The official number of voluntary organ donors in China has been falsified, researchers claim, renewing concerns that prisoners of conscience are being covertly killed for their organs by the Chinese state.
China expert and doctoral student Mathew Robertson, Israeli surgeon Dr. Jacob Lavee, and Dr. Raymond L. Hinde, an Australian Ph.D. in statistics, have challenged official Chinese explanations over how organs are sourced for transplantation purposes in China.
Chinese officials have said their transplant sector only uses organs donated from volunteers since early 2015. They often tout advances and reforms in their country’s transplant sector.
This comes amid long-standing claims from activists and researchers that large numbers of prisoners of conscience have been killed for their organs in the communist state.
The three researchers examined key deceased organ donation datasets in China from 2010 to 2018 and, through forensic statistical methods, they found that the official Chinese figures have been fabricated.
“A variety of evidence points to what the authors believe can only be plausibly explained by systematic falsification and manipulation of official organ transplant datasets in China,” they wrote in their paper published in BMC Medical Ethics on Nov. 15.
“Some apparently non-voluntary donors also appear to be misclassified as voluntary. This takes place alongside genuine voluntary organ transplant activity, which is often incentivized by large cash payments,” they said. “These findings are relevant for international interactions with China’s organ transplantation system.”
‘A revolution in transplant practice’
The researchers also noted the sizeable claims made by Chinese health officials about the growing numbers of voluntary donors supplying the so-called reformed transplant system.
“They have claimed a revolution in transplant practice across the country, with numbers of allegedly voluntary deceased donors growing at geometric rates and the cessation of all sourcing of organs from prisoners. It is these claims that are assessed in this report,” wrote the researchers.
In their work, the researchers pointed out that evaluating the Chinese transplant industry was extremely complicated.
“Most of the data held by Chinese governmental agencies on the matter is not available for public inspection,” they wrote, adding that they compiled and analyzed three available national datasets.
From this, they found what they believe to be manipulated data showing “extraordinarily smooth growth rates” which they said was the effort of human manipulation.
“We believe that the only plausible explanation for this is that the data were man-made, based on a mathematical formula; we believe that the sheer smoothness of the growth curve precludes it from having resulted from voluntary transplant activity or from minor manipulations of real data. This is borne out by the comparison to every other country with comparable data in the GODT (Global Observatory on Donation and Transplantation) database,” the researchers wrote.
They stated the “only plausible explanation” was that the three datasets “were manufactured and manipulated from the central levels of the Chinese medical bureaucracy.”
The researchers said they believe the falsification of the data was done on purpose.
“The goal of these elaborate efforts appears to have been to create a misleading impression to the international transplantation community about the successes of China’s voluntary organ donation reform, and to neutralize the criticism of activists who allege that crimes against humanity have been committed in the acquisition of organs for transplant,” they wrote.
A hybrid transplant program
The researchers said that they found a complex system driving the Chinese transplant sector that has evolved over time.
“Thus, rather than the solely prisoner-based organ transplant system of years past, or the untarnished voluntary system promised by officials, the available evidence indicates in our view that China has a complex hybrid transplant program: voluntary donations, incentivized by large cash payments, are apparently used alongside nonvoluntary donors who are marked down as citizen donors,” they wrote.
They stated that the nonvoluntary donors were most plausibly prisoners who are misclassified as “voluntary.”
“Our analysis of cases of misclassification found that the apparent prisoner donors were up to seven times more numerous than the apparently legitimate voluntary donors,” they wrote.
The researchers pointed out the international implications of their findings.
“China’s apparent systematic falsification of national organ donation data severely undermines the good faith efforts being made to integrate China into the international transplantation community,” they wrote.
“The World Health Organization, The Transplantation Society, the Declaration of Istanbul Custodian Group, and the Pontifical Academy of Sciences have all provided endorsements of the reforms based on what appears to be contaminated data. Medical journals have published transplant data on the good faith assumption that their Chinese counterparts have not falsified the true source of organs.”
As part of its conclusion, the paper advised the international transplantation community to reconsider its position on China’s transplant industry.
“Given that this data appears to have been falsified, international medical organizations may wish to reassess their stance. The welcoming of China’s organ transplantation system into the international medical community has been based on trust; in light of our findings, we believe this trust has been violated,” they wrote.
The release of the paper follows the China Tribunal, a people’s tribunal held in London chaired by Sir Geoffrey Nice QC, which delivered its findings in June that said large numbers of prisoners of conscience had been killed for their organs in China.
Based on a year-long investigation, the tribunal’s judgment prompted worldwide media attention over an atrocity that first came to light in 2006 following claims that imprisoned Falun Gong practitioners were being killed for their organs in Northeastern China.
Senior lawyer Hamid Sabi, who partook in the tribunal, recently told the UN Human Rights Council that it and UN member states are legally obligated to address the killing of innocent people for their organs in China.
The tribunal was established by the International Coalition to End Transplant Abuse in China (ETAC), an association of lawyers, academics, ethicists, medical professionals, researchers, and human rights advocates.
Among ETAC members are U.S. investigative journalist Ethan Gutmann, Canadian researchers former MP David Kilgour and human rights lawyer David Matas, who authored a 700-plus page report published in 2016 that demonstrated the extent of forced organ harvesting in China.
The report estimated that 60,000 to 100,000 organ transplants are performed annually in China. Among the evidence used to calculate these figures was data from hospital revenues, transplantation volumes, bed utilization rates, surgical personnel, training programs, and state funding.
They too concluded the source for these organs was prisoners of conscience, primarily Falun Gong practitioners.
Watch a short film about the tribunal and its findings here.