A WOIPFG Investigation Report on the Chinese Communist Party’s Ongoing Crime of Live Organ Harvesting against Falun Dafa Practitioners

From July 2016 to June 2017, World Organization to Investigate the Persecution of Falun Gong [WOIPFG] continued its phone investigation on 169 hospitals qualified to perform organ transplant surgeries, some unqualified hospitals, which also perform organ transplants, and some civilian organ donation organizations in mainland China. The investigation results show that the Chinese Communist Party’s [CCP] state crime of live organ harvesting against Falun Dafa practitioners is still ongoing. Moreover, the phenomenon of free liver transplantation has re-emerged in China!

This report shows104 recordings of telephone investigations on surgeons, nurses, organ transplant department heads and hospital presidents of nearly 100 hospitals located in most provinces of China. The reactions of this investigation’s subjects reveal from different angles the actual situation of the organ transplantation industry in mainland China.

The latest investigation results reveal:

1. The total organ transplant volume hasn’t been reduced. In particular, almost all of the 169 hospitals qualified to perform organ transplants are performing a large number of organ transplants, with an annual transplant quantity ranging from over 100 cases to over 1,000 cases each. The organ transplant volumes mentioned in this report are based on the information given orally by the investigation subjects. The actual amounts of the hospitals’ organ transplants might be even larger.

2. The situation of the hospitals offering short donor organ wait times, having ample donor organs and ensuring the excellent quality of donor organs has not changed. Furthermore, there are various signs suggesting the presence of a living human organ donor bank. It can be inferred that the CCP’s crime of live organ harvesting Falun Gong practitioners hasn’t stopped yet.

3. In the recent few years, the newly emerged organ transplant trends in China should arouse vigilance in all sectors of the society, both in China and abroad. After 2015, the CCP used the so-called “brain death” organ donations to replace its previous lie of using the organs of “executed prisoners”, and under the veneer of legality of the organ distribution network of the CCP’s National Health and Family Planning Commission [NHFPC], the crime of live organ harvesting Falun Gong practitioners has become part of the hospitals’ routine operations, and it has become more high-sounding and more deceptive than previously!

1) Regarding “brain death” organ donations

Regarding the “brain death” organ donations, on April 15, 2017, we investigated Zhang Wenlan, MD, from the Kidney Transplant Department at the First Hospital of Jilin University. She said, “Right now in our country, cardiac death donations are currently permitted. There is no clear diagnosis to determine brain death yet, so the answer is no.”

However, after 2015, the Chinese hospitals have always been claiming that they use donated organs from both DCD [Donations after Cardiac Death] and brain-death donations.

Wu Liming, a liver transplant surgeon at the First Affiliated Hospital of Zhejiang University, said, “Our current [organ sources] are mainly DCD. The state policy allows [the use of DCD organs] and encourages us to do as usual, anyway.”

Surgeon Piao Daxun of the First Affiliated Hospital of Harbin Medical University said, “Now China has started implementing the legislation on brain deaths. Unlike in the past, when it was illegal, now it is legal.”

Regarding the procurement of “brain-death” organs, on May 30, 2017, Doctor Liao Jixiang, organ procurement coordinator at the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province said during the phone investigation, “When you do a surgery, one person must be gone. I can assure you that the quality of our donors is definitely very good. We usually have many…we also use [many organs] from teenagers and people in their 20s, those kids. In the past, [the donors] needed to be shot, and the heartbeats would have been stopped for several minutes, over 20 minutes, [before the organs were excised]. We excise organs from braindead people, according to the government’s [regulations] right now. There’s almost no wait time to procure [the organs].”

2) The organ distribution network of the CCP’s National Health and Family Planning Commission

The hospitals with many transplant cases and stable donor sources, such as the PLA No. 303 Hospital, the PLA No.181 Hospital, the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Zhengzhou, all said that their donors were assigned to them by the state.

The surgeons, nurses, Red Cross organ donation coordinators and hospital organ procurement coordinators all said that they had never accessed this organ distribution website.

Doctor Liao Jixiang, organ procurement coordinator at the PLA No. 303 Hospital said that a password was required to access the website, because the state didn’t want people to know the secrets of these organs.

Director Wang, Coordinator for kidney transplant operations at Yantai Yuhuangding Hospital, said that the website couldn’t solve any problems. “That’s all deceiving people…all formalities.”

If the official website can distribute organs, then where do the large number of regularly delivered “brain death” organs come from?

4. A more serious phenomenon is that Jilin Provincial Travel Radio and the Hepatic Transplantation Center of the First Hospital of Jilin University jointly launched a program of free liver transplants for the first 10 children, who register with the program [From June 1 to June 30, 2017].[i] Therefore, both organizations are being suspected of rush killing the hostages held in the live organ donor pool.

Part I: Hospitals’ Organ Procurement Coordinators

WOIPFG conducted 10 telephone investigations on 8 organ procurement coordinators in 6 organ transplant hospitals. The investigation results reveal the following information:

I. The suspected existence of a human organ bank 

1. Yantai Yuhuangding Hospital, Shandong Province: It is guaranteed to operate on the patient within two weeks; the kidney donor is guaranteed to be under 30 years old.  The organs are not donated or obtained from the NHFPC. We have our own channels.

2. Zhejiang University International Hospital: “Liver procurement mainly depends on President Zheng. He has established a reputation and has lots of connections on various aspects. We would usually receive information on donor livers on the second day, [after we make an inquiry].”

3. The PLA No. 303 Hospital: “The organs are not from the Red Cross. There is a set of national procedures to follow [for organ allocation].”
 

II. “Brain death” donations are live organ harvesting

1. The PLA No. 303 Hospital: “In the past, [the donors] needed to be shot, and the heartbeats would have been stopped for several minutes, over 20 minutes, [before the organs were excised]. [As for brain-death donations,] there’s almost no wait time to procure [the organs] now. When you do a surgery, one person must be gone.”

2. Guo Hui, Organ Procurement Coordinator in the Organ Transplant Center at West China Hospital, Sichuan University: “One is donation by one’s relatives, and another is donation from braindead patients. There are two ways. All organ transplants are from these two ways.”
 

III. Suspicious-looking “persuasion for organ donations” by various hospitals

1. Ma Xiao, Organ Procurement Coordinator at the People’s Liberation Army No. 302 Hospital in Beijing: “I contact various hospitals or the hospitals nearby to find some donors. We cooperate with many other hospitals.”

2. The Second Xiangya Hospital of Central South University, Hunan Province: “We let the doctors do it [i.e. the explanation] for us. The patients’ families don’t trust us, they trust the doctors instead. The local patients and their families doubt us, then the local Red Cross people would be responsible for explaining it to them that this is a regular work supported by the state.”

Investigative Recordings:

Investigative Recording 1. Director Wang, Coordinator for kidney transplant operations at Yantai Yuhuangding Hospital, Shandong Province

Phone number: +86+ 13181994782    Date: 05/26/2017

1. To wait for the kidney source and for the operation, “including the physical examination, it will be within half a month, within two weeks.” “Even for half a month, or even two weeks, the estimates are on the long side.”
2. We ask for 400,000 yuan, and [you] give the hospital [another]100,000 yuan.
3. “You need to find the [donors] under 30 years old. You get what you pay for, understand?”

(Download Recording MP3， please seeAddendum 1)

 

Investigative Recording 2. Director Wang, Coordinator for kidney transplant operations at Yantai Yuhuangding Hospital, Shandong Province

Phone number: +86+ 13181994782    Date: 06/10/2017

1. (Waiting time for kidney transplant) It won’t take long, ten days. For blood type B patients, it’s within 10 days, one week or ten days, it’s within ten days for sure. Ten days will definitely do.
2.  (Question: Where do the donors come from?) We have our own channels. You don’t have to ask.
3. (Question: Taken from national organ network?) That’s all deceiving people. They are all formalities.
4.  (Question: Is that website accessible with an ID?) It is inaccessible. It belongs to the armed police. It’s not like that anyone can access it.

(Download Recording MP3， please seeAddendum 2)

Investigative Recording 3. Doctor Li, coordinator for kidney transplant surgeries at Yantai Yuhuangding Hospital, Shandong Province

Phone number: +86 18660597760      Date: 04/18/2017

1. “With blood type B, there are many donors, so it’s going to be quick.”
2. “We’ve just done a few Type B cases…about half a month.”
3. Donors from prisons, with the consent of their families, can be used, and these donors are available.

(Download Recording MP3， please seeAddendum 3)

Investigative Recording 4. Doctor Liao Jixiang, Organ Procurement Coordinator at the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86 182 7573 1616    Date: 05/30/2017

“We usually have many…we also use [many organs] from teenagers and people in their 20s, those kids. The quality of that type [of organs] is very good. And also, we excise organs from braindead people, according to the government’s [regulations] right now. They are even more than what we need. There’s almost no wait time to procure [the organs]. In the past, [the donors] needed to be shot, and the heartbeats would have been stopped for several minutes, over 20 minutes, [before the organs were excised]. When you do a surgery, one person must be gone.”

(Download Recording MP3， please seeAddendum 4)

Investigative Recording 5. Doctor Liao Jixiang, Organ Procurement Coordinator at the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86 182 7573 1616    Date: 06/11/2017 

1. “There should have been more than 120 cases of organ transplantation [this year].”
2. “The organs are not from the Red Cross. There is a set of national procedures to follow [for organ allocation].”
3. “For kidney transplantation, before reimbursement, it’s about 300,000 yuan.”

(Download Recording MP3， please seeAddendum 5)

Investigative Recording 6. Guo Hui, Organ Procurement Coordinator in the Organ Transplant Center at West China Hospital, Sichuan University

Phone number: +86 189 8086 1857    Date: 01/30/2017

“Our living donor organ transplantation ranks first, and the quality of the donor organs is quite good.”

(Download Recording MP3， please seeAddendum 6)

Investigative Recording 7. Ma Xiao, Organ Procurement Coordinator at the People’s Liberation Army No. 302 Hospital in Beijing

Phone number: +86-13911099030      Date: 07/31/2016

1. “We have done a lot [of liver transplants]. It’s been almost 60 cases in the first half of this year.”
2. “The organ transplantation is our highlight.”

(Download Recording MP3， please seeAddendum 7)

Investigative Recording 8. Xie Qinfen, Organ Procurement Coordinator for Liver Transplantation at Zhejiang University International Hospital

Phone number:  +86+13968153957    Date: 02/28/2017

1. “Generally speaking, it may take about two weeks [to get the liver]. Sometimes it’s very fast. Sometimes people can even do it on the second day. It depends on your situation. Critically ill patients can take the priority.”
2. “We have done a lot [of liver transplants], and we do a good job. The quality of liver sources at our hospital is relatively good, too. We did over 120 cases last year.”
3. “We would usually receive information on donor livers on the second day, [after we make an inquiry].”
4. “Liver procurement mainly depends on President Zheng. He has established a reputation and has lots of connections on various aspects.”

(Download Recording MP3， please seeAddendum 8)

Investigative Recording 9. Tan Liang, Organ Procurement Coordinator of the Second Xiangya Hospital of Central South University, Hunan Province

Phone number: +86 15116101512      Date: 04/24/2017

1. The hospital did over 300 cases of kidney transplantation.
2. [Investigator: I would like to know how you expand this business, I mean, to get so many donors.] Tan Liang: It’s mainly because of the doctors from different hospitals. Um, they help us carry out the work, this is the key part.
3. [Investigator: Does your hospital get many organs [from the website of National Health and Family Planning Commission?] Tan Liang: Do you mean that kind allocated through the network? Well, just so so, just so so.

(Download Recording MP3， please seeAddendum 9)

Investigative Recording 10. Guo Yong, organ procurement coordinator of the Second Xiangya Hospital of Central South University, Hunan Province

Phone number: +86+ 13787120686                Date: 04/25/2017

1. There are seven of us [coordinators liaising with local hospitals]
2. We let the doctors do it [i.e. the explanation] for us. The patients’ families don’t trust us, they trust the doctors instead.
3. The local patients and their families doubt us, then the local Red Cross people would be responsible for explaining it to them. [We pay] around 80,000 yuan for each donor’s family…according the provincial government’s documents.

(Download Recording MP3， please seeAddendum 10)

Part II : Hospitals’ Current Organ Transplant Situation

Below are 94 phone recordings of the investigations on the surgeons, nurses, Red Cross organ donation coordinators and hospital organ procurement coordinators from more than 80 hospitals, revealing from different angles the actual situation of the organ transplantation industry in mainland China.

1. The amounts of organ transplants are on the rise. When being investigated, the hospitals generally said that they would perform a lot of organ transplants, more than what they did last year, and they’d already done a lot this year. The transplant numbers mentioned have significantly increased from previous years. In most regions, the organ transplant volume is on the rise.

2. Wait times are short. Although the doctors wouldn’t give the exact wait times for organs, they generally would promise to the patients that for lucky ones, the wait times would be as short as one or two weeks, or possibly one or two months. But in general, the wait time is about one month.

3. The donors are all young and healthy. All doctors said the donor quality would be excellent: They are young and healthy, aged between 20 and 40 years old. And they wouldn’t use the donor organs, if their quality wasn’t good enough.

4. The organs used previously were the organs of executed prisoners and [Falun] Gong practitioners.  Many doctors and nurses being investigated admitted that they had used the organs of executed prisoners and [Falun] Gong practitioners in the past. But the use of such organs is no longer allowed. Some doctors directly admitted that their organ transplants used the organs of Falun Gong practitioners in the past.

I. Major hospitals suspected of live organ harvesting Falun Gong practitioners’ organs remain major organ transplant hospitals

1. In Beijing, Tianjin, Shanghai and Guangzhou, for more than a decade, a number of organ transplant hospitals are known as the major organ transplant hospitals, due to their ample organ donor sources and large transplant volumes. This investigation shows that the General Hospital of Chinese People’s Armed Police Forces in Beijing, Tianjin First Central Hospital’s Orient Organ Transplant Center, Renji Hospital of Shanghai Jiaotong University School of Medicine, Huashan Hospital Affiliated to Fudan University in Shanghai, Jiangsu Province Hospital, Zhongshan Hospital, Fudan University, Changhai Hospital in Shanghai, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Military Region General Hospital, the First Affiliated Hospital Sun Yat-sen University in Guangzhou, the Second Affiliated Hospital Sun Yat-sen University in Guangzhou and the Third Affiliated Hospital Sun Yat-sen University in Guangzhou have been performing a large number of organ transplants. They all said that they had ample donor sources, with an annual transplant volume ranking among the top several hospitals in the entire country.

2. Shandong has already had many organ transplant hospitals, which have been performing organ transplantation surgeries as part of their routine business. The Affiliated Hospital of Qingdao University had some surplus organs, which were given to Shanghai. Yantai Yuhuangding Hospital’s kidney transplant volume is as large as 300 cases per year. When Shandong Provincial Hospital’s organ transplant department was being investigated, a nurse repeatedly said, “Our surgeons are rarely here. They all went to do surgeries.”

3. The First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Zhengzhou are two large organ transplant hospitals. In 2016, the former performed more than 140 cases of liver transplantation and over 300 cases of renal transplantation; the latter performed more than 200 cases of liver transplantation and over 300 cases of renal transplantation.

4. Tongji Hospital in Wuhan performed more than 100 cases of liver transplantation and 400 to 500 cases of renal transplantation in 2016.

5. The Second Xiangya Hospital of Central South University performed 300 to 400 renal transplant operations in 2016.

II. The Emergence of New Hospitals with Large Organ Transplant Volumes

1. Headed by Zheng Shusen, the Organ Transplant Center of People’s Hospital of Zhengzhou has always been performing a very large number of liver transplants. In 2016, it conducted more than 200 cases of liver transplantation. In the same year, Zheng Shusen’s private hospital, “Zhejiang University International Hospital”, performed more than 120 cases of liver transplantation. It would perform 2 to 3 operations a day. The hospital would usually receive information on donor liver sources on the second day, after it makes an inquiry.

2. West China Hospital, Sichuan University, performed around 400 cases of kidney transplantation in 2016, and it can also perform several hundred cases of liver transplantation per year.

3. The PLA No. 303 Hospital in Nanning and the PLA No. 181 Hospital in Guilin are both military hospitals, with each having established one organ transplantation research center for the entire army. In 2016, both hospitals performed around 300 cases of kidney transplantation each. However, due to the lack of liver transplantation patients, most of their liver sources were given to other hospitals. 

 

Investigative Recordings:

Beijing

Investigative Recording 11. Doctor-on-duty, Kidney Transplant Department at the General Hospital of Chinese People’s Armed Police Forces in Beijing

Phone number: +86-10-57976857      Date: 03/29/2017

1. The Organ Transplant Department the General Hospital of Chinese People’s Armed Police Forces is divided into a kidney transplant team and a liver transplant team. The kidney transplant team is managed by two chief physicians; while there are several chief physicians in charge of the liver transplant team.
2. Each of the two kidney transplant teams can do more than 200 cases of kidney transplantation every year. Altogether, both teams can do more than 500 cases of kidney transplantation each year.
3. Director Wang Jianli and Director Liu Hang oversee both teams respectively.

(Download Recording MP3， please seeAddendum 11)

Investigative Recording 12. Nurse on duty, liver transplant department at the General Hospital of Chinese People’s Armed Police Forces in Beijing

Phone number: +86+ 10_57976114    Date: 05/06/2017

We do them [i.e. liver transplants] every day. For us, it’s not very difficult.

(Download Recording MP3， please seeAddendum 12)

Investigative Recording 13. Doctor on duty, liver transplant department at 302 Military Hospital of China in Beijing

Phone number: +86+ 10_66933449                Date: 05/05/2017

1. Some people get it faster, like in a week; some people get it slower, like in 2 or 3 months.
2. We did more than 100 cases last year.

(Download Recording MP3， please seeAddendum 13)

Investigative Recording 14. Dr. He Enhui, liver transplant operations at Beijing Friendship Hospital

Phone number: +86+ 13699102049    Date: 09/02/2016

1. “We have been doing liver transplants for more than a dozen years. Every year we do more than 100 cases.”
2. “In this year, there must have been [several dozen cases] till now. We do 2 to 3 cases on average every week.”
3. “Altogether for an adult liver transplant, it costs more than 600,000 yuan.”
4. “Professor Zhu has done more than 1,900 cases.”

(Download Recording MP3， please seeAddendum 14)

Investigative Recording 15. Dr. Kou Jiantao, the Liver Transplant Ward at Beijing Chao-Yang Hospital

Phone number: +86+ 10_85231501    Date: 03/12/2017

1. “We have done 20 cases since the New Year’s Day [this year].”
2. “We did 60 cases last year. [Investigator: It looks like that this year you are going to do more than last year.] Right.”

