

Many educated people, on the other hand, ask what benefits they themselves could get from donating their relatives' organs, and often drop the idea after learning that there is no cash on offer, she said.

Yu Li, secretary of the Red Cross Society of Jilin Province, also said that organ donors in Jilin are mostly poor families from rural areas, news site sina.com.cn reported.

"Poor families cannot afford several thousand yuan in daily ICU treatment, and often give up on treatment if they are told that the patient has very slim chances," an anonymous organ donation volunteer told sina.com.cn.

An organ donation official in Beijing, who asked for anonymity, told the Global Times that the majority of donors are those who die in traffic accidents.

Traffic accidents claim an average of 200,000 lives every year in China, according to the World Health Organization.

"So it would greatly boost China's organ donation rate if transportation departments mentioned it when issuing driving licenses," the official said.

Uncooperative medical staff

Despite the growth in organ donation, China's supply of organs remains far below demand.

Currently, there is only one organ for every 30 people in need, Zhu Jiye, director of the Organ Transplantation Center of Peking University, told the Global Times.

In Luo's hospital, patients who need kidney transplants often have to wait for three to five years. 

China only has 169 hospitals that are permitted to perform organ transplant surgeries, and their doctors can only perform around 10,000 operations every year, according to Huang Jiefu, former vice-minister of health.

One important reason for the shortage of organs is that many doctors do not inform volunteers when they discover a potential donor, Zhu said.

For volunteers like Gao, the traditional belief that the deceased should be buried whole, with all of their organs intact, is one important obstacle to donation.

"In most cases, I receive calls from the families of possible donors directly," said Gao, adding that many doctors never bring up the topic to families as they fear strong reactions.

Some patients' families believed that doctors who mention organ donation to them are actually trying to sell their organs, according to Gao.

The underground organ sales market in many parts of China has been widely reported in recent years. In June, at least 10 cases of medical staff being attacked were reported in China.

Even after being called by the family, Gao still needs to go through hours of persuasion to get into the ICU and meet the doctors of potential donors. "The doctor sometimes just throws the medical records of the potential donor at me rather than explaining the patient's condition," Gao said.

Zhao Lizhen, deputy head of the Shenzhen branch of the Red Cross Society of China, also admitted that hospital noncooperation is the most common problem in organ donation, the Xinhua News Agency reported.

China's regulations on organ transplants only mention the responsibilities of hospitals that are allowed to perform such procedures, but fail to mention any penalties for hospitals that refuse to cooperate in organ donations, said Xinhua.