(Download Recording MP3， please seeAddendum 15)

Investigative Recording 16. Dr. Zhu from Liver Transplant Doctor’s office at Beijing YouAn Hospital

Phone number: +86+10-83997176     Date: 03/24/2017

1. The hospital can perform more than 80 cases of liver transplantation each year.
2. The wait time can be as fast as a week or two.
3.  [Investigator: you previously used livers from death-row prisoners. Is it still available now?] Dr. Zhu: This, it’s impossible to tell you, regarding this aspect it’s impossible to, whoever...I don’t even know it myself. But we don’t use non-functioning livers for our patients.
4. [Investigator: If it all relies on donation from the Red Cross, are there that many voluntary donors?] Dr. Zhu: Uh, this, I can’t…it’s inconvenient for me to tell you.
5. “The liver source…, I don’t know about the liver source, either. I don’t know the situation, either.”
6. [Investigator: If it’s not allowed to be used, I need to tell her.] Dr. Zhu: This...it’s not convenient for me to tell, not convenient to tell, alright?

(Download Recording MP3， please seeAddendum 16)

Tianjin

Investigative Recording 17. A doctor from the Doctor’s office of the Liver Transplant Department at Tianjin First Central Hospital, Orient Organ Transplant Center.

Phone number: 022-23626860            Date: 07/21/2016

1. “Our hospital does several hundred cases each year.”
2. [Investigator: For the first half of this year, has your hospital done 100 or 200 cases of liver transplantation?] Doctor: More than that.

(Download Recording MP3， please seeAddendum 17)

Investigative Recording 18. Dr. Zhou in the Department of Cardiac Surgery at Tianjin First Central Hospital, Orient Organ Transplant Center.

Phone number: +86-2223627096        Date: 08/11/2016

1. “Our hospital can do heart transplants. We rank among the top 5 in the entire country every year.”
2. “Type O is the most difficult [to find donors]. A while ago, a Type O patient waited for more than a month to get a donor.”
3. “We do a lot of liver and kidney [transplants]. However, there are fewer heart donors, unlike livers and kidneys.”
4. “We are a center here. [Investigator: So there are many teams doing it, not just him alone.] Right.”
5. “We’ve done 9 cases [of heart transplantation] so far this year.”

(Download Recording MP3， please seeAddendum 18)

Investigative Recording 19. A surgeon of the Liver Transplant Department on the Eighth Floor of Orient Organ Transplant Center at Tianjin First Central Hospital.

Phone number: 022 23626848            Date: 01/01/2017

“Performed 300 to 400 liver transplants in 2016.”

“Everything is as usual. [He was referring to performing organ transplants during the Chinese New Year period]”

(Download Recording MP3， please seeAddendum 19)

Investigative Recording 20. Kong Defu, a Surgeon for kidney transplant operations at Renji Hospital of Shanghai Jiaotong University School of Medicine

Phone number: +86+ 18817667836    Date: 03/18/2017

1. “In 2016, we should have done 700 cases [of organ transplantation].”
2. The hospital has done more than 100 transplants, since the beginning of year 2017.
3. In the past, the patients only needed a very short wait time to find a donor from the prisons.
4.  “Many [organs] are from other cities. For instance, when a matching liver is found, it will be shipped to us very quickly.”
5. The hospital has the capability to form three or four teams to perform transplants simultaneously.

(Download Recording MP3， please seeAddendum 20)

Investigative Recording 21. Director Hang Hualian of the Liver Transplant Division at Renji Hospital of Shanghai Jiaotong University School of Medicine

Phone number: +86+ 18616206806    Date: 03/25/2017

1. “For [Blood] Type B, it should take less than two weeks [to find a donor].”
2. “We did 521 cases last year. We have performed nearly 100 operations this year. We almost perform two transplants a day.”
3. [Investigator: When a patient is in critical stage and identified as brain-dead, do you use them as donors?] Hang: That is the usual situation for us…
4. [Investigator: Do you excise livers in your own hospital? Or do you procure (livers) from other hospitals?] Hang: Both situations exist.

(Download Recording MP3， please seeAddendum 21)

Investigative Recording 22. Doctors’ Office of the Liver Transplant Division at Huashan Hospital Affiliated to Fudan University in Shanghai

Phone number: +86 2152887174        Date: 11/02/2016

1. “We have done a lot [of liver transplants]! We have done more than 100 cases [this year].”
2. The hospital has an ample supply of donors.
3. “We did two transplants just today.”
4. “Our hospital is among the top three in Shanghai [in terms of liver transplants].”

(Download Recording MP3， please seeAddendum 22)

Investigative Recording 23. Doctor-on-duty (liver transplantation) at Huashan Hospital Affiliated to Fudan University in Shanghai

Phone number: 2152887174   Date: 03/07/2017

1. Last year we did more than 100 cases. Some people did it as soon as they arrived.

2. We’ve always been doing it. We’ve never stopped doing it.

3. We’ve been doing it almost every day. Now, [such operations] have been routinely carried out.

(Download Recording MP3， please seeAddendum 23)

Investigative Recording 24. Wang Ping, liver transplantation director at Jiangsu Province Hospital

Phone number: + 86 + 13951873090              Date: 07/24/2016

1. [To change the liver], no problem. You just come, and directly come to see me.

2. We often do this. This is our routine work, a routine thing.

3. Patients of blood Type B can obtain a liver after waiting for one month.

(Download Recording MP3， please seeAddendum 24)

Investigative Recording 25. A doctor at the liver transplantation department of Jiangsu Province Hospital

Phone number: +86+ 25_68136851                Date: 02/19/2017 (10:37:11)

1. For peak periods, there are 4-5 operations per week, and at least 2-3 operations per week.
2. We should have done the largest number [of operations] in our province, but certainly less than [the hospitals in] Shanghai.
3. If death-row prisoners sign an organ donation consent before they die…then [we] would just go to take [their organs].
4. Then I can take it before he dies or, when he has just died, when he is dying, and then donate it.
5. When the kidney source is taken here,…who can guarantee that it was definitely donated, if it’s from an executed prisoner. Who knows what the kidney source is?...

(Download Recording MP3， please seeAddendum 25)

Investigative Recording 26. A doctor-on-duty for the large department of organ transplantation at the First Affiliated Hospital of Soochow University

Phone number: + 86-51267972185     Date: 04/19/2017

1. Q: Can we still use [the organs from] the prisons, the ones, who are sentenced to death [and who were used] in the past? A: Yes.

2. Q: The patient has a request to use [an organ] from someone in prison, you can help find one, right? A: About this, it’s not that we can help you find [one kidney]. If they have a kidney source, then they will inform our hospital… If the [blood] type matching is successful, then we use it.

(Download Recording MP3， please seeAddendum 26)

Shandong Province

Investigative Recording 27. Doctor Yue of the Kidney Transplantation Ward at the Affiliated Hospital of Qingdao University, Shandong Province

Phone number: +86 + 532_82919529             Date: 11/15/2016

1. “[The number of transplants] we did this year is among the top three in China.”
2. “Our advantage is that we have ample kidney sources. In general, if a patient’s lucky enough, then [it takes] just two weeks. Generally speaking, it’s very fast.”
3. “They have a special organ donation organization. We have abundant kidney sources.”

(Download Recording MP3， please seeAddendum 27)

Investigative Recording 28. Doctor Wang of the Organ Transplantation Department at the Affiliated Hospital of Qingdao University, Shandong Province

Phone number: +86 53282919528      Date: 02/11/2017

1. “We have more [opportunities to perform organ transplants] here.”
2. “We have 300 donated kidneys, but we only performed 160 cases… The rest were sent by us to Shanghai.”

(Download Recording MP3， please seeAddendum 28)

Investigative Recording 29. Doctor Yan Jieke of the Doctors’ Office in the Renal Transplantation Department at the Second Affiliated Hospital of Shandong University

Phone number: +86 531-85875622     Date: 12/20/2016

1. “We have done about 130 [kidney transplants this year].”
2. “In Shandong Province, we do relevantly more [cases]. Almost all of ours are allogeneic.”
3. “Today I just finished one operation. Today we performed two cases. Tomorrow we’ll also have two cases.”
4. “We are on the 13th floor in the tallest building.” The entire 13th floor belongs to the organ transplantation department.

(Download Recording MP3， please seeAddendum 29)

Investigative Recording 30. Doctor on duty for kidney transplant operations in the Urinary Surgery Department at Qianfoshan Hospital of Shandong Province.

Phone number: +86 53189268575      Date: 03/31/2017

1. “Our hospital has a specific coordinator for organ [procurement]. He makes contacts [to obtain organs].”
2. “We have two wards. For both wards combined, there are more than 70 beds. In one year, we can do more than 100 cases [of kidney transplantation], including [the cases using organs from] relatives. [The doctors] are very skilled in these techniques.”
3. “We can do around 30 cases [of liver transplantation]. We rank second in the entire province.

(Download Recording MP3， please seeAddendum 30)

Investigative Recording 31. A ward nurse for kidney transplant operations at Shandong Provincial Hospital

Phone number: +86 531 68776161     Date: 04/07/2017

The hospital does a lot of kidney transplants. It has done 50 cases of kidney transplantation this year. “Our surgeons are rarely here. They all went to do surgeries.”

(Download Recording MP3， please seeAddendum 31)

Investigative Recording 32. A ward nurse for kidney transplant operations at Shandong Provincial Hospital

Phone number: +86 531 68776161     Date: 04/08/2017

1. “We’ve already done a lot [of kidney transplants] this year! We did several cases in recent several days.
2. Just come here, it’s very fast [to have the surgery].
3. [Investigator: Generally speaking, the allografts were from death-row prisoners and practitioners, right?] Nurse: Yes, they were, in the past.
4. The nurse knew that the hospital used death-row prisoner and practitioner donors in the past.

(Download Recording MP3， please seeAddendum 32)

Investigative Recording 33. A Doctor from the Doctors’ Office for kidney transplantation in the Urinary Surgery Department of Jinan Military General Hospital, Shandong Province

Phone number: 053151665311           Date: 04/08/2017

1. The hospital did 200 or 300 cases last year.
2. “This kind of things are arranged by the hospital. We don’t know how long you’ll have to wait.”

(Download Recording MP3， please seeAddendum 33)

Investigative Recording 34. Doctor Li Facheng, Organ Procurement Coordinator for kidney transplant operations at Yantai Yuhuangding Hospital, Shandong Province

Phone number: 18660597760             Date: 04/18/2017

1. “He can have his surgery within half a month.”

2. “Our director [Liu Dongfu] has done nearly 2,000 cases, starting from 1988.”

(Download Recording MP3， please seeAddendum 34)

Investigative Recording 35. Doctor Shan Zhenfei for kidney transplant operations at Yantai Yuhuangding Hospital, Shandong Province

Phone number: +86 535 6691 999      Date: 04/25/2017

1. “I can only tell you that this year is better than last year, [in terms of the transplant volume].” Last year, the hospital performed more than 200 cases.

2. “In general, the wait time here is very short. We have a lot [of patients] here. Some patients from other provinces are all living in our hospital here.”

(Download Recording MP3， please seeAddendum 35)

Investigative Recording 36. Ni Jialian, the former Director of the Kidney Transplantation Department at Jinan Military General Hospital, Shandong Province

Phone number: +86-1192017_134231            Date: 01/19/2017

1. “It is hard to say. The previous donors were all prisoners.”

2. [Investigator: So all the ones you used in the past were the organs from Falun Gong practitioners, right?] Ni: Yes.

(Download Recording MP3， please seeAddendum 36)

Guangxi Province

Investigative Recording 37. A staff on duty in the Nurses’ Office at the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86+ 771_2870605                Date: 01/12/2017

1. The hospital did around 300 cases of kidney transplantation in 2016.

2. “We have around 100 inpatients right now.”

3. The ward beds are in short supply in the organ transplantation center. “[The patient] has to live in the hallway first, if he comes.”

4. “[The building has] ten floors. Nine floors belong to our organ transplantation center.”

(Download Recording MP3， please seeAddendum 37)

Investigative Recording 38. Doctor Huang Xiaochun for liver transplantation in the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86+ 771_2870635                Date: 01/11/2017

1. “In general, it needs more than a dozen days or even a month [to find a donor].”

2. “We can do about 200 or 300 kidney transplants, about 30 or 50 liver transplantation operations in one year.”

3. “There are many such organ transplantation centers in Guangdong, but they don’t have such ample organ donors as we do.”

(Download Recording MP3， please seeAddendum 38)

Investigative Recording 39. Director Huang Pinghua of Outpatient Service ICU in the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86+ 771_2870029                Date: 01/24/2017

1. “We’ve done all kinds of organ transplantation operations, including liver, heart, lung, kidney and pancreas transplants. We are quite powerful, as we can do any organ transplantation operations. We can do all the [organ transplant] operations available.”

2. “There are many chances to receive the liver transplantation operations. And it would be very fast. Please come over immediately. We might do [transplants] before the Chinese New Year, during the New Year…at any time.”

3. “[We can do] about several dozen operations in a year. We have been doing them for a long time, eight to ten years.”

(Download Recording MP3， please seeAddendum 39)

Investigative Recording 40. Doctor Nie Feng for liver transplantation at the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +8613907867158                   Date: 06/02/2017

1. “It would be very fast, very fast [to find organ donors]!”

2. “We received around 100 donated organs last year. So there was on average one operation every three days. We did more than 200 kidney transplantation operations [last year].”

3. “There are should be more organ transplantation operations this year. In the first half of the year, we should have received more than 80 cases [of liver donations]. We did approximately more than 30 cases of liver transplantation. Now we may have done more than 100 kidney transplantation operations. There have been many [organs] distributed elsewhere.”

(Download Recording MP3， please seeAddendum 40)

Investigative Recording 41. A Nurse on duty for kidney transplantation at the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86+ 771_4978171    Date: 06/30/2017

1. [Investigator: You have four kidney transplantation operations today, right?] Nurse: Yes, yes! Dr. Gao Zhao is still doing the operations now, and he hasn’t finished yet.
2. [Investigator: Did the four patients (who are being operated on) wait for a long time?] Nurse: Not very long, just several months.

(Download Recording MP3， please seeAddendum 41)

Investigative Recording 42. Doctor Yang Zhijian of the Hepatobiliary Surgery Department at the Chinese People’s Liberation Army No. 181 Hospital in Guilin, Guangxi Province

Phone number: 134 7135 6190           Date: 09/01/2016

1. “Starting from April 1, [2017], it’s not allowed to use organs from executed prisoners.”
2. “We did around 30 kidney transplantation operations in July.”
3. “If there are 30 kidneys, there would be at least 15 livers. We do a small number of liver transplantation operations. Nobody is doing them. [People in] Guangxi are poor. They cannot afford to do that.”
4. “In the past, they [i.e. the organs] were all excised in the prisons. Now they’re all excised in the hospital.”
5. [Investigator: Oh, do you have a special department [excising organs] in the hospital? Not done by yourselves?] Yang Zhijian: The hospital is doing it. It’s the hospital doing it. It has a set of specific procedures.

(Download Recording MP3， please seeAddendum 42)

Investigative Recording 43. Chen Huaizhou, Director of the Organ Transplant Department at the Chinese People’s Liberation Army No. 181 Hospital in Guilin, Guangxi Province

Phone number: 13087737632             Date: 01/18/2017

1. “Sometimes [the organ] becomes available, as soon as the patient comes. Very fast.”
2. [Investigator: Does the Red Cross provide the donors?] Chen: You don’t have to care about the donors.

(Download Recording MP3， please seeAddendum 43)

Investigative Recording 44. Yang Ming, President of the Chinese People’s Liberation Army No. 181 Hospital in Guilin, Guangxi Province

Phone number: +86 13977320723      Date: 01/21/2017

1. “Now the organs are from brain-dead or cardiac dead people.”
2. [Investigator: If the organs are from donation, are there enough people to donate locally?] Yang: Now there are a lot of donated [organs]. We generated the stories featured on the TV program “Touching China”.

(Download Recording MP3， please seeAddendum 44)

Investigative Recording 45. Director Sui Weiguo of the Organ Transplantation Center of the Chinese People’s Liberation Army No. 181 Hospital in Guilin, Guangxi Province

Phone number: 13907735881             Date: 01/31/2017

1. “We do more than 200 cases of kidney transplantation in a year, and about 30 to 40 cases of liver transplantation in a year.”
2. “We started [doing organ donations] early in the country, because [we are] advanced. So, we have many [donated organs] a year.”
3. “We have more than 100 [organ donors] every year. As for every week, there would be one or two [donors].”

(Download Recording MP3， please seeAddendum 45)

Zhengzhou

Investigative Recording 46. Doctor Liu Yifan in the doctors’ office for liver transplantation at the First Affiliated Hospital of Zhengzhou University, Henan Province

Phone number: +86 37167967127                  Date: 12/16/2016

1. “We did 16 cases [of liver transplantation] in November, and in [December], we did 6 cases.”
2. “This year, from January 1, 2016 to the present, we have done 139 cases.”

(Download Recording MP3， please seeAddendum 46)

Investigative Recording 47. Doctor Yuan for liver transplantation at the First Affiliated Hospital of Zhengzhou University, Henan Province

Phone number: 0371-67967127                      Date: 03/03/2017

1. “If being lucky, in fact, you can do [the transplant] on the same day, when you arrive here.”
2. “Last year, we did over 140 cases, basically one case every two days.”
3. “There is a specialized agency of the state to distribute [organs] to us. Nobody knows when there will be donors.”
4. Investigator: The [use of the] kind of [organs from] those death-row prisoners in the past. Yuan Bai: No, those were all banned in the country. Very interesting!

(Download Recording MP3， please seeAddendum 47)

Investigative Recording 48. Doctor on duty for kidney transplantation at the First Affiliated Hospital of Zhengzhou University, Henan Province

Phone number: +86+ 371_66862191              Date: 05/09/2017

1. “We did more than 300 cases [of kidney transplantation last year].”
2. “We already did more than 100 cases this year.”

(Download Recording MP3， please seeAddendum 48)

Investigative Recording 49. Doctors on duty for kidney transplantation at the First Affiliated Hospital of Zhengzhou University, Henan Province

Phone number: +86-37166862192                  Date: 06/28/2017

1. “Our hospital has relatively more ample kidney sources than the other hospitals.”
2. “[From the beginning of this year till now, we should’ve done 200 to 300 cases [of kidney transplantation].”
3. “Last year we did more than 300 cases [of kidney transplantation].”  

(Download Recording MP3， please seeAddendum 49)

Investigative Recording 50. Doctor on duty in the organ transplantation department at the People’s Hospital of Zhengzhou, Henan Province

Phone number: +86+ 371_67077512              Date: 12/17/2016

1. “Some [donor organ] wait times are long and others short. Shouldn’t be more than three or five days, or a week or half a month. It should be relatively fast.”
2. “[We’ve done] more than 200 cases [this year]…basically non-stop…In December, we did several dozen cases.”
3. “For us now, organ transplantation surgeries are very common. Sometimes, we can perform two, three or four surgeries back-to-back.”
4. “We basically can do five or six [operations] back-to-back within 24 hours. Two liver [transplants] and four kidney [transplants].”

(Download Recording MP3， please seeAddendum 50)

Hangzhou

Investigative Recording 51. Liang Jianzhong, Liver Transplant Department at Zhejiang University International Hospital

Phone number: +86+ 13516703061                Date: 07/25/2016

1. “If it’s really urgent, we can certainly do the surgery immediately.”
2. “Our doctors’ team is relatively strong. Our medical team is relatively strong, too. Liver transplantation is [our] preponderant discipline.”
3. “Every day, we do 2-3 cases [of liver transplant surgeries].”
4. “The liver sources are relatively easy to find.”

(Download Recording MP3， please seeAddendum 51)

Investigative Recording 52. Dr. Wu Weilin, Liver Transplant Department at Zhejiang University International Hospital

Phone number: +86 +15958185259                Date: 07/28/2016

1. “Zhejiang University International Hospital was just established this year… We have already done more than 50 cases [of liver transplantation].
2. They are waiting for the approval of transplant qualification. But the authorities have tacitly approved it.
3. “We have about 100 inpatients [for liver transplants]. We do transplants every day.”

(Download Recording MP3， please seeAddendum 52)

Investigative Recording 53. Doctor Zhao for liver transplant operations at the Third Hospital of Hebei Medical University

Phone number: +86-31188603029                  Date: 03/13/2017

1. “We do a lot [of liver transplants].”
2. “For last year, I don’t remember the exact number clearly. However, our overall number is among the top 10 in the entire country.”
3. “If you can wait until the surgery time, it will be about a month or so.”
4. “We started [conducting liver transplants] in 2003.”
5. “We are now all [using organs] donated by brain-dead donors.”

(Download Recording MP3， please seeAddendum 53)

Investigative Recording 54. Doctor Jiang Jianwen for liver transplant operations at the First Affiliated Hospital of Zhejiang University

Phone number: +86+13588449092                 Date: 02/28/2017

1. The First Affiliated Hospital of Zhejiang University has been conducting more than 200 cases of liver transplants each year.
2. Zheng Shusen has newly established a hospital called Shulan Hospital [i.e. Zhejiang University International Hospital], which has done more than 100 cases of liver transplants.   

(Download Recording MP3， please seeAddendum 54)

Guangzhou

Investigative Recording 55. A ward nurse for kidney transplant operations at the Second Affiliated Hospital of Guangzhou Medical University

Phone number: +86+ 20_34153251                Date: 01/06/2017

1. The hospital is still open during the Chinese New Year period.
2. “We do [kidney transplants] at any time. There are donors all the time, we do it at any time, as long as there are materials.”
3. “Tomorrow there will be four operations.”
4. The hospital performed about 260 cases [of kidney transplantation] in 2016.

(Download Recording MP3， please seeAddendum 55)

Investigative Recording 56. Doctor Pu Miaoshui for liver transplant operations at Guangzhou Military Region General Hospital

Phone number: +86+13682253550                 Date: 01/23/2017

1. The donor wait time is about a month.
2. “There are now temporarily four hospitals in Guangzhou [doing liver transplantation]. Our General Hospital, two hospitals affiliated with Sun Yat-sen University, and in Zhongshan, China Southern Airlines Hospital, a total of four hospitals.”
3. “[The use of organs from death-row inmates and (Falun) Gong practitioners] was legal before, now it is not illegal, but now it has been forbidden by the government. It does not work when the state says no. It is not an issue of legality.”

(Download Recording MP3， please seeAddendum 56)

Investigative Recording 57. Doctor Zhao Jiqiang for liver transplant operations at Guangzhou Military Region General Hospital

Phone number: +18002262868                       Date: 03/10/2017

1. “[In terms of liver transplantation,] the Guangzhou Military Region General Hospital is also one of the top three organ transplant centers in southern China, its rank is also relatively high.”
2. “[The death-row prisoner donors] have all been abolished, no more. There are still a lot [of liver transplants], in comparison with the previous situation.”

(Download Recording MP3， please seeAddendum 57)

Investigative Recording 58. Nurse on Duty in the Nurse’s Station of the First Ward of the Liver Transplant Department at the First Affiliated Hospital of Sun Yat-sen University in Guangzhou

Phone number: +86 20_28823388                  Date: 02/02/2017

1. “It should be more than 100, around 200 [cases of liver transplantation done in 2016].”
2. “For some people with the shortest [wait times], it could be done in a few days or a week, after they came into the hospital.”

(Download Recording MP3， please seeAddendum 58)

Investigative Recording 59. A Ward of the Kidney Transplant Department at the Third Affiliated Hospital of Sun Yat-sen University in Guangzhou

Phone number: +86-76089880660                  Date: 03/15/2017

1. “We do an average of 80 cases [of kidney transplantation] per year.
2. “We have always been doing them, even during the Chinese New Year period.”
3. “We have opened a new place to do kidney transplants…in another building. It’s a special place to do transplants. It’s like a small hotel, [with all single rooms].”

(Download Recording MP3， please seeAddendum 59)

Investigative Recording 60. A Nurse in the Nurses’ Office for kidney transplantation at the First Affiliated Hospital of Jinan University

Phone number: +86 + 20_38688524

1. The hospital performs around 100 cases of kidney transplantation a year.
2. The nurse is not clear about their kidney sources.

(Download Recording MP3， please seeAddendum 60)

Hunan Province

Investigative Recording 61. Head nurse Nie Menghua in the Third Ward of kidney transplantation at the Second Xiangya Hospital of Central South University, Hunan Province

Phone number: 073185296141                       Date: 04/18/2017

1. “We may indeed have shorter wait times here than those of other places.”
2. “Last year we did 300 or 400 cases [of kidney transplantation].”

(Download Recording MP3， please seeAddendum 61)

Investigative Recording 62. Doctor Liu in the liver transplantation ward at the Third Xiangya Hospital of Central South University, Hunan Province

Phone number: 073188618236                       Date: 04/17/2017

1. “We do a lot of liver transplants. We’ve already done a total of over 1,000 cases of liver transplantation.”
2. “We did kidney transplants last year, more than 200 cases. The liver transplants were slightly less than the kidney transplants, but we still did 80 or 90 cases [last year]!

(Download Recording MP3， please seeAddendum 62)

Investigative Recording 63. A nurse in the kidney transplant ward at Yiyang Central Hospital in Yiyang City, Hunan Province

Phone number: +86-737 4230527                   Date: 01/10/2017

1. “As long as you do the surgery, we can arrange [a bed for you].”
2. “We did more than 100 cases [of kidney transplantation in 2016].”

(Download Recording MP3， please seeAddendum 63)

Wuhan

Investigative Recording 64. Doctor Mao in the Liver Transplantation Team of the Organ Transplant Department at Tongji Hospital in Wuhan

Phone number: +862783665363                     Date: 06/07/2017

1. “Last year, we did over 100 cases [of liver transplantation].”
2. “[The donor organ wait time] is probably about a month or so.”
3. “Specifically, about the other aspects [of the donors], we do not know. This information is also confidential.”
4. Last year, the hospital did 400 or 500 kidney transplants.

(Download Recording MP3， please seeAddendum 64)

Investigative Recording 65. The Person in charge of the registrar at the Tongji Hospital Transplantation Institute in Wuhan (A)

Phone number: +86 + 2783665283                 Date: 06/13/2017

1. “We’ve ranked first nationwide, in terms of the kidney transplant volume, in the recent two years.”
2. “In the past few years, it was about 400 cases [per year].”

(Download Recording MP3， please seeAddendum 65)

Investigative Recording 66. The Person in charge of the registrar at the Tongji Hospital Transplantation Institute in Wuhan (B)

Phone number: +86 + 2783665283                 Date: 06/13/2017

1. “We do liver transplants, approximately over 100 cases a year.”
2. A kidney transplant costs 400,000 yuan, and liver transplant costs 600,000 yuan.

(Download Recording MP3， please seeAddendum 66)

Investigative Recording 67. Doctor Zhang for Liver Transplantation at Zhongnan Hospital of Wuhan University

Phone number: 18942924741                         Date: 09/12/2016

1. The donor organ wait time is usually a month.
2. Every year, the hospital does more than 100 cases of liver transplantation.

(Download Recording MP3， please seeAddendum 67)

Investigative Recording 68. A kidney transplantation doctor in the Organ Transplantation Division of Renmin Hospital of Wuhan University

Phone number: +86 2788041919                    Date: 04/16/2017

1. “We did more than 100 cases [of kidney transplantation] last year!”
2. The hospital has done at least 30 or 40 cases, which would the doctor’s lowest estimate. He said, “[It should be] more than that. We even did two cases today.” 

(Download Recording MP3， please seeAddendum 68)

Investigative Recording 69. Doctor Chen in the Kidney Transplantation Division of Renmin Hospital of Wuhan University

Phone number: 88041919—81848                 Date: 04/26/2017

1. “Our hospital did 130 cases [of kidney transplants] last year.”
2. “Up to April this year, we have done more than 60 cases.”

(Download Recording MP3， please seeAddendum 69)

Sichuan Province

Investigative Recording 70. Doctor Chen Kai, Hospitalization Director for liver transplantation at Sichuan Provincial People’s Hospital

Phone number: +86 17708130503                  Date: 03/29/2017

1. “This year, we might have already done more than 30 cases.”
2. “This donor information is confidential on a national level. We, we do not know about the donor’s information.”
3. “We have special personnel in charge of procuring donor [organs]. Even we organ transplant doctors do not know the specific information of these donors.

(Download Recording MP3， please seeAddendum 70)

Investigative Recording 71. Doctor on Duty for Liver Transplantation at Sichuan Provincial People’s Hospital

Phone number: +862887393722                     Date: 03/29/2017

1. “Last year, it seems to be more than 60 cases [of liver transplantation]…A little bit more [cases] in the recent months in this year. For example, last Sunday we did one, today [Wednesday] we did another one.”  
2. “Since we excised [some organs] last night, so we have both liver and kidney transplants today.”

(Download Recording MP3， please seeAddendum 71)

Investigative Recording 72. Doctor in the Doctors’ Office for Liver Transplantation at Sichuan Provincial People’s Hospital

Phone number: +862887393722                     Date: 03/30/2017

1. “We usually do three kidney transplants. That is, three pairs [i.e. six] of kidney transplantation operations.”
2. “[In terms of the wait time,] it is quite fast in general.”
3. This hospital does “several hundred operations” a year.

(Download Recording MP3， please seeAddendum 72)

Investigative Recording 73. A ward nurse on duty of the kidney transplant department at West China Hospital, Sichuan University

Phone number: +86 28-85422925

1. The hospital did “300 or 400 cases [of kidney transplantation] last year.
2. “Now our departments are divided into very specific sections. We also do liver transplantation, heart transplantation, brain transplantation and kidney transplantation here.”

(Download Recording MP3， please seeAddendum 73)

Investigative Recording 74. Doctor on duty of the liver transplant department at West China Hospital, Sichuan University

Phone number: +86 18980601479                  Date: 06/06/2017

1. There is someone in charge of finding organ donors in this hospital.
2. “No one else knows the specific situation about the donors. The organ recipients’ family members are not allowed to know anything about the donors. And it’s the same for the donors’ family members, who are not allowed to know anything about the recipients.”
3. The hospital is doing a lot of liver transplants.
4. The doctor refused to disclose the numbers of liver transplants performed in 2016 and in 2017.

(Download Recording MP3， please seeAddendum 74)

Kunming

Investigative Recording 75. A ward doctor for kidney transplant operations at the First Hospital of Kunming

Phone number: +86+ 871_67390509              Date: 07/22/2016

1. When the investigator called, the director and his team were not in the office, as they were doing a kidney transplant operation.
2. The hospital has done around 200 transplants in the past six months.
3. The patients’ donor organ wait time is approximately one month.

(Download Recording MP3， please seeAddendum 75)

Investigative Recording 76. A nurse on duty in the Liver Transplant Ward A at the First Hospital of Kunming

Phone number: +86 87167390554                  Date: 11/25/2016

1. “We have done a lot [of liver transplants]! We haven’t stopped doing them since last August.”
2. “We should have done more than 100 [cases this year, so far].”
3. The nurse is not sure about the organ sources.
4. “We were able to do three operations in one day, when we had liver sources in the past.”
5. The hospital has more than 20 doctors, who can do liver transplants.

(Download Recording MP3， please seeAddendum 76)

Investigative Recording 77. Zhu Xinfeng, Doctor on duty in the Liver Transplant Department at the First Hospital of Kunming

Phone number: +86+ 15877991035                Date: 05/20/2017

1. “Back in the days, I am not afraid of saying this out, let me tell you, [the organ donors] were all executed prisoners, etc. This is not allowed anymore.”
2. “We have done several dozen cases this year for sure. Altogether, we’ve done more than 800 cases [of liver transplants].”
3. There is a separate fee for liver procurement.

(Download Recording MP3， please seeAddendum 77)

Jilin Province

Investigative Recording 78. A nurse on duty in the Liver Transplant Ward at the First Hospital of Jilin University

Phone number: +86 43 181875162                 Date: 07/14/2016

“We did do three [operations] on the night before last. Why would I say so, if we didn’t actually do three of them?”

(Download Recording MP3， please seeAddendum 78)

Investigative Recording 79. Zhang Wenlan, MD, in the Kidney Transplant Department at the First Hospital of Jilin University

Phone number: +86 13756868617                  Date: 04/15/2017

1. “Right now in our country, cardiac death donations are currently permitted. There is no clear diagnosis to determine brain death yet, so the answer is no.”
2. “Among us northeastern Chinese people, there aren’t a lot of donations. Around 50 or 60 [a year].”
3. “[We can do] about 200 cases at most in one year. One third would come from the patients’ relatives’ donations.”

(Download Recording MP3， please seeAddendum 79)

Investigative Recording 80. Zhang Haiyu, Director of the Pediatric Surgical Department at the First Hospital of Jilin University

Phone number: +86-13756661622                  Date: 06/14/2017

Zhang Haiyu: The “Previous Children” assistance program of liver transplantation is definitely real. The surgery wait time will not be long, because we have a particularly large number of DCD [donations after cardiac death], and we do a lot of [organ transplant operations for] adults. So we carry out [this program] for children. The first ten [surgeries] are free of charge. We can do more than 200 cases [of liver transplantation] a year.

(Download Recording MP3， please seeAddendum 80)

Investigative Recording 81. A Jilin Provincial Travel Radio staff member at the information desk for the “Previous Children” assistance program for free liver transplantation of the First Hospital of Jilin University

Phone number: +86 43185815665                  Date: 06/14/2017

 “We don’t really have any specific requirements regarding the registration process. As long as [your child] is qualified in terms of age and illness, you can go ahead and register. Let’s just say that if you come to the hospital now with 2 million yuan, you still won’t know your [donor] liver source, because this is confidential.”

(Download Recording MP3， please seeAddendum 81)

Liaoning Province

Investigative Recording 82. Doctor Du Wenxiao at the anesthesiology department of Lingyuan Prison Hospital, Liaoning Province

Phone number: 013050922179                       Date: 04/12/2017

1. “Go ask a police station [about organs]! You are better off with them!”
2. [Investigator: I can even pay you a visit in person! I will come over to do [the transplant…] Du Wenxiao: Then how much money are you preparing to pay our Director Ai?”
3. “Liver transplantation is Director Ai’s specialty! I will ask him to talk to you.”
4. The phone was handed to Ai, but he suddenly hang up, once the investigator mentioned that she wanted their help with getting organ donors from prisons.

(Download Recording MP3， please seeAddendum 82)

Investigative Recording 83. Gao Guangjie, Anesthesiologist at the PLA’s No. 463 Hospital in Shenyang

Phone number: +86 13352456947                  Date: 04/12/2017

1. “There are many kidney transplants. There are many, many.”
2. “Tomorrow morning, call the operator to find the number of the Department of Urologic Surgery, OK? Today they are performing surgeries. They must be doing operations, kidney transplants.”

(Download Recording MP3， please seeAddendum 83)

Investigative Recording 84. Nurse on duty in the Department of Renal Transplantation at Dalian [Municipal] Friendship Hospital

Phone number: +86 411-82718882-3508                   Date: 06/01/2017

1. “We can [still] do kidney transplants. It’s just around 20 cases. 10 or 20 cases, roughly. We’ve done 7 cases since [the beginning of] this year”
2. “There exists a specific national allocation system [of organs].” Hospitals procure organs from this system.
3. Both patients and medical workers are not permitted to access that network.
4. There are strict national rules regarding this system. Only certified individuals have access to the system. Only OPO [Organ Procurement Organizations] have access to it. We cannot access.”
5. “The donor’s age, birth place or name will not be revealed. This is not allowed by the state.”

(Download Recording MP3， please seeAddendum 84)

Other Provinces and Cities

Investigative Recording 85. A ward physician in the Department of Urology at Inner Mongolia Baotou Steel Hospital

Phone number: +86 472-5992751                   Date: 04/13/2017

1. “I think [we perform] at least 100 or 200 cases per year.”
2. [Investigator: Only counting allografts?] Ward Physician: I think so.

(Download Recording MP3， please seeAddendum 85)

Investigative Recording 86. A nurse on duty physician in the Urology Ward at Inner Mongolia Baotou Steel Hospital

Phone number: +86 472-5992751                   Date: 04/14/2017

1. “I never count the number [of kidney transplants we do]. Anyway, there was a sharp increase last year.”
2. “There are currently people specialized in procuring kidney sources. So they procured a lot last year, donated kidneys. So we did relatively more [kidney transplants] last year. The number will definitely increase because the [relevant] law just changed last year.”

(Download Recording MP3， please seeAddendum 86)

Investigative Recording 87. Li Wengang, Surgeon in the Department of Hepatobiliary Surgery at the PLA No. 174 Hospital in Xiamen

Phone number: +86 18906055326                  Date: 04/30/2017

1. Peng Zhihai from the liver transplantation center of Shanghai Jiao Tong University is prepared to perform surgeries at Xiamen University. Peng has performed over 5,000 transplants throughout his career.
2. “The surgery itself is not complicated. The key is [how to get] the donor source.”
3. “My boss did about 400 [cases] annually several years ago in Shanghai. Nowadays maybe each year, he did less now, maybe 100 [cases] each year.”
4. [Investigator: Then after that person comes, you will have donor sources?] Li Wengang: He has access to a lot of donor sources all over the country!
5. “Prof. Peng will found a liver transplantation center for Xiamen University, a very big one.”

(Download Recording MP3， please seeAddendum 87)

Investigative Recording 88. He Fangping, Hepatic Transplantation Surgeon at the First Affiliated Hospital of Xinjiang Medical University

Phone number: +86 13999801966                  Date: 06/04/2017

1. “Regarding doing the surgery, we will do it within three days, once a [matching] liver becomes available.”
2. “The donors are from the entire Xinjiang region, brain-dead ones.”
3. “The technical level of [DCD transplantation] is not high at all. We do cadaveric liver transplantation here, over 30 cases each year. The cadaveric liver transplantation is much, much, much more difficult than DCD [transplantation].”

(Download Recording MP3， please seeAddendum 88)

Investigative Recording 89. Nurse, Renal Transplantation and Dialysis Center, Shanxi No.2 People’s Hospital

Phone number: +86 14797169153                  Date: 05/06/2017

1. “We do at least more than 100 [kidney] transplants every year.”
2. “We have performed nearly 100 [kidney] transplants [since the beginning of] this year.

(Download Recording MP3， please seeAddendum 89)

Investigative Recording 90. A Ward Nurse in the Department of Urology and Renal Transplantation at the First Affiliated Hospital of Medical School, Xi'an Jiaotong University.

Phone number: +86 29-85323955                   Date: 06/08/2017

1. “We have done quite a lot [of kidney transplants.] More than 50 cases, I guess.”
2. “We definitely do more than Xijing [Hospital].”

(Download Recording MP3， please seeAddendum 90)

Investigative Recording 91. A Staff Member on Duty at Bright Eye Hospital in Nanchang

Phone number: 0791-86259791                      Date: 07/06/2016

1. “In general, once the patients come in here, once the corneas arrive, we would do the operations for them right away.”
2. “Since our hospital has an advantage, that is, we have our own corneal bank and corneal sources, so we can start doing operations sooner than other hospitals do.”
3. The donor corneas are all fresh but not obtained locally.

(Download Recording MP3， please seeAddendum 91)

III: Investigation on the organ donation offices of the Red Cross Societies of China

The following telephone investigation recordings show that some provinces and cities with large organ transplant volumes only have a very small number of organ donations.

1. A staff member in the Organ Donation Office of the Red Cross Society of China Jiangsu Branch said in April 2017: The office received about 80 donated organs in 2016 and about 30 or 40 cases in 2017. And some of them cannot be used in organ transplants.

Under the Organ Donation Office of the Red Cross Society of China Jiangsu Branch, there are five cities, whose numbers of donated organs as of April 2017 are listed below: 

Changzhou City：“[We have around] five to ten [cases of successful donations] a year. We have received four cases [of donated organs] this year.” This Red Cross Society received 29 cases of donated organs from 2011 to April 2017.

Suzhou City: The Red Cross in Suzhou received 6 or 7 cases of organ donations in 2016. In the first four months of 2017, they had two cases of organ donations. From July 2011 to April 2017, this branch received a total of 35 cases of donated organs.

Taizhou City: “[We receive] very few [donated organs], one or two cases last year. [This year], it seems that there’s nothing, I have not even heard of [any donation].”

Nantong City: “For all these years, the total number [of donated organs that we’ve received] is only two.”

Yangzhou City: “Our Red Cross [Society] here has only corpse donations and cornea donations, organ donations haven’t started in our Yangzhou City yet.”

2. A staff member at the Organ Donation Management Center of the Zhejiang Red Cross Society said during two phone investigations that they had a very small number of donated organs, and in 2016, there were only over 100 donated organs in the entire province, and some of them couldn’t be used in organ transplant operations.

3. A staff member in the Emergency Department at the Red Cross Society of Guilin, Guangxi Province revealed in September 2016: This branch received 30 or 40 donated organs in 2016. From 2011 to September 2016, the branch received over 160 donated organs in total. A staff member in the Organ Donation Office revealed in November 2016: “[We’ve received] over 40 cases [of donated organs in 2016].”

4. The Organ Donation Office at the Red Cross Society of China, Yunnan Branch revealed in December 2016: The number of organs donated was nearly 70 for the entire year of 2016.

5. The Red Cross Society of China, Nanchang Branch revealed in December 2016: “We only have 50 to 60 people registered with us to donate their bodies during one year. Approximately 20 organ donations are successful in Nanchang City [this year].”

Investigative Recordings:

Investigative Recording 92. Person on Duty at the Organ Donation Management Center of the Zhejiang Red Cross Society

Phone number: +86+ 571-85043999              Date: 12/15/2016

“It is certain that most people would refuse to donate; otherwise, it wouldn’t be such a small number of donations!”

(Download Recording MP3， please seeAddendum 92)

Investigative Recording 93. Person on Duty in the Organ Donation Office at the Red Cross Society of China Jiangsu Branch

Phone number: +86 25 8331 8652                  Date: 04/24/2017

1. “[The number organ donations here is] so so, not particularly a lot, just so so.”

2. “We received about 80 cases last year.”

3. “[We’ve received] about 30 or 40 cases so far this year.” And some of them cannot be used in organ transplants.

(Download Recording MP3， please seeAddendum 93)

Investigative Recording 94. Person on Duty in the Organ Donation Office at the Red Cross Society of Changzhou City, Jiangsu Province

Phone number: +86 51988155335                  Date: 04/26/2017

1. “[We have around] five to ten [cases of successful donations] a year. We have received four cases [of donated organs] this year.”

2. The Red Cross has received 29 cases of donated organs from 2011 to the present.

3. “Generally speaking, Shanghai would have a little more [organs]. Then you can contact other channels by yourself. Our Red Cross does not [have organs]... You can contact other channels by yourself.”

(Download Recording MP3， please seeAddendum 94)

Investigative Recording 95. Person on Duty in the Organ Donation Office at the Red Cross Society of China, Suzhou Branch, Jiangsu Province

Phone number: +86 +51265233433                Date: 04/26/2017

1. The Red Cross in Suzhou received 6 or 7 cases of organ donations in 2016.

2. “There have been two cases of donations this year.”

3. From July 2011 to the time this phone call was made, this branch has received a total of 35 cases of donated organs.

4. “The Ministry of Health has a national distribution system of donated organs. It’s not up to the Red Cross to decide the distribution. So the best way for you is registering at all the organ transplant hospitals.”

(Download Recording MP3， please seeAddendum 95)

Investigative Recording 96. Person on Duty in the Organ Donation Office at the Red Cross Society of Taizhou, Jiangsu Province

Phone number: +86 +52386393269                Date: 04/27/2017

1. “[We receive] very few [donated organs], one or two cases last year.”

2. “[This year], it seems that there’s nothing, I have not even heard of [any donation].”

3. “The doctor would tell the family members that this person would no longer be saved due to a car accident. There’s certainly no way [to save him]. In this case, organ donation can be considered.”

4. “In the case, where the person is not dead but is brain-dead, then his organs can be used. So how many [useful] organs can there be?”

(Download Recording MP3， please seeAddendum 96)

Investigative Recording 97. Person on Duty in the Organ Donation Office at the Red Cross Society of Nantong City, Jiangsu Province

Phone number: +86 +51385053656                Date: 04/27/2017

1. “We do very little here. In all these years, we’ve only handled a couple of cases. We have had few donations here.”
2. “For all these years, the total number [of donated organs that we’ve received] is only two.”

(Download Recording MP3， please seeAddendum 97)

Investigative Recording 98. Person on Duty in the Organ Donation Office at the Red Cross Society of Guilin, Guangxi Province

Phone number: +86 +7732896981                  Date: 09/12/2016

1. [Investigator: So the 165 donations all took place this year?] Staff on duty: That’s impossible. That’s [the total number] of all [received organs] since we started organ donations here.
2. [Investigator: Since last year, you’ve received that many?] Staff on duty: No, no. I cannot disclose the figure to you, ok?

(Download Recording MP3， please seeAddendum 98)

Investigative Recording 99. Person on Duty in the Organ Donation Office at the Red Cross Society of Guilin, Guangxi Province

Phone number: +86 +7732896981                  Date: 11/24/2016

1. [Investigator: So the organs of those 30 kidney transplants performed in July didn’t all come from you?] Staff on duty: These? No, no.
2. “[We’ve received] over 40 cases [of donated organs this year].”

(Download Recording MP3， please seeAddendum 99)

Investigative Recording 100. Person on Duty at the Red Cross of China, Yangzhou Branch, Jiangsu Province

Phone number: +86 +51487323121                Date: 04/27/2017

1. “Our Red Cross here has only corpse donations and cornea donations, organ donations haven’t started in our Yangzhou City yet.”
2. “Some cities nationwide are currently experimenting with organ donation pilot projects. But our Yangzhou is not one of them.”

(Download Recording MP3， please seeAddendum 100)

Investigative Recording 101. Office Staff on Duty in the Red Cross Society of Yantai City, Shandong Province

Phone number: +86 0535_2123999                Date: 04/21/2017

[Investigator: Last year Yuhuangding Hospital did 270 cases (of kidney transplantation). For those 270 kidney transplants, they couldn’t all come from you?] Staff on duty: Certainly not. How could we have that many?

(Download Recording MP3， please seeAddendum 101)

Investigative Recording 102. Ms. Huang in the Organ Donation Office at the Red Cross Society of China, Guangdong Branch

Phone number: +86 020-38824642                 Date: 04/28/2017

1. Only hospitals can access the organ distribution online system of the National Health and Family Planning Commission [NHFPC], the Red Cross Societies cannot.
2. If more organs are transplanted than donated, the excess ones aren’t managed by the Red Cross. These organs are allocated to different hospitals through a distribution system supervised by the NHFPC.

(Download Recording MP3， please seeAddendum 102)

Investigative Recording 103. Mr. Chen in the Organ Donation Office at the Red Cross Society of China, Yunnan Branch

Phone number: +86 0871 67195073               Date: 12/01/2016

1. An Organ Donation Office at the Provincial Red Cross Society should be able to oversee the sources of all organs donated in the entire province.

2. According to Mr. Chen’s statistics, two days before the phone investigation, the number of organs donated was nearly 70 for the entire year of 2016.

3. [Investigator: But there are such incidences, where they don’t go through you (to procure organs). They do this themselves, looking for donors and operating surgeries, there are such incidences.] Mr. Chen: As far as I know, now that the government has passed legislation banning it, and they are prohibited from doing so. It is equivalent to organ trafficking.

4. “Today our Red Cross obtains the results from our systematic statistics. For example, about one million organs are in demand each year, now only about 300,000 organs are available, possibly accounting for less than 1/3 of the required number.”

(Download Recording MP3， please seeAddendum 103)

Investigative Recording 104. Mr. Wang, Organ Coordinator at the Red Cross Society of China, Nanchang Branch

Phone number: +86+791_86771992               Date: 12/08/2016

1. “We as a provincial capital city, only have 50 to 60 people registered with us to donate their bodies during one year.”
2. “Approximately 20 organ donations are successful in Nanchang City [this year].”
3. “Mr. Wang: If they want to violate the law, [they can], as our Red Cross has no supervisory authority.”
4. “What they do on their own black market is not our business!”

(Download Recording MP3， please seeAddendum 104)

 

 

Appendix:
 

Addendum 1

Director Wang, Coordinator for kidney transplant operations at Yantai Yuhuangding Hospital, Shandong Province

Phone number: +86+ 13181994782

Date: 05/26/2017

Key points:

It is guaranteed to operate on the patient within two weeks; the kidney donor is guaranteed to be under 30 years old; “you get what you pay for”; the cost is about 500,000 yuan, from which the hospital gets 100,000 yuan, and “we get 400,000 yuan”.

1. To wait for the kidney source and for the operation, “including the physical examination, it will be within half a month, within two weeks.” “Even for half a month, or even two weeks, the estimates are on the long side.”
2. “Do you want the complete package? The whole thing will cost over 500,000 yuan.”
3. “We ask for 400,000 yuan, and [you] give the hospital [another] 100,000 yuan.”
4. [Question: “Can you still find that kind [of donors] from the prisons?”] Answer: “You need to find the ones under 30 years old. You get what you pay for, understand?”
5. [Question: “What if they drag on and delay it for two months, or three months, or even longer, what should we do then?”] Answer: “Ah, no, it is impossible. Impossible, impossible.”
6. “We just performed a surgery for a 64-year-old patient, who has already been discharged from the hospital.”

Phone Investigation Recording:

……

Director Wang: Hello?

Investigator: Hello there, how are you? I want to ask you…Can you tell me if your place could help me contact Yuhuangding Hospital for kidney transplant?

Director Wang: Yes.

Investigator: Alright then. Could you tell me…hmm, I know a patient, who was referred there by you. That is, that patient told me…then how much you charge for the patient…

Director Wang: Where are you from? Suzhou?

Investigator: No, from Anhui.

Director Wang: From Anhui?

Investigator: Yeah.

Director Wang: Oh, kidney source fees? What type? What blood type?

Investigator: Oh, Type A.

Director Wang: Who gave you my phone number? How did you get to know my phone number?

Investigator: It’s Yu…from Yuhuangding, their internal medicine department got me your number, from the renal internal medicine department. But he told me that it’s better to go through you. He said [I] shouldn’t go through him, because they are different from the surgical department. Anyway, between the two departments, there may be some internal issues between them…

Director Wang: Oh, no problem, just tell me who. No problem, you can just tell me who it was.

Investigator: Alas, I, since that may involve some of their colleagues, so he told me not to tell who told him. He just told me that you are the one to contact. Anyway, he wanted to find out if you can…

Director Wang: Oh…

Investigator: yeah, yeah, yeah.

Director Wang: Yes, we can, yes, we can do it.

Investigator: So through your contact, if the blood type is A, then to wait for the kidney source and for the operation, how long will it take? Could you give me an estimate?

Director Wang: Within half a month.

Investigator: Half a month?

Director Wang: Yes, including the physical examination, it will be within half a month, within two weeks.

Investigator: Within only two weeks, are you sure it could be done?

Director Wang: It’s guaranteed that we can do it.

Investigator: Oh, so you will contact Director Liu directly? Or through some other doctors in his department?

Director Wang: Oh, regarding this question, it will be done directly with the director. We, eh, the director is like an elder brother to me.

Investigator: Oh, Director Liu is a very good friend of yours?

Director Wang: You bet, others cannot commit.

Investigator: Oh, no wonder that doctor didn’t want to promise anything. You, anyway, perhaps everyone in the hospital has some kind of interest in it. He said that you should have a way to do it, anyway.

Director Wang: That’s right.

Investigator: He also told me so.

Director Wang: Yes, yes.

Investigator: Yeah.

Director Wang: The doctors don’t know much. They just cannot pull it off!

Investigator: Yeah, right. He said that for the ordinary doctors, even if you find them, they cannot do anything, so you can…

Director Wang: Yes.

Investigator: Ah, then what would you say… regarding the cost for the whole thing, how do you charge it?

Director Wang: Hmm…Do you want a large package?

Investigator: Yeah, whatever you say will work. He has this illness, anyway. The patient, anyway, has already spent a lot of money. Will he argue with a much smaller sum? That is the patient’s mentality.

Director Wang: Hmm…if you want the whole package…

Investigator: Yeah.

Director Wang: The complete package is, the whole thing, will cost over 500,000 yuan.

Investigator: 500,000 yuan?

Director Wang: Yes, yes.

Investigator: So, if by that time we come straight to Yuhuangding to see you. Say if the patient brings [the money] with him…how will you handle the payment? Say that you definitely want them to pay you. How would you receive the initial payment or something? How should they pay you?

Director Wang: Hmm…how to pay me?

Investigator: No, I meant that when a patient comes to the hospital. Eventually he will require hospitalization and so forth. So the payment due to the hospital for sure will be paid to the hospital, that’s for sure, right? You know what I meant?

Director Wang: Yes, yes.

Investigator: Yeah.

Director Wang: Yes, yes, yes.

Investigator: So why don’t you give me a figure, as how you would divide it into your portion and the hospital’s portion. The hospital’s portion will be separate from your portion. Like you told me, you just told me two, two weeks, right?

Director Wang: Yes, that is right.

Investigator: So how much is your portion?

Director Wang: 400,000 yuan.

Investigator: Oh, then, you meant that the hospital side will charge about 200,000 yuan for hospitalization, etc.?

Director Wang: 100,000 yuan.

Investigator: This amount goes to the hospital?

Director Wang: Right.

Investigator: Oh, so as far as the hospital side is concerned…Since I heard that Xiangya [Hospital] is similar, and you need to give a portion to the hospital, then you can find the doctors to do it, and doctors will go to get it for you. Anyway, they will get it for you, so a portion of the payment will go to the doctors, who do the liaison for you. So you pretty much can give me a figure, and you said it was 500,000 yuan, right? And you said that for a kidney transplant, this is an acceptable amount. So, 100,000 yuan is for the hospital portion. Basically, you are pretty sure that there won’t be any large discrepancies?

Director Wang: No.

Investigator: Oh, no large discrepancies?

Director Wang: It is about this figure, yes, yes.

Investigator: Oh, oh, okay, so that was one question. Anyway, if we are going to see each other, where do you plan to meet? Yuhuangding [Hospital] or somewhere else?

Director Wang: Either way.

Investigator: OK, then I have another question for you. As far as payment is concerned, we are fine with the overall figures. This is a small problem. And for the amount of time it will take, you pretty much told me already, two weeks. Then as for the 500,000 yuan, how would you prefer to be paid? Obviously, [the patient] cannot pay it in full before the operation, right?

Director Wang: You pay half of it before the operation.

Investigator: Hmm, what happens if, say like you told me, it’s about two weeks, then we are OK with that. But what if they drag on and delay it for two months, or three months, or even longer, what should we do then?

Director Wang: Ah, no, it is impossible. Impossible, impossible.

Investigator: So in other words, you are certain that the second half will be paid after you fulfill your promise, right?

Director Wang: Yes, you can rest assured! OK, even for half a month, or even two weeks, the estimates are on the long side.

Investigator: Oh, he didn’t mention to me that you and Director Liu are good buddies. He didn’t tell me this.

Director Wang: Ah, I am also a director.

Investigator: You are also a director, right?

Director Wang: I am a director of operations.

Investigator: Oh, no, you meant that you manage the operations, so you don’t work on the operation tables?

Director Wang: I don’t perform operations.

Investigator: So you don’t do operations, and you are only managing that...

Director Wang: Operations are done by the professor, well, Professor Liu.

Investigator: I understand, I understand, so if you are on the operations side, I want to ask you this question: the source of the kidney. I asked my friends working in medicine, and they are pretty sure that kidneys from young donors are, relatively speaking, good. So can you still…still find…?

Director Wang: Of course.

Investigator: Right, so can you still find that kind [of donors] from the prisons?

Director Wang: You need to find the ones under 30 years old.

Investigator: Under 30 years old?                            

Director Wang: Yes.

Investigator: So when can you provide the kidney? The ones from under 30-year-old donors?

Director Wang: Well, you will know when you come. We are not going to eat our words, you get what you pay for, understand?

Investigator: Oh, oh, oh, yeah, he gave me an overview, and told me that you are the one to get things done. But I still want to hear it from your own mouth. I want to hear it from you personally. Yes, just give me a reply. So I’ve obtained some information from him, and then [I wanted to] verify with you. So I can feel comfortable in my heart. Anyway, it is you, just like what you said, oh, yes, to me, it is an assurance.

Director Wang: Rest assured. We guarantee to find a young donor for you. I kept on asking, who is the patient? Who is the patient? You haven’t told me yet.

Investigator: My elder brother, well, just right.

Director Wang: Who?

Investigator: My elder brother.

Director Wang: Who is he? Oh, how old?

Investigator: He is 50 years old.

Director Wang: Oh, oh, not too old.

Investigator: Right, he isn’t that old. If you say you would find a donor similar to him in age, in his 50s, or even older, then I would feel difficult to accept it.

Director Wang: Hey, we just performed a surgery for a 64-year-old patient. Very good, from Tianjin…64 years old, and already discharged from the hospital.

Investigator: What? You meant the patient was 64 years old?

Director Wang: Yes, I did it for this patient.

Investigator: Oh, the key is that the kidney is sourced from a donor, who is not older than 35, like you just said, right?

Director Wang: No, no, no, right, right, right.

Director Wang: Oh, didn’t I already tell you, just 400,000 yuan. And you pay the hospital directly, OK?

Investigator: I got it, just like you said, you take 400,000 yuan, and the hospital takes 100,000 yuan. There won’t be large discrepancies, right?

Director Wang: Yes, well, do you want the whole package? 500,000 yuan, OK?

Investigator: I got it.

Director Wang: The complete package is 500,000 yuan. Yes, Yes.

Investigator: The complete package is 500,000 yuan. And you said that it would take about two weeks, within two weeks, right?

Director Wang: Yes, yes, right.

Investigator: Ok, I got the information. Very well then, I will contact you on your cellphone in time.

Director Wang: Great, just a send message to me, OK?

Investigator: What did you say, send you a message? Ok.

Director Wang: Right, right, right, you send me a message. So that I can contact you just in case. I will call you, OK?

Addendum 2

Director Wang, Coordinator for kidney transplant operations at Yantai Yuhuangding Hospital, Shandong Province

Phone number: +86+ 13181994782   

Date: 06/10/2017

Key points:

1. [Regarding wait time for kidney transplant] It won’t take long, ten days. For blood type B patients, it’s within 10 days, one week or ten days, it’s within ten days for sure. Ten days will definitely do.
2. [Investigator: Will the organ donors be young people or elderly people?] Right, they will be young people.
3. [Question: Where do the donors come from?] We have our own channels. You don’t have to ask.
4. [Question: Taken from national organ network?] That’s all deceiving people, all of them are deceiving people. They are all formalities.
5. [Question: It’s all up to hospitals to look for donors, rather than being allocated by state?] That’s correct.
6. [Question: Is that website accessible with an ID?] It is inaccessible. It belongs to the armed police. It’s not like that anyone can access it. ……

Phone Investigation Recordings:

……

Investigator: Hi.

Director Wang: Hello.

Investigator: Hi, is this Director Wang? Hi.

Director Wang: Yes. Who’s this?

Investigator: Hi. I am also from Shandong Province. One of my family members wants to have a kidney transplant. I wanted to ask Yuhuangding Hospital, I heard that quite a lot of patients have done this… if we go there, will we have to wait for a long time?

Director Wang: No, it won’t take long.

Investigator: Oh, it won’t take long.

Director: Ten days. What’s the patient’s type?        

Investigator: Hello, Director Wang?

Director Wang: What’s the patient’s blood type?

Investigator: It’s Type B, Type B.

Director Wang: Oh, it will be within ten days.

Investigator: So it’s within ten days. Director Wang, this is our situation. We are from the same hometown, I am also from Yantai City, in its surrounding area. I am living abroad now, and I want to ask about this. As I’ve done some research on various hospitals, I found that your hospital did the most [kidney transplants]. I’ve checked the official websites of these hospitals and found that your hospital did transplants for 270 patients last year. So you have indeed done more than any other hospitals, so I decided to call you and planned to have the transplant done here……   

Director Wang: That is correct.

Investigator: I am making this call for my child. He’s 48 years old and is ready to have a transplant. It’s been 11 months, nearly one year now, since his last dialysis. He has been like this, so it’s not good.

Director Wang: Oh…oh…

Investigator: Since we are overseas. I discussed this with my child. I said, “Let’s go home.” Now I want to know that…if the wait time is short, we’ll go back soon; and if the wait time is long, I’ll think it over, like how I am going to go back. You said……

Director Wang: Oh, one week, ten days, ten days for sure. Ten days will be fine.

Investigator: Oh, do I need to bring with me the physical examination documents from overseas?

Director Wang: There’s no need. [The patient] will do the check-up all over again when he comes here.

Investigator: Ok, there’s no need. The thing that I care the most……

Director Wang: Oh, you wait……

Investigator: Another thing is that I think…

Director Wang: Oh.

Investigator: I’d like to ask about the organ donor. Is there any guarantee that he’s healthy? Or he doesn’t have any diseases?

Director Wang: You can be assured that this will be guaranteed. We don’t want any trouble, either.

Investigator: So it’s guaranteed. I fear that if it were from someone who’s old or who’s in poor health, and we spend so much money, and after the transplant, something would happen…will there be anything…

Director Wang: Oh, oh, oh.

Investigator: You said that there wouldn’t be any problem with the donor, right?

Director: Absolutely not. We wouldn’t do it if there were any problems.

Investigator: Ok, you wouldn’t do it [if there were any problems]. Are they usually young people? Or are they old people?

Director Wang: Right, young people.

Investigator: They are young people. Ok.

Director Wang: Ha ha, we did hundreds of them, how come there were so many…we did hundreds of cases a year, how could there be so many old people, right? There weren’t that many.

Investigator: Oh.

Director Wang: We have ways and channels. Which country are you in now?

Investigator: I am in Europe. 

Director Wang: Ah, ah, ah, ah.

Investigator: I am sorry to have troubled you, and it’s also Sunday today. I am so sorry, and we’ll…

Director Wang: No problem, no problem, no problem.

Investigator: Approximately how much will it cost? Can you tell me that? I need to prepare for it.

Director Wang: Mm, it’s not going to cost you more than 500,000 yuan. It’s over 400,000 yuan.

Investigator: It’s going to be less than 500,000 yuan. Ok.

Director Wang: Yes.

Investigator: Oh, oh, oh. Please give me a specific figure. I’ll prepare some money. At least, I’ll think about it and get it ready. I’ll need to do some preparations. 

Director Wang: Ah, ah, ok, you need to get things ready…

Investigator: There’s another thing…

Director Wang: No problem. Be rest assured, you, you…

Investigator: Ah, what if… ah, what did you say?

Director Want: Your home, where is it?

Investigator: Ah, I beg your pardon?

Director Wang: Where is your hometown?

Investigator: I am from the surrounding area of our Yantai City.

Director Want: I was asking you…

Investigator: Oh, so I-I…why do I want to come here to do the transplant? Because if I chose to go to Qingdao City for the transplant, that would be too far. So, I made this call, that is how it is. By the way…

Director Wang: Oh.

Investigator: By the way, there’s another thing, that is the time needed to stay in the hospital. After the surgery, how long will it take before the patient gets discharged from the hospital?

Director Wang: Ten days.

Investigator: The patient can get out of the hospital in ten days, right?

Director Wang: Ten days will do. Right.

Investigator: That is to say, we go back first, and then we do [tissue] typing, right? We’ll do [tissue] typing first, and after the typing, the approximate time will be …

Director Wang: You-you just come over, and there’s nothing for you to worry about. Nothing at all. Absolutely nothing for you to worry about.

Investigator: That is, you know, since I’ve been overseas for about 20 years, I don’t know very well about the situation in China. Others told me that…Director Wang, I’d like to ask you…in the past, didn’t they use that kind of…one of my friends did the transplant in your hospital, you know what I mean? So, he said that the kind of organ donors used before…that is, from the judiciary system, can that kind still be used? Now. He said that that kind is healthy. It would have a better survival rate, in other words, people will live longer, it seems.  

Director Wang: You, you, out with it. What is it you were talking about?

Investigator: It was those from executed prisoners, [Falun] Gong practitioners…that kind, Weren’t those allowed to be used before?

Director Wang: Oh, that kind—that kind can’t be used.

Investigator: So it can’t anymore. Then can you tell me where our organ donors come from? Who supplies this kind of donors?

Director Wang: We have our channels. You’d better not ask. Alright?

Investigator: Oh, so there’s absolute guarantee that it’s healthy. There’s no problem about that, right? And I…

Director Wang: Right, right, right. Right, right.

Investigator: Oh.

Director Wang: Right. 

Investigator: This is what we are most concerned about, so you may understand us, the family members of the patients…this concern of ours. You said that…that…that…

Director Wang: Eh, eh, eh…

Investigator: There won’t be that kind anymore…we all have them from the Red Cross. Now they all say that it’s the Red Cross that provide the donations. Will the Red Cross do it?

Director Wang: How could there be so many? Don’t concern yourself with that. There’s no need for you to be concerned about that, alright? How could the Red…how could they have that many? It’s for the entire country, right? The Red Cross isn’t able to handle it. How could, the Red Cross…

Investigator: There is this network thing as well. They talk about this national network…

Director Wang: Oh, those are all for deceiving people, they are all for deceiving people. They are all formalities.

Investigator: You say that the national network is for deceiving people. They don’t have that many organ donors. I was thinking, if they had [organs], could I visit the website, and if I could do it this way…

Director Wang: Impossible. Ha ha…those are all formalities. You know, that network can’t do a thing…those are all formalities.

Investigator: So you are not getting them from the net, right? That is to say, your hospitals all have your own…

Director Wang: No, no. Ha ha.

Investigator: Ha, ha, ha, ha.

Director Wang: Right, we each have our own channels. Ok?

Investigator: Oh, you have your own channels. So each hospital goes about finding its own donors, and it’s not that the state makes such allocations.

Director Wang: Ah, right. Right.

Investigator: It’s not, right? Oh.

Director Wang: Ha, ha, no, no, right.

Investigator: I thought…others said…I said, if the state was to make allocations, the country is so huge, how would the state do it? There are as many as 1.4 billion people, I said. 

Director Wang: Impossible, impossible.

Investigator: Impossible?

Director Wang: Impossible.

Investigator: Besides, I also heard them say…Could I go online and take a look, and pick a good kidney donor? Ah, they said, you can’t get online unless you your special ID, and you don’t have it. I told him I didn’t have it. So a special ID is required, right?

Director Wang: You are not allowed to log in. It’s all for the armed police. It’s not that anyone is able to log in.

Investigator: But are you able to log onto it? Can people like you at the director level log in?

Director Wang: Yes, I can log into it.  

Investigator: Oh, but you don’t get them from there, not from there. So your hospital will go find them yourself?

Director Wang: Right.

Investigator: That’s my only concern now. I just hope that when I go to your hospital, you’ll find a good one for us, a healthy donor. Is that alright?

Director Wang: No problem. You don’t have to worry. You just come, and we’ll take care of the rest. Trust us. We’ll do it. Ok?

Investigator: Ok, ok. Thank you very much. Director Wang, I’ll talk to my child about this.

Director Wang: Ok, ok, ok, ok, ok.

Investigator: If we come to your hospital…

Director Wang: Ok, ok, ok.

Investigator: …I’ll talk to you soon. Bye now.

Director Wang: Alright, alright. Yes, yes.

Addendum 3

Doctor Li, coordinator for kidney transplant surgeries at Yantai Yuhuangding Hospital, Shandong Province

Phone number: +86 18660597760

Date: 04/18/2017

Key points:

1. The patient waits for no more than half a month before he has the surgery.
2. Sometimes, the hospital performs two operations a week.
3. Director Liu has performed more than 2,000 cases of kidney transplantation.
4. From the beginning of 2017 to April 18, 2017, 50 to 60 cases of kidney transplants have been done.
5. Donors from prisons, with the consent of their families, can be used, and these donors are available.

Phone Investigation Recording:

Investigator: Hello! Is this Doctor Li from Yuhuangding Hospital? How are you? Hello, can you hear me?

Doctor Li: Yes, I can hear you. How did you get my phone number?

Investigator: A friend told me. I just wanted to know which hospital did it better and did the most, so that I can go back sooner and have the transplant. So they…[Doctor Li: Oh.] They recommend this hospital, saying your hospital did the most and best [organ transplant surgeries]. They said that you could perform 200 or 300 kidney transplants a year. I want to know how long I’ll have to wait after I go to your hospital?

Doctor Li: What is the patient’s blood type?

Investigator: Type B.

Doctor Li: Where are you from?

Investigator: I am from Dezhou.

Doctor Li: Oh. What is the patient’s blood type?

Investigator: Type B. “B”, as in “AB”.

Doctor Li: Oh. So it’s type B, right? With blood type B, there are many donors, so it’s going to be quick.

Investigator: Approximately how long will we have to wait? I hope we won’t have to wait too long before the transplant can be done.

Doctor Li: Hmm…with Type B, we’ve just done a few Type B cases…about half a month.

Investigator: How long will the patient have to be hospitalized, approximately?

Doctor Li: If you are lucky, if the [tissue] typing is done really quickly, and if you are lucky, probably it won’t take half a month.

Investigator: It won’t take half a month for the patient to have the transplant done and get out of the hospital?

Doctor Li: No, no. It’s not that. The patient doesn’t have to wait for half a month before he can have his transplant operation.

Investigator: How long will he have to stay in the hospital after the surgery? I have to consider if we need to have someone to accompany the patient or if we need to find a care worker.

Doctor Li: If the patient recovers well, it’ll take about 10 days. 

Investigator: So shall we come and see you when we arrive? I don’t know what your full name is.

Doctor Li: My last name is Li.

Investigator: So I’ll ask for Doctor Li?

Doctor Li: Yes.

Investigator: So, is it true that your hospital does as many cases a year as they mentioned? You said that you couldn’t do that many?

Doctor Li: The thing is that you haven’t done the [tissue] typing. If you had, it would be quick. It’ll need quite a few days to have the [tissue] typing done in the hospital.

Investigator: Did you say that the hospital has been doing it all along? Have you been doing kidney transplants this year?

Doctor Li: We’ve always been doing it.

Investigator: You do it every week?

Doctor Li: Yes, if we happen to have [one or more surgeries].

Investigator: So you can do one transplant a week?

Doctor Li: Sometimes two transplants a week.

Investigator: So would you say that you won’t be able to do 100 or 200 cases a year?

Doctor Li: Our director, Liu Dongfu, has done 2,000 cases since 1988.

Investigator: I’ll let your director do it. Is it your director who will do it?

Doctor Li: You think the director will do it if you want it that way?

Investigator: What is your director’s last name?

Doctor Li: His last name is Liu.

Investigator: Director Liu. Ok, I’ll remember that. Doctor Li, can you tell me how many kidney transplants the hospital does a year?

Investigator: How many has it done this year? Is it a lot?

Doctor Li: How many this year? Up to now, there are about 50 or 60 cases.

Investigator: Can you tell me the price? Approximately.

Doctor Li: Price, price. You are on the phone…we don’t charge people for that.

Investigator: It’s fine if you don’t want to tell me.

Doctor Li: Because the state regulations do not allow the sale of organs.

Investigator: About the organ donors, there are people who say that we can talk to the doctor and ask for organs from death row inmates. They are death row inmates and will be executed anyway, and they are all healthy. Can that kind still be used? Can we still find them?

Doctor Li: It still can, as long as the family agrees, as long as the family wants to donate organs. If they do not agree, it can’t be used. If the family agrees, it can.

Investigator: Can you help with that?

Doctor Li: About this…, I can if we keep it private. If there’s a private contact, and it’s the family… and the Red Cross has an operational procedure.

Investigator: The Red Cross will contact the prisons directly?

Doctor Li: The Red Cross will allocate organs.

Investigator: it’s not that you contact prisons directly?

Doctor Li: That…, we can’t do it!

Investigator: Ok, thank you, Doctor Li.

Addendum 4

Doctor Liao Jixiang, Organ Procurement Coordinator at the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86 182 7573 1616

Date: 05/30/2017

Key points:

1. “I think that the possibility to perform the surgery within one month is very large, I think, but I cannot guarantee in some cases. For this kind of things, because when you do a surgery, one person must be gone.”
2. “The state actually doesn’t allow you to know the information about the organ donors. But let’s put it this way, I can assure you that the quality of our donors is definitely very good. For example, if we procure 100 livers, our [organ transplant] center might only perform 20 transplants, and the other 60 to 80 livers are allocated [elsewhere]. So basically, we keep the good ones for our operations.”
3. “We usually have many…we also use [many organs] from teenagers and people in their 20s, those kids. The quality of that type [of organs] is very good. And also, we excise organs from braindead people, according to the government’s [regulations] right now. They are even more than what we need. There’s almost no wait time to procure [the organs]. In the past, [the donors] needed to be shot, and the heartbeats would have been stopped for several minutes, over 20 minutes, [before the organs were excised].”
4. “We usually get 15-20 donor organs every month.”

Phone Investigation Recording:

Investigator: Hello, is this Doctor Liao?

Doctor Liao: Oh, yes.

Investigator: Ah, Doctor Liao, right? Excuse me that I am calling from another city. I’m using an Internet phone to make this long-distance call.

Doctor Liao: Oh, hello, hello.

Investigator: The patient is from another province, in Guizhou. I’ve heard that the wait time in your hospital is relatively short. So he told me to ask you, to see [due to the short] wait time, if he can get registered in your hospital. I’ve heard that your president has done lots of liver transplants, so he should be very experienced, right?

Doctor Liao: Oh, tell me his blood type.

Investigator: You mean his blood type, right?

Doctor Liao: Right.

Investigator: Type O.

Doctor Liao: Type O, right?

Investigator: Yes.

Doctor Liao: How old is the patient?

Investigator: 52.

Doctor Liao: What’s his problem?

Investigator: He has Hepatitis B Cirrhosis, only cirrhosis. It means that a liver transplant is relatively…

Doctor Liao: Is he in a good physical condition right now?

Investigator: Ah, the phone’s connection is not very good. So, I would like to know if we can come to your hospital, because it is relatively close [to our province]. And another key thing is that I’ve heard that the wait time wouldn’t be long. So that’s why I’m calling you to ask, to see if you can give me an estimate.

Doctor Liao: Is his physical condition ok?

Investigator: Oh, basically, it’s ok. He can move about. He can basically take care of himself.

Doctor Liao: Oh, the [surgical] effect should be good. Since he is in this condition, having a benign illness. Another things is, I think that he should do this surgery as soon as possible, as the risk is low. If he later gets complications after coming here, such as hepatic encephalopathy, hepatorenal [syndromes], hepatopulmonary [syndromes] or something else, then the risk will be much higher.

Investigator: Right, right. So, do you think…

Doctor Liao: It’s okay, we can do it.

Investigator: So I’ve been asking around everywhere. I think that your hospital [is ok]. Could you give an estimate, like how long I should wait? Because we need to wait for the liver source.

Doctor Liao: Well, this is the case. Since his illness is benign… actually we will definitely…Currently, our liver sources are very few. Recently, it seems that for each single one…So far, we’ve done almost 100 cases [this year]. And it’s only May now.

Investigator: You mean in this year, you’ve done 100 cases?

Doctor Liao: Yes, yes, almost.

Investigator: Oh, my friend told me that your hospital had done lots of kidney transplants, and your liver transplants are relatively few, because liver…..

Doctor Liao: Oh.

Investigator: Oh, so you’ve done almost 100 cases of liver transplantation, right?

Doctor Liao: No, no, no. 100 cases, we have done almost 200 cases of liver and kidney transplantation. We should have done over 20 cases of liver transplantation by now, because we don’t have many patients. But there’s no problem on our side. The patient can come to our hospital for a checkup.

Investigator: Do you mean that I should bring him here for hospitalization and to wait for the surgery? Or something else?

Doctor Liao: Yes, yes. Generally speaking, his physical condition is good, so I think that he shouldn’t wait for something to happen to do [the surgery]. In general, there shouldn’t be a big problem, and it should be relatively fast. I think that the possibility to perform the surgery within one month is very large, I think, but I cannot guarantee in some cases. For this kind of things, because when you do a surgery, one person must be gone. And generally speaking, our hospital [has good liver sources], because when the state allocates livers [to hospitals], it’s done according to the principle of proximity.

Investigator: I see.

Doctor Liao: The quality of our donors should be good, because we are the best in the country in this area. And generally speaking, we always keep the relatively good donor organs for our own hospital. The state also knows that this kind [of organs] exists, and we are not violating that principle of allocation.

Investigator: Oh…

Doctor Liao: Because the allocation starts from our hospital.

Investigator: I see, from your…

Doctor Liao: Generally speaking, [the donor organs] are relatively good, that’s why we use them... It’s benign.

Investigator: Can we know how old the donor is, by that time?

Doctor Liao: Generally speaking, the state actually doesn’t allow you to know the information about the organ donors. But let’s put it this way, I, myself, I, I can assure you that the quality of our donors is definitely very good, because we’ve been doing this for so many years. This is roughly the case. For example, if we procure 100 livers, our [organ transplant] center might only perform 20 transplants, and the other 60 to 80 livers are allocated [elsewhere]. So basically, we keep the good ones for our operations, that’s for sure.

Investigator: I see, you mean that you keep the good ones, right?

Doctor Liao: Right, right.

Investigator: Oh, so your [donor organs] include the type from the judicial system?

Doctor Liao: Yes, yes, actually I don’t think that the quality of [organs from] the judicial system is necessarily better than that of the donated organs right now. Not necessarily so.

Investigator: Oh

Doctor Liao: Because we usually have many…we also use [many organs] from teenagers and people in their 20s, those kids. The quality of that type [of organs] is very good. And also, we excise organs from braindead people, according to the government’s [regulations] right now. They are even more than what we need. There’s almost no wait time to procure [the organs]. In the past, [the donors] needed to be shot, and the heartbeats would have been stopped for several minutes, over 20 minutes, [before the organs were excised].

Investigator: Oh, you mean now it’s instead…

Doctor Liao: Usually, [the heartbeats] would have been stopped for over 10 minutes. Yes. But now, this period of wait time no longer exists.

Investigator: Oh…

Doctor Liao: Because he is already braindead. Although he’s braindead, he has heartbeats, but nothing else, no other functions. So his organs’ functions are good.

Investigator: Oh…

Doctor Liao: It’s also quite good.

Investigator: Oh, good, good. So professor, I will text you, when I come.

Doctor Liao: Right, right. If you come, please give me a call or text me, I will make arrangements for you, okay?

Investigator: When it’s the time for surgery, the one, who performs it, should be your president, right?

Doctor Liao: Yes, yes, yes….

Investigator: I see.

Doctor Liao: But I think, in comparison with other [hospitals], our advantages are, first, the quality of our donor livers should be better; second, it’s definitely faster. For him, having the surgery fast could be safer. When you get complications, whichever hospital you go to, it will still be unsafe.

Investigator: Oh, yes.

Doctor Liao: That’s for sure, because, because…

Investigator: Yes, that’s the case.

Doctor Liao: Yes, because we know the hospitals that do organ transplantation very well.
We know each other very well

Investigator: Yes, yes, so technically you are about the same, right? The more you perform, the more experiences you gain, right?

Doctor Liao: Right, right, right…

Investigator: You just mentioned Type O to me. According to your estimate, for someone with Blood Type O, [the organ can be procured] within one month, right?

Doctor Liao: I think it should be ok. Generally speaking, it should be ok.

Investigator: So for one month, he basically…he can try to stay in the hospital and wait, right?

Doctor Liao: Because we usually get 15-20 donor organs every month. Among these 15-20 donor organs, I don’t believe that he cannot find a matching one. Relatively good livers of Blood Type O…generally speaking, the possibility of not procuring one of this type is relatively small. That is, the possibility of not obtaining this type of organs after waiting for one month is smaller. Of course, I can’t guarantee.

Investigator: One of my friend from Fujian told me that your hospital does almost 300 cases of kidney transplantation every year, right?

Doctor Liao: That’s right, 300 case, that’s for sure.

Investigator: Ok, good, I’m calling to today to get to know the situation.

Addendum 5

Doctor Liao Jixiang, Organ Procurement Coordinator at the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86 182 7573 1616

Date: 06/11/2017 

Key points:

1. “There should have been more than 120 cases of organ transplantation [this year].”
2. “The organs are not from the Red Cross. There is a set of national procedures to follow [for organ allocation].”
3. “For kidney transplantation, before reimbursement, it’s about 300,000 yuan.”

Phone Investigation Recording:

Investigator: Hello, Doctor Liao, this is Doctor Liao Jixiang, right?

Doctor Liao: Hi, Hello.

Investigator: I would like to ask you if, if our No. 303 Hospital can still do kidney transplantation?

Doctor Liao: Lung? Yes, we can.

Investigator: You can.

Doctor Liao: Did you just say lung or kidney?

Investigator: I am saying that the donor, the kidney source, must be good.

Doctor Liao: Oh, generally speaking, if the donor organs are used by us, they must be very good.

Investigator: Oh, very good [organs]. Where [are they from], in general? Donor [organs] donated at the Red Cross?

Doctor Liao: Well, they are not from the Red [Cross]…but similar, anyway there is a set of national procedures to follow. That is, for organ donation, they are usually from braindead patients.

Investigator: Ah, that’s right, that’s right. What did you say? The state has a…website, right? Organ donation website?

Doctor Liao: Oh, yes.

Investigator: Then you said, you just said, you get the organs from the state’s system, this system. Oh, can we get in to take a look?

Doctor Liao: I…I have no idea about his, because even for us, there is a password. I, I, I really don’t know. It should be impossible. It should be administrated by someone.

Investigator: Oh, even people like you doctors can’t login, right? I can’t even see [the data]?

Doctor Liao: We have someone especially doing this, too, the system has someone specifically administrating the data.

Investigator: Well, well, two more questions. One is about the fees, how much? For one surgery?

Doctor Liao: For kidney transplantation?

Investigator: Yes.

Doctor Liao: For kidney transplantation, before reimbursement, it’s about 300,000 yuan.

Investigator: What do you mean by “before reimbursement”? I don’t get it, reimbursement?

Doctor Liao: It means for the 300,000 yuan, you can actually get money back, if you have bought medical insurance in the country.

Investigator: Oh, oh, oh, I see. Ok, I got you. People mentioned to me about the death-row prisoners and the kind from the judicial system, when they knew that I want to do this. Can we still use this type, just like before? And I was told that this type was good.

Doctor Liao: In 2015, the government banned [the use of this type of organs]. We don’t have a single case like this. We really don’t have any now.

Investigator: Oh, you mean the state stipulated that this type couldn’t be used to do surgeries? It was allowed in the past, right?

Doctor Liao: Yes, yes, yes, yes……

Investigator: Oh, for that kind of [Falun] Gong practitioners, death-row prisoners, you could do operations [with their organs] in the past, but now you can’t? They are willing. They told me, “you’d better spend some more money to get this kind of relatively good [organs]. You discuss with the hospital…”

Doctor Liao: Ah, no, no more...

Investigator: Have you done a lot this year? This year, your hospital.

Doctor Liao: Yes, yes, I’ve done a lot.

Investigator: Several hundred cases, this year?

Doctor Liao: Hmm, hmm…anyway, there should have been more than 120 cases of organ transplantation.

Investigator: Oh.

Doctor Liao: I don’t have the exact number. I just count the cases after a certain period of time. I don’t know the total number in this period.

Investigator: Well, you said that you had done more than 100 cases this year, right? That’s good, you’re doing well.

Doctor Liao: Yes, yes, yes….

Investigator: Ok, good. Thank you, Doctor Liao. Sorry for bothering you. Good, bye, bye.

Doctor Liao: Oh, you are welcome, never a bother. Ok, bye.

Investigator: Bye.

Addendum 6

Guo Hui, Organ Procurement Coordinator in the Organ Transplant Center at West China Hospital, Sichuan University

 

Phone number: +86 189 8086 1857

Date: 01/30/2017

Phone Investigation Recordings:

……

Investigator: Well, how is the quality of your donor organs?

Guo Hui: Very good, our donor organs, our kidney transplantation ranks first or second in the entire country. And our living donor organ transplantation ranks first, and the quality of the donor organs is quite good.

Investigator: I know, you just mentioned living donor organ transplantation. What do you mean?

Guo Hui: Kidney transplantation includes living donor transplantation. It refers to donation from a related donor. And there is also… One is donation by one’s relatives, and another is donation from braindead patients. There are two ways. All organ transplants are from these two ways. Our hospital has more than 1,000 patients waiting in a queue. [Investigator: Really?] And [the number of] kidney transplantation increases every year. There is an annual growth of 300,000 transplants in the entire country. Think about it, this thing [i.e. organs], to be honest with you, is in short supply.

Addendum 7

Ma Xiao, Organ Procurement Coordinator at the People’s Liberation Army No. 302 Hospital in Beijing

Phone number: +86-13911099030

Date: 07/31/2016

Key points:

1. “We have done a lot [of liver transplants]. It’s been almost 60 cases in the first half of this year.”
2. “Since we work with different hospitals. So the donors would emerge from time to time.”
3. “Director Liu Zhengwen [, who does operations,] used to perform surgery for Fu Biao.”
4. “The organ transplantation is our highlight.”

Phone Investigation Recordings:

……

Investigator: Hello, hello. Is this Doctor Ma Xiao from No. 302 Hospital?

Ma Xiao: Ah, yes, hello, who is calling, please?

Investigator: Well, I would like to ask you a question. It’s about you, you are an organ transplant coordinator, right?

Ma Xiao: Yes, yes, yes…

Investigator: It means that you coordinate the donor organ [procurement], right?

Ma Xiao: Right, that’s my job. I contact various hospitals or the hospitals nearby, that is, to find some donors. I am looking for donors, right.

Investigator: Ah, great. There is a high-ranking government official, who wants to do liver transplantation. He has advanced liver cirrhosis.  If I come to your hospital, how long do we need to wait? Can we do it very soon?

Ma Xiao: Well, it’s hard to tell you now, you need to come here to get registered and take some relevant medical examinations. It’s difficult to give an estimate. Some can be done very quickly, but some still need to go through...

Investigator: Have you done a lot this year? If there are a lot, can…

Ma Xiao: Uh, we have done a lot. It’s been almost 60 cases in the first half of this year, nearly 60 cases.

Investigator: Oh, that’s good. If we wait in line at your hospital, can we get the organ after waiting for one or two months?

Ma Xiao: I am not sure about that, I think it should be, should be ok. We can only say so, because we can’t be sure, maybe a couple of days later, we’ll find this kind of donors. Because the donors [can be found] at any time, how to put it. [The organ procurement] is not regular. Because we work with different hospitals. So the donors, who are suitable in terms of blood type and so on, would emerge from time to time. But I think our hospital is okay, because we cooperate with many other hospitals, so our donor procurement is better. Yes, anyway, it’s your decision. Our No. 302 Hospital is better. Ah, we can’t talk about other hospitals. For instance, No. 301 [Hospital] seldom does liver [transplantation]; No. 309 [Hospital] performs a lot of kidney transplants.

Investigator: Oh, yes, yes, Shi Binyi, Shi Binyi has done a lot of kidney [transplants]. I have noticed that different hospitals have different situations regarding their supply of donor organs. Some have more, and others have less. People suggested me to ask different hospitals. So if your hospital has more, then I will ask him to come here.

Ma Xiao: How about this? You register for our hospital’s outpatient consultation. Tomorrow our Director Liu will be on duty. You can come to see him or me, or you can get registered for Liu Zhengwen’s consultation. He is very famous in the organ transplantation circle. Liu Zhengwen used to perform surgery for Fu Biao, very famous.  He is the one, who did surgery for Fu Biao. Because every hospital has their own experts, but experts can work in different hospitals. They can be hired specifically [for their expertise]. He used to work in an armed police hospital, and he has come to work in our hospital as an expert for many years.

Investigator: I see, I thought that Fu Biao had his surgery in an armed police hospital. How come [Liu] has come to your hospital? It seems that the experts can be transferred among different hospitals.

Ma Xiao: Yes, yes, yes. He has excellent skills. Especially in No. 302, in the armed police hospital, he did the surgery for Fu Biao, he is a big shot on various aspects in the organ transplantation circle. He is awesome.

Investigator: It means that he is a top expert.

Ma Xiao: Yes, yes, top. That means, you can find nobody better than him. But the organ transplantation is our highlight, because our patients, patients…

Investigator: So you only have two wards for organ transplantation?

Ma Xiao: Yes, we are the transplant surgery department. Director Liu is managing these two floors, which are for organ transplantation.

Investigator: There are 100 beds on the two floors, aren’t there?

Ma Xiao: No, we don’t have so many beds. We don’t have so many.

Investigator: That’s why people have to wait, because you don’t have so many beds. So as you said, there are also other kinds of patients?

Ma Xiao: Not like this. We have many patients, a lot of patients from all over the country. Many come to No. 302 Hospital, because of our reputation, in addition to [patients] from our own city.

Investigator: Yes, yes.

Ma Xiao: They all come here because of our reputation. This is the largest hospital specializing in liver diseases in the entire military. So there are lots of this kind of organ recipients.

Investigator: So generally speaking, you go to different hospitals to look for this type of donor organs, right? Do you have an age limit? The donor organs can’t be used if the donor is very old, too old?

Ma Xiao: Right, right. We do have an age limit. We have a range. We won’t use that kind of organs. We are very strict with our donor organs, very strict.

Investigator: Yes, so for your [donor organs], in addition to the ones you find yourself, you can still get some from the Red Cross. The Red Cross can provide some, can’t they?

Ma Xiao: Well, it’s hard to say. Anyway, from the Red Cross or hospitals, we…. I would like to know how you got my telephone number.

Addendum 8

Xie Qinfen, Organ Procurement Coordinator for Liver Transplantation at Zhejiang University International Hospital

Phone number:  +86+13968153957

Date: 02/28/2017

Key points:

1. “Generally speaking, it may take about two weeks [to get the liver]. Sometimes it’s very fast. Sometimes people can even do it on the second day. It depends on your situation. Critically ill patients can take the priority.”
2. “We have done a lot [of liver transplants], and we do a good job. The quality of liver sources at our hospital is relatively good, too. We did over 120 cases last year.”
3. “We would usually receive information on donor livers on the second day, [after we make an inquiry].”
4. “Liver procurement mainly depends on President Zheng. He has established a reputation and has lots of connections on various aspects.”
5. “Some [organs] are delivered from other cities or provinces; some were excised by ourselves, we do both.”

Phone Investigation Recording:

……

Investigator: Hello, hello. Is this Doctor Xie Qinfen from Zhejiang University Hospital?

Doctor: Hello, hello.

Investigator: Hello. I would like to ask, can your Zhejiang University Hospital still do liver transplantation.

Doctor: Yes.

Investigator: Oh, I have a nephew, who has advanced liver cirrhosis.

Doctor: Uh, depending on your situation, sometimes we give priority to critically ill patients.

Investigator: How long do we need to wait, approximately?

Doctor: Generally speaking, it may take about two weeks.

Investigator: Two weeks seem too…your hospital does more cases than other hospitals, right?

Doctor: Yes, we have done a lot, and we do a good job.  The quality of liver sources at our hospital is relatively good, too.

Investigator: Oh, so how many cases of liver transplantation did your hospital perform last year, in year 2016?

Doctor: We did over 120 cases last year.

Investigator: Oh, for a year, over 100 cases is not a lot.

Doctor: No, we have just started. It’s our first year, so of course, there won’t be too many.

Investigator: Ah, is this the First Affiliated Hospital of Zhejiang University?

Doctor: Zhejiang University International Hospital.

Investigator: Oh, International Hospital. Is it the one that President Zheng has just established?

Doctor: Yes.

Investigator: Oh, I checked it out online, and then I thought that it’s just in its first year. So maybe technically it’s not as strong as the First Affiliated Hospital of Zhejiang University? So I thought. So I decided to make a call, now I have the chance to talk to you.  It’s not bad, because you happen to be International Hospital, and Zheng Shuseng is very famous.

Doctor: Yes, that’s the situation right now.

Investigator: Your hospital was just established last year, it’s brand new.

Doctor: Yes, it is. President Zheng Shuseng only performs surgeries in our hospital now, and the doctors in our International Hospital all came from the First Affiliated Hospital of Zhejiang University…

Investigator: Oh, so this is the case. You just mentioned that the donor organs in your hospital are very good, better than those of the other hospitals.

Doctor: Yes.

Investigator: So why can your hospital get such good quality liver sources?

Doctor: This mainly depends on President Zheng. He has established a reputation and has lots of connections on various aspects.

Investigator: Oh, you said that you did more than 100 cases last year.

Doctor: Right.

Investigator: Oh, since it was just established, over 100 cases are good enough. Maybe gradually, more and more people will…

Doctor: We would usually receive information on donor livers on the second day, [after we make an inquiry].

Investigator: Gradually people will get to know it. It was just established, many people don’t know about it. I think that President Zheng would definitely have connections. In the past, when my friend told me about him, he was doing surgeries in the First Affiliated Hospital of Zhejiang University. So he told me that the hospital had done a lot of cases and it was doing well. President Zheng worked there, too. Speaking of donor livers, can we still use that kind of donor livers, which were relatively good, from death-row inmates? For liver sources, we definitely want healthy ones.

Doctor: No, we can’t do it right now!

Investigator: Can’t do it right now?

Doctor: No, but what we are using now are from BDC, braindead, donations from braindead people.

Investigator: You said it’s from braindead [people]. According to the overall organ donation situation of our country, it seems that there are not so many people donating, people just…

Doctor: They do, they do. In many places in our country, people actually donate organs as braindead [people].

Investigator: Really? So you mean that there are more people donating [organs] right now?

Doctor: Yes!

Investigator: So President Zheng has been doing this for a long time, so he must have lots of connections.

Doctor: Yes, what’s your name, please? If he comes, please ask him to see me.

Investigator: Ok, you are the one, who is responsible for liver transplantation, right?

Doctor: Right, right, right, tell him about this. Anyway, if he comes to our hospital and wants to contact me, he can just make a call.

Investigator: Ok, the beds are not in short supply? [Hope] to get a bed, if we go.

Doctor: Bed shortage is gradually surfacing, but it’s still ok.

Investigator: It’s ok?

Doctor: But priority will be given to liver transplant patients.

Investigator: Oh, I see.

Doctor: That’s right.

Investigator: Then, in general, how long would the patients be hospitalized before being discharged?

Doctor: About 3 weeks, 3-4 weeks.

Investigator: Oh, then they get discharged?

Doctor: Yes.

Investigator: Ok, good. I will go home to discuss with him, to see his situation, and then prepare some documents.

Doctor: Ok, anyway we can shorten the wait time, but you ask him to come here first. We need to make an evaluation.

Investigator: Just like what my friend did before. When he went to the First Affiliated Hospital of Zhejiang University, he had the surgery one week later.

Doctor: Sometimes it’s very fast. Sometimes people can even do it on the second day. It depends on your situation. Critically ill patients can take the priority.

Investigator: Critically ill patients can take the priority, right?

Doctor: Yes.

Investigator: As to the donors...

Doctor: But you need to come here first…we need to make an evaluation, alright?

Investigator: Oh, ok. Speaking of the donor organs, does your hospital usually go to excise organs yourselves, or get them from other cities?

Doctor: Well, some are delivered from other cities or provinces; some were excised by ourselves, we do both.

Investigator: Oh, if you excise organs yourselves, usually it is done in your hospital, because it’s close.

Doctor: We do both, anyway, not all is done in this way…It depends on the situation.

Investigator: Oh, all right, that’s it.

Doctor: The earlier you come [to our hospital], the better. Coming earlier means [doing the surgery] earlier.

Investigator: Do you have many patients waiting in line, right now?

Doctor: Waiting in line? Not so many.

Investigator: Not so many, ok, that’s good

Doctor: Not particularly a lot. Well, we do it fast.

Investigator: Pardon, what did you say?

Doctor: Since we do [the surgeries] fast, the patients wait in line only for a short period of time. They all got it done. So, [the waiting list] of the patients is relatively short.

Investigator: Oh, I see, so can you tell me about the fees? The fees to do this?

Doctor: The fee is over 500,000 yuan. The total might include costs to search for the liver source and the surgery fees.

Investigator: How much approximately? I need to prepare the money.

Doctor: Over 500,000 yuan.

Investigator: Oh, over 500,000 yuan. Ok, ok, I will go home to tell him about this.

Doctor: How should I address you, please?

Investigator: My last name is Liu.

Doctor: Ok, oh, good, good.

Addendum 9

Tan Liang, Organ Procurement Coordinator of the Second Xiangya Hospital of Central South University, Hunan Province

Phone number: +86 15116101512     

Date: 04/24/2017

Key points:

1. [Investigator: I would like to know how you expand this business, I mean, to get so many donors.] Tan Liang: It’s mainly because of the doctors from different hospitals. Um, they help us carry out the work, this is the key part. Because we are working in the same hospital system after all, so it’s convenient.
2. [Investigator: Do you have many donor organs from the Red Cross?] Tan Liang: The Red Cross? Which part of the Red Cross are you referring to?
3. [Investigator: Does your hospital get many organs [from the website of National Health and Family Planning Commission?] Tan Liang: Do you mean that kind allocated through the network? Well, just so so, just so so.

Phone Investigation Recordings:

……

Investigator: Hello, hello, is this Doctor Tan Liang?

Tan Liang: Who is calling, please?

Investigator: I am from Henan, well, you are, in your Second Xiangya Hospital, you are the organ [procurement] coordinator, aren’t you?

Tan Liang: Yes, I am. How come your number appears to be in the US?

Investigator: Haha, I am calling you through the Internet, online calling. Making calls online is cheap, this call is free.

Tan Liang: Oh.

Investigator: I am wondering, the donor organs, that kind used before…We both know what I’m referring to. The type of donor organs like what Huang Jiefu talked about in 2015 was relatively easy to obtain. Just make a phone call to contact the jails, and it’s done. You can operate directly from there. But now they implement this kind of [organ] donation [system]. For this type, I would like to know how you expand this business, I mean, to get so many donors.

Tan Liang: Well, for this, it’s mainly because of the doctors from different hospitals. Um, they help us carry out the work, this is the key part.

Investigator: Well, do you have so many people to go and make contacts?

Tan Liang: Anyway, we just contact them, because we are working in the same hospital system after all, so it’s convenient.

Investigator: Do you have many donor organs from the Red Cross?

Tan Liang: The Red Cross? The Red Cross?  Which part of the Red Cross are you referring to?

Investigator: I’m referring to the organ donation, from corpses, are there many?

Tan Liang: Well, for this, how can I put it? The Red Cross now, I mean the Red Cross has always been…

Investigator: On the website of National Health and Family Planning Commission, they have listed some organs. Do all the hospitals get organs from the website? Does your hospital get many organs?

Tan Liang: Oh, do you mean that kind allocated through the network?

Investigator: That’s right, right. Do you get a lot of organs?

Tan Liang: Well, just so so, just so so.

Investigator: Oh, that means, you did over 300 cases of kidney transplantation. So all these 300 kidneys have the signatures of the Red Cross, right?

Tan Liang: Uh…no. Joint signatures. Among these 300, there were some from living donors.

Investigator: Living donors, were there a lot?

Tan Liang: Not a lot, far below 30%.

Investigator: Oh, 30% were from living donors?

Tan Liang: Much lower, didn’t reach 30%. It’s about 15%

Investigator: I see, they were mainly allografts, right?

Tan Liang: You can ask your director to call our director, so they can communicate together to discuss about these things.

Addendum 10

Guo Yong, Organ Procurement Coordinator of the Second Xiangya Hospital of Central South University, Hunan Province

Phone number: +86+ 13787120686               

Date: 04/25/2017

Key points:

1. “There are seven of us [coordinators liaising with local hospitals]”
2. “We let the doctors do it [i.e. the explanation] for us. The patients’ families don’t trust us, they trust the doctors instead.”
3. “The local patients and their families doubt us, then the local Red Cross people would be responsible for explaining it to them. [We pay] around 80,000 yuan for each donor’s family…according the provincial government’s documents.”

Phone Investigation Recording:

……

Investigator: Hello, hey, hello, hello. Is this Mr. Guo Yong?

Guo Yong: Yes. (His sound is particularly unclear)

Investigator: Hello, hi, I’m from Hebei Province. I want to learn from you Hunan Province. You are doing so well in organ donation. I’m also a coordinator for that. So, I want to learn from your experience. We are doing so poorly in Hebei. In your Second Xiangya Hospital, the number of organ transplant has always been increasing. You are definitely doing so well. So, I want to call you to learn about your operations.

Guo Yong: Ah, ah, which work unit are you from?

Investigator: Ah, I’m from the Second Hospital of Hebei Medical University in Shijiazhuang. I’m also a coordinator [of organ procurement]. So, I want to learn from other hospitals’ experiences, as our transplant cases here are so few every year.

Guo Yong: Oh, you are from Hebei. The number of organ transplant is not small in your hospital in Hebei, either. How many coordinators do you have? How do you contact the local hospitals?

Investigator: We only have 5 or 6 coordinators.

Guo Yong: Ah, 5 or 6 people. We only have 5 or 6 people, as well. Actually, there are seven of us. Besides putting up promotional posters to let the patients and their families see these posters, we also regularly give lectures to the doctors in each department of the hospitals.

Investigator: Oh, wow, you also give lectures. That is, you give lectures to the hospitals, which are not qualified to do organ transplants?

Guo Yong: Eh, let them, let the doctors do it for us...for sure, he doesn’t believe us, the patients’ families don’t trust us, they trust the doctors instead.

Investigator: Do you also inform the Red Cross?

Guo Yong: We do inform the Red Cross, the local Red Cross. The local Red Cross staff would go together with us.

Investigator: Oh, I see. Then do you do appraisals together?

Guo Yong: Yes, in many places here, the local patients and their families doubt us, then the local Red Cross people would be responsible for explaining it to them.

Investigator: Oh, oh.

Guo Yong: When we get there and talk to them in mandarin, which they don’t understand, then they would be skeptical. Then the local Red Cross people would explain to them that this is a regular work supported by the state, not organ trafficking.

Investigator: Um, um, do you also give their families any compensation?

Guo Yong: Uh, the compensation… the compensation is provided by our hospital. Our hospital gives the compensation to the family members of the organ donors. But we have standards.

Investigator: Have standards. Then how much do you compensate them for one organ?

Guo Yong: Um, around 80,000 yuan for each donor’s family.

Investigator: How much? 8 yuan?

Guo Yong: 80,000 yuan, yea.

Investigator: 80,000? So much!?

Guo Yong: 80,000 yuan is 3 to 4 times of the average annual income of the people in Hunan province. Hunan Province’s per capita income is 19,000…19,000 to 20,000 yuan.

Investigator: Yo, you compensate quite a lot for that...

Guo Yong: Yes, yes, our provincial Red Cross [does so] according to the provincial government’s spirit, there’re official documents.

Investigator: Oh, oh, you have unified regulations?

Guo Yong: Yea, unified regulations. There are our provincial government’s documents (about it).

Investigator: Oh, oh, so you have to give this much to the families for compensation?

……

Addendum 11

Doctor-on-duty, Kidney Transplant Department at the General Hospital of Chinese People’s Armed Police Forces in Beijing

Phone number: +86-10-57976857

Date: 03/29/2017

Key points:

1. The Organ Transplant Department the General Hospital of Chinese People’s Armed Police Forces is divided into a kidney transplant team and a liver transplant team. The kidney transplant team is managed by two chief physicians; while there are several chief physicians in charge of the liver transplant team.
2. Each of the two kidney transplant teams can do more than 200 cases of kidney transplantation every year. Altogether, both teams can do more than 500 cases of kidney transplantation each year.
3. Director Wang Jianli and Director Liu Hang oversee both teams respectively.

…

Phone Investigation Recording:

…

Doctor on duty: Hello

Investigator: Hi, is this the General Hospital of Chinese People’s Armed Police Forces?

Doctor on duty: Yes.

Investigator: I’d like to ask. A family member of mine needs to have a kidney transplant.  Is your hospital still doing it?

Doctor on duty: What? Your family member wants to do a kidney transplant, so?

Investigator: Oh, because our local doctor has suggested us to ask the hospitals in Beijing, such as the General Hospital of Chinese People’s Armed Police Forces, which does a lot of organ transplants. So, I’m calling you to make an inquiry.

Doctor on duty: You can also bring the checkup results from your local hospital to register at our hospital. Let our chief physician take a look and evaluate, to see if his condition is suitable for an organ transplant operation.

Investigator: Oh, is it still Director Wang Jianli, who’s performing the surgeries?

Doctor on duty: Yes, chief physician Wang Jianli.

Investigator: Oh, which means...

Doctor on duty: Make an appointment with him. He’s available to see outpatients every Wednesday and Thursday afternoon. He’s available tomorrow afternoon for outpatient services.

Investigator: Oh, all are afternoons. I’d like to ask, doctor, is your hospital doing a lot of organ transplants nowadays? How many kidney transplants did you do last year, for instance?

Doctor on duty: In one year, we can do more than 200 cases.

Investigator: More than 200 cases, more than other hospitals, right?

Doctor on duty: Yes, definitely. [This number] is just for one of our teams. Both of our teams can do more than 500 cases altogether each year.

Investigator: Oh…

Doctor on duty: We have two teams.

Investigator: What are the two teams? Two wards?

Doctor on duty: Two different chief physicians are in charge.

Investigator: Oh, I know there’s Chief Physician Liu Hang working at your hospital, as well.

Doctor on duty: Yes, right.

Investigator: One chief physician would do more than 200 cases, and two chief physicians, do they do [operations] separately?

Doctor on duty: Yes.

Investigator: How many wards are there in your hospital? Just this one? Or two?

Doctor on duty: We have the liver transplant team and the kidney transplant team. And there are several chief physicians in the liver transplant team.

Investigator: Wow, so the kidney transplant only has one ward, right?

Doctor on duty: We are all in the same ward, just different doctors being in charge of different [operations].

Investigator: Oh, so liver and kidney [transplant teams] are in the same large ward, belonging to the transplantation...

Doctor on duty: Yes.

Investigator: Oh…

Doctor on duty: They all belong to our Organ Transplantation Department.

Investigator:  Oh, I see. Then, as they are all in one large ward, there must be a lot of ward beds available, right.

Doctor on duty: Yes.

Investigator: Is the wait time for liver transplantation shorter than for kidney? It seems that your liver transplantation...

Doctor on duty: This, um, [Investigator: Not necessarily?] I cannot tell you. Because the wait time…the later you start, the longer you’ll wait for sure. It’s hard to say.

Investigator: Alright, then I...

Doctor on duty: We cannot always tell you all this information.

Investigator: Why? Because...

Doctor on duty: You can see the information online, to see our workload. It’s all online.

Investigator: Ok, alright, alright, thank you! Thank you! Hmm, okay, bye. Bye.

Addendum 12

Nurse on duty, liver transplant department at the General Hospital of Chinese People’s Armed Police Forces in Beijing

Phone number: +86+ 10_57976114

Date: 05/06/2017

Key points:

“We do them [i.e. liver transplants] every day. For us, it’s not very difficult.”

Phone Investigation Recording:

……

Nurse [operator]: Hello?

Investigator: Hello, could you transfer my call to the Organ Transplant Center’s nurse station? Eh, hello!

Nurse: Hello, hello!

Investigator: Eh, hello! Is this the Organ Transplant Center’s nurse station?

Nurse: Yes.

Investigator: Oh, have you done any this year?

Nurse: What?

Investigator: I am asking, have you done any liver transplants this year?

Nurse: We do them every day.

Investigator: You do it every day? It’s quite difficult to do a kidney transplant, so...

Nurse: For us, it’s not very difficult, okay?

Addendum 13

Doctor on duty, liver transplant department at 302 Military Hospital of China in Beijing

Phone number: +86+ 10_66933449               

Date: 05/05/2017

Key points:

1. “Some people get it faster, like in a week; some people get it slower, like in 2 or 3 months.”
2. “We did more than 100 cases last year.”

Phone Investigation Recordings:

……

Investigator: Hello, doctor, I’d like to know the procedure [for a patient] to transfer from another hospital to your liver transplant department.

Doctor: Hello, what’s your situation?

Doctor: Eh, what blood type?

Investigator: Type B.

Doctor: Ah, type B.

Investigator: You asked about the blood type. According to the chief physician, it is relatively fast [to find a donor of Blood] Type B. In the past, it took about a month for a patient to wait [for the operation] in your hospital. If a patient comes now, does it still take almost the same amount of time?

Doctor: Um, possibly. Some people get it faster, like in a week; some people get it slower, like in 2 or 3 months. It’s all possible.

Investigator: Eh, is it still performed by Chief Physician Liu?

Doctor: Yes.

Investigator: Oh, it’s just him or there are others?

Doctor: Chief Physician Liu and Chief Physician Wang.

Investigator: Hey, I’ve never heard of Wang, what’s his full name?

Doctor: Wang Hongbo.

Investigator: Oh, I’ve never heard of him. Is it that the patients choose which chief physician to perform their surgeries, or you arrange it?

Doctor: Then let me ask you, if Dr. Liu is on a business trip, and only Dr. Wang is available, and then a liver arrives, do you want to do it or not?

Investigator: Yes, that’s right, that’s right.

Doctor: Ah.

Investigator: Then I’d also like to ask you, can we be admitted into the hospital at any time? There’s no problem in getting a ward bed?

Doctor: Not exactly, our hospital beds are in short supply right now.

Investigator: Your 302 Military Hospital in Beijing has done quite a lot liver transplants, right? Plenty of experiences, right?

Doctor: We did quite a lot [of liver transplants]. I don’t know about the rest.

Investigator: I was asking you just now whether you do a lot or not. If only one or two cases a year, then...

Doctor: We did more than 100 cases last year.

Investigator: What’s the surname of the other chief physician on the phone, please? I want to know how to address him.

Doctor: Oh, Li, Li, Li Hongling. Professor Li.

Investigator: Li Hongling, Professor Li. He is a chief physician, right?

Doctor: He is the one specifically in charge of our organ transplant, before and after the transplant surgery...um.

Investigator: Ok, Ok, I see. Thank you! Bye!

Doctor: Um, Ok.

Addendum 14

Dr. He Enhui, liver transplant operations at Beijing Friendship Hospital

Phone number: +86+ 13699102049

Date: 09/02/2016

Key points:

1. “We have been doing liver transplants for more than a dozen years. Every year we do more than 100 cases.”
2. “In this year, there must have been [several dozen cases] till now. We do 2 to 3 cases on average every week.”
3. “Altogether for an adult liver transplant, it costs more than 600,000 yuan.”
4. “Professor Zhu has done more than 1,900 cases.”

Phone Investigation Recording:

[Phone ringing]

Staff on duty: Hello?

Investigator: Hello! Is this Dr. He Enhui at Friendship Hospital? I’d like to ask...

He Enhui:  Yes.

Investigator: I’ve heard that your Friendship Hospital is mainly doing organ transplantation for children. Do you also do it for adults?

He Enhui: We can, it’s the same.

Investigator: Oh, you can. I thought that you only do it for children, because...

He Enhui: No, no.

Investigator:  On one forum, I saw that they were all children’s cases. A friend of mine wants to have [a liver transplant]. What’s the average wait time?

He Enhui: Um, what’s his blood type?

Investigator: Type B.

He Enhui: Type B, it won’t take long, but it also depends on the severity of his illness. Um, if it’s very severe, we will arrange for him to have the surgery earlier; if it’s not too severe, we will arrange it for him at a later date. However, normally it takes just a few months. It’s hard to say.

Investigator:  Then, who gave [the donor organ] to the hospital? How come it would suddenly arrive?

He Enhui: Um, the state has a network to distribute organs. That is, there is organ donation everywhere. It’s registered into the system, then it starts to search in the system. The system distributes the organs automatically, to some hospital or to someone. That is, it’s random.

Investigator: So the earliest [He Enhui: There’s no guarantee]…why I’m calling is because a friend of mine had an organ transplant operation here. So I’m calling you. He also told me that when he had the transplant, they used organs from death-row prisoners, they were all healthy?

He Enhui: Now the state no longer allows the use of organs from death-row prisoners. It’s prohibited by law. Previously, it exploited the loopholes in the regulations. It was not mentioned in any law in the past.

Investigator: Really? That friend told me, “You ask them, and it would be the best if you get organs of this type”. He said, “You see, I used this [type of organ], which was good, very good.

He Enhui: Then, he must have had the transplant early on.

Investigator: He did it earlier, several years ago, 7 or 8 years ago.

He Enhui: Right, right, we have been doing liver transplants for more than a dozen years. Every year we do more than 100 cases. Professor Zhu has done more than 1,900 cases in a total of more than a dozen years, that...

Investigator: Have you done a lot this year? Like this kind of allograft operations?

He Enhui: A lot. We do more than 100 cases every year.

Investigator: More than 100 cases. So [in this year], you’ve done several dozen till now?

He Enhui: Yes, in this year, there must have been [several dozen cases] till now. We do 2 to 3 cases on average every week. On average, we have 2 to 3 organ transplant [operations] each week.

Investigator: Oh, what about the price? Can you give me a rough number?

He Enhui: Altogether for an adult liver transplant, it costs more than 600,000 yuan.

Investigator:  Oh, more than 600,000 yuan...that is, are your hospital beds in short supply? Can [my friend] be hospitalized as soon as he arrives?

He Enhui: Our hospital beds are in short supply. But if you have a transplant surgery, we’ll make sure that you have a bed. After the surgery, you go to ICU, and they will make sure there’s a vacancy for you. But if you are in a different situation, then we might not let you take a vacated bed, because our hospital beds are indeed in short supply. But if you do a surgery, then we’ll make sure that the surgery patients are the first to have their needs satisfied.

Investigator: Ah, I see, I see.

He Enhui: You tell him to come for evaluation first. Come to our hospital to have his condition evaluated.

Investigator: Alright, I see. Thank you! Bye!

He Enhui: Bye!

…

Addendum 15

Dr. Kou Jiantao, the Liver Transplant Ward at Beijing Chao-Yang Hospital

Phone number: +86+ 10_85231501

Date: 03/12/2017

Key points:

1. “We try to [have the organ] in about a week, if you are in a very critical condition.”
2. “We have done 20 cases since the New Year’s Day [this year].”
3. “We did 60 cases last year. [Investigator: It looks like that this year you are going to do more than last year.] Right.”
4. “If the patient is in grave condition, then we need to find a suitable donor. The [organs] of marginal donors might not be good for transplantation.”

Phone Investigation Recordings:

……

Investigator: Hello, is this the hepatobiliary surgery department of Chao-Yang Hospital?

Nurse [at the nurse station]: Yes.

Investigator: I’d like to ask if your hospital is still doing liver transplants.

Nurse: Yes, we are.

Investigator: You are still doing them.

Nurse: Yes, a doctor should talk to you about it.

Investigator: How many liver transplants you do every year, a few hundred, now?

Nurse: Um, how about this? I’ll find a doctor to talk to you. You can ask the doctor. This is the nurse station.

[The nurse on duty is finding someone else to answer the phone]

Nurse: A doctor happens to be here, maybe you can talk to him?

Investigator: Oh, ok, good.

Kou Jiantao: Hello!

Investigator: Hello, I’d like to ask if you are still doing liver transplantation right now. How long is the wait time, after the patient is sent to your hospital?

Kou Jiantao: It depends on the situation. We try to [have the organ] in about a week, if you are in a very critical condition. If it’s extremely urgent, then let’s see. It depends on his luck.

Investigator: His blood type is B.

Kou Jiantao: Type B… [Investigator: Yes], we have done 20 cases since the New Year’s Day [this year].

Investigator: Oh, that means, you’ve always been doing it.

Kou Jiantao: Yes.

Investigator: In comparison with the armed police hospitals, do you do a lot? How many do you do each year?

Kou Jiantao: We did 60 cases last year.

Investigator: Ah, 60 cases, so it looks like that this year you are going to do more than last year.

Kou Jiantao: Right.

Investigator: Look, which month is this? And you’ve already done 20 cases, and you only did 60 last year. So the wait time would be impressive. If you did fewer, then the wait time must be longer?

Kou Jiantao: Well, it’s alright, the wait time won’t be too long...it depends.

Investigator: Oh, generally speaking, we are not talking about special cases, just normal cases. If there’s an emergency, and the patient’s condition is severe, can we do it as an emergency treatment? Is this allowed?

Kou Jiantao: It depends on if [we] can find a suitable donor. If the patient is in grave condition, then we need to find a suitable donor. The [organs] of marginal donors might not be good for transplantation. According to the situation, we will choose a suitable donor.

Investigator:  Oh, if it’s emergency, then you can. Because you used to have a green channel for [transplant] patients, who were in emergency situation. It could be faster. Now can you still do it?

Kou Jiantao: Yes, basically we can. We will give consideration to this [type of patients]. But it also depends, to see if the patient’s condition is suitable. If yes, then we would arrange it faster, but [the organs are] all allocated online.

Investigator: Oh, now you don’t have problem with the donors, right? That is, in the past, the donors were from prison, so it was done faster. Now can you still get that kind of donors?

Kou Jiantao:  Now what we are using…are all donated [organs].

Investigator: So now that kind of organs from prison cannot be used anymore, right? Even if we are willing to pay more for it?

Kou Jiantao: There’s no more that kind of channels. No more in our entire country.

Investigator: How long ago did they ban it? Because someone said that, a patient told me, he requested...

Kou Jiantao: I’m not so sure about this. That is, our [organ transplant] center stopped using it for quite a while. Now the state has regulations. It was stopped a long time ago, yes.

Investigator: Oh, is it since 2015, when Huang Jiefu announced that it was not allowed to use it...

Kou Jiantao: The Ministry of Health issued a notice about it.

Investigator: Is it, then it cannot be used now. Because the patient told me to see if I could ask, even paying more for it...

Kou Jiantao: No.

Investigator: Alright. How long the patient needs to be hospitalized after surgery?

Kou Jiantao:  About 3 to 4 weeks after surgery.

Investigator: Oh, 3 to 4 weeks will do.

Kou Jiantao: Right.

Investigator: Ok, I’ll tell him to get in line as soon as possible, then it can be faster, right?

Kou Jiantao: Yes, it can.

Investigator: Ok, then we will ask for you. What’s your last name?

Kou Jiantao: My last name is Kou, I see outpatients every Wednesday.

Addendum 16

Dr. Zhu from Liver Transplant Doctor’s office at Beijing YouAn Hospital

Phone number: +86+10-83997176

Date: 03/24/2017

Key points:

1. The hospital can perform more than 80 cases of liver transplantation each year.
2. The wait time can be as fast as a week or two.
3. “[The hospital performed] quite a lot [liver transplants] this year, quite a lot.”
4. [Investigator: you previously used livers from death-row prisoners. Is it still available now?] Dr. Zhu: This, it’s impossible to tell you, regarding this aspect it’s impossible to, whoever...I don’t even know it myself. But we don’t use non-functioning livers for our patients.
5. [Investigator: If it all relies on donation from the Red Cross, are there that many voluntary donors?] Dr. Zhu: Uh, this, I can’t…it’s inconvenient for me to tell you.
6. “The liver source…, I don’t know about the liver source, either. I don’t know the situation, either.”
7. “We only do liver transplants.”
8. [Investigator: If it’s not allowed to be used, I need to tell her.] Dr. Zhu: This...it’s not convenient for me to tell, not convenient to tell, alright?

Phone Investigation Recordings:

……

Dr. Zhu: Hello

Investigator: Hi, is this Dr. Zhu at YouAn Hospital?

Dr. Zhu: How can I help you?

Investigator: My younger sister just called you from Anqing of Anhui Province. I’m a doctor working in Beijing. She just called me after calling you. Her husband has liver problems and needs to have a liver transplant. She asked me before, but I didn’t really actively ask around for her. She wants me to ask you again if your hospital is still doing liver transplantation and how’s it?

Dr. Zhu: Uh, we are still doing it, and doing it well.

Investigator: Because hospitals in Beijing have done quite a lot of liver transplants. Like in your hospital, how many liver transplant cases do you do every year?

Dr. Zhu: Uh, more than 80 cases.

Investigator: Have you done any this year?

Dr. Zhu: Uh, we have.

Investigator: This year, oh, do you do quite a lot of liver transplants this year?

Dr. Zhu: Quite a lot, this year, quite a lot.

Investigator: Quite a lot, that is, the quality of the livers, the liver sources. She is particularly concerned with the quality of the liver source, and hoping to find a healthy one. She also told me that you previously used livers from death-row prisoners. Is it still available now? Dr. Zhu, could you ask your hospital...

Dr. Zhu: This, it’s impossible to tell you, regarding this aspect it’s impossible to, whoever...I don’t even know it myself. But we don’t use non-functioning livers for our patients [Investigator: oh...this]. If the quality is not good, we won’t use it on our patients.

Investigator: Oh, there are so many hospitals in Beijing. If it all relies on donation from the Red Cross, are there that many voluntary donors? Chinese people don’t seem to have the awareness of donating organs.

Dr. Zhu: Uh, this, I can’t…it’s inconvenient for me to tell you.

Investigator: Ah, inconvenient

Dr. Zhu: You can, you are also a doctor, you can also ask. You are also a doctor in Beijing...

Investigator: I know, I know that there are other hospitals that are still using, still, using...

Dr. Zhu: Not that…., just let me finish.

Investigator: Oh, go ahead.

Dr. Zhu: Let me finish. You are also a doctor in Beijing. You might...uh...you are a doctor in Beijing, you might have a lot of connections in this area, I assume. You can ask other areas, ask around, that is, our hospital is not the only one doing liver transplants!

Investigator: Oh, yeah.                                  

Dr. Zhu: Other hospitals, like Chao-Yang and Friendship, they are doing it, as well, you can ask them, alright?

Investigator: What my younger sister meant was that she’s willing to pay more, if your hospital are still using organs from death-row prisoners like before, because [this type of organs] is relatively healthy.

Dr. Zhu: The liver source…, I don’t know about the liver source, either. I don’t know the situation, either.

Investigator:  That is, you are only specialized in doing the transplant surgeries, and there are others specialized in finding livers. You are mainly doing transplants?

Dr. Zhu: We...We don’t know the situation. We only do liver transplants.

Investigator: Oh, you...

Dr. Zhu: I don’t know about other liver sources, alright?

Investigator: Oh, so you just do the liver transplants, and you don’t know where the livers are from, right?

Dr. Zhu: Right, I...we don’t know.

Investigator: Oh, oh

Dr. Zhu: Most of what we use are from donation, voluntary donation.

Investigator: Oh, I’ll tell her that now it’s impossible to use that type, which you used before, right?

Dr. Zhu: Then, you… you do whatever you see fit.

Investigator: Oh, that is, if it’s not allowed to be used, I need to tell her. She asked me to ask about this, she said...

Dr. Zhu: This...it’s not convenient for me to tell, not convenient to tell, alright?

Investigator: Not convenient to tell, then, you just told her it normally takes 2 or 3 months’ wait time to do the transplant, right?

Dr. Zhu: Not necessarily. I told her, it depends, it can be as fast as a week or two. The slowest would be 2 to 3 months...it’s hard to tell.

Investigator: Oh, it depends on the source of the donor, uh, it’s hard to set the time, right?

Dr. Zhu: Right.

Investigator: So did you tell her the price? How much roughly?

Dr. Zhu:  Uh...about this, you tell her to contact me herself. I’ve already told her before, I told her in the past, okay?

[Dr. Zhu hang up the phone.]

Addendum 17

A doctor from the Doctor’s office of the Liver Transplant Department at Tianjin First Central Hospital, Orient Organ Transplant Center.

Phone number: 022-23626860

Date: 07/21/2016

Key points:

1. The hospital is still doing liver transplantation.
2. The average wait time is about 3 months.
3. “Our ward beds are relatively in short supply.”
4. “Our hospital does several hundred cases each year.”
5. [Investigator: For the first half of this year, has your hospital done 100 or 200 cases of liver transplantation?] Doctor: More than that.

Phone Investigation Recording:

Investigator: Hello! Is this the Liver Transplant Department?

Doctor: Who is this?

Investigator: I’m from Beijing. I’d like to know if you are still doing it?

Doctor: Yes, still doing it.

Investigator: Under normal circumstances, what’s the average wait time?

Doctor: It’s hard to say, on average, about 3 months.

Investigator: Are the ward beds in short supply?

Doctor: You have to contact us in advance, so we can reserve a hospital bed for you. Our ward beds are relatively in short supply.

Investigator: Is just this department in your hospital doing liver transplants?

Doctor:  Yes, we do liver transplants.

Investigator: Has your hospital done a lot of cases of liver transplantation this year?

Doctor: We are doing alright, our hospital does several hundred cases each year.

Investigator: I’ve heard that you do quite a lot. Shen Zhongyang used to be here. Is he still working here?

Doctor: He is the president of our hospital.

Investigator: Is he still performing surgeries?

Doctor: If you can find him, then he’s still willing to do.

Investigator:  So that is, for the first half of this year, has your hospital done 100 or 200 cases of liver transplantation?

Doctor: More than that.

Investigator: Then if you do it like this, you might do more than 1,000 case a year?

Doctor: More than 100 or 200 cases.

Investigator: Because you are doing it every day.

Addendum 18

Dr. Zhou in the Department of Cardiac Surgery at Tianjin First Central Hospital, Orient Organ Transplant Center.

Phone number: +86-2223627096

Date: 08/11/2016

Key points:

1. “Our hospital can do heart transplants. We rank among the top 5 in the entire country every year.”
2. “Type O is the most difficult [to find donors]. A while ago, a Type O patient waited for more than a month to get a donor.”
3. “We do a lot of liver and kidney [transplants]. However, there are fewer heart donors, unlike livers and kidneys.”
4. “The surgery costs 300,000 to 400,000 yuan.”
5. “We are a center here. [Investigator: So there are many teams doing it, not just him alone.] Right.”
6. “We’ve done 9 cases [of heart transplantation] so far this year.”

Phone Investigation Recording:

Nurse:  Hello, this is Department of Cardiac Surgery.

Investigator: Ah, the Department of Cardiac Surgery. This is the First Central Hospital? I would like to ask, can your department do heart transplant surgeries?

Nurse: We can.

Investigator:  You can, does your hospital do a lot? I’d like to come to your hospital to have a heart transplant.

Nurse: Wait a second, I’ll find a doctor for you.

Investigator:  Ok, thanks!

Nurse: Just a second!

Doctor: Hello!

Investigator:  Hello! Is this a doctor?

Doctor: Yes.

Investigator: I’d like to ask you. I have a family member, who wants to have a heart transplant. I know that your doctors perform liver and kidney transplants, do you also do heart [surgeries]?

Doctor: We do.

Investigator: I’m calling from Beijing. But our kid works here. So they said, “You go to Tianjin. The hospital in Tianjin is large, and their technologies in this area are very advanced.” So I’m calling to ask, if you can, it’s not bad to do it here.

Doctor: We can do it. We rank among the top 5 in the entire country every year.

Investigator:  Oh, I didn’t know that you could do it. I only knew that Fuwai Hospital in Beijing does a lot and very well.

Doctor: No.

Investigator: I really didn’t know. It’s good that I asked. So your hospital does quite a lot every year, right?

Doctor: Yes. What’s your family member’s blood type?

Investigator: He is Type B.

Doctor: Type B. Type B has a larger pool. Type O is the most difficult [to find donors]. A while ago, a Type O patient waited for more than a month to get a donor.

Investigator:  Ah, you can do it.

Doctor: Yes.

Investigator: Then have you done a lot this year? Have your surgeons done a lot this year?

Doctor: This year is alright, we are doing alright.

Investigator: Can you do more than 100 cases per year?

Doctor: More than 100 cases? Of course we’d like to. Not that many donors. This, the donors are not as many as you think. This, you know, the thing is, the source of the donors is very limited.

Investigator: Is it?

Doctor: So, if you want to do it, it’s not that you come, and you can have the transplant surgery on the next day or in a few days. It might be that after your checkup, you can get one immediately, or you’ll have to wait.

Investigator:  Then...

Doctor: For instance, our patient who had surgery the day before yesterday waited for more than a month.

Investigator: How much money is needed to do this? The fees to do this?

Doctor: Anyway, at least 300,000 yuan.

Investigator: Ah, 300,000 yuan. It’s Ok, it’s Ok.

Doctor: It doesn’t include the fees charged [for the hospitalization] when the patient’s waiting for the surgery. Because, how many days he needs to wait? Will there be any complications? It’s hard to say. The surgery costs 300,000 to 400,000 yuan.

Investigator:  It’s Ok. I’ll think about it. I didn’t know that you can also do heart transplants. I thought that you only do a lot of liver and kidney [transplants].

Doctor:  Yes, we do a lot of liver and kidney [transplants]. However, there are fewer heart donors, unlike livers and kidneys.

Investigator: Because they said, “You go to Tianjin to ask. We only know that they do several thousand cases of liver and kidney transplantation, but we don’t know whether they do heart transplants or not. We never heard of them doing it.” That’s why I’m calling you.

Doctor: We do, we do everything, heart, liver, kidney and pancreases. We do all these types of surgeries. We are an organ transplant center after all.

Investigator: You are classified as an organ transplant center?

Doctor: Yes.

Investigator: Shen Zhongyang is...I searched online, Shen Zhongyang seems to work here, in your hospital?

Doctor: Yes, he’s our hospital’s president.

Investigator: Your hospital’s president. They say that Shen Zhongyang is quite famous. This person is quite famous. So in Tianjin, your hospital can do several thousand cases of liver and kidney transplantation per year. Can Shen Zhongyang do them all by himself?

Doctor: Alas, it’s not just one surgeon. We are a center here.

Investigator: So there are many teams doing it, not just him alone.

Doctor: Right.

Investigator: I see that for some hospitals in Beijing, there is only one doctor, who can perform surgeries. Then I think, one doctor cannot do many [cases], right?

Doctor: Right, right. There are a lot of people, who can do this kind of surgeries, in our hospital.

Investigator: They do liver and kidney [transplants]. Few can do heart transplants. What about in your hospital, very few?

Doctor: Yes, only our Director Hong does heart transplants.

Investigator: Oh, just one person. Then you do very few transplants?

Doctor: Mm.

Investigator: Then they have several teams. Then they must do a lot?

Doctor: Right.

Investigator:  Ok, thank you, doctor! What’s your last name?

Doctor: Ok. My last name is Zhou.

Investigator:  Then, thank you!

Doctor: It’s alright. It’s alright.

Investigator:  I’d like to ask how many heart transplants have you done this year?

Doctor: We’ve done 9 cases so far this year.

Investigator:  9 cases, that’s not bad. Ok, then, thank you, Dr. Zhou! Bye!

Doctor: Ok, you are welcome. Bye.

Addendum 19

A surgeon of the Liver Transplant Department on the Eighth Floor of Orient Organ Transplant Center at Tianjin First Central Hospital.

Phone number: 022 23626848

Date: 01/01/2017

Key points:

“Performed 300 to 400 liver transplants in 2016.”

“Everything is as usual. [He was referring to performing organ transplants during the Chinese New Year period]”

Phone Investigation Recordings:

Surgeon: Hello?

Investigator: Hi, is this the liver transplant department at Tianjin First Central Hospital?

Surgeon: First Central Hospital. How can I help you?

Investigator: Oh, do you still accept liver transplant patients, when it is approaching the Chinese New Year?

Surgeon: It doesn’t matter whether or not it is during the celebration of Chinese New Year.

Investigator: Doesn’t matter? So you will carry out your work as usual?

Surgeon: Correct.

Investigator: Oh, here is my situation. I have a nephew, who has advanced alcoholic liver cirrhosis. Then…

Surgeon: What did you say about alcohol?

Investigator: Can he come over for treatment?

Surgeon: I beg your pardon?

Investigator: Can he come to your hospital now?

Surgeon: Where is this patient?

Investigator: In Dezhou.

Surgeon: Yes, he can come for treatment.

Investigator: How many liver transplants have you done this year?

Surgeon: Several hundred cases.

Investigator: Can you be more specific? One hundred, two hundred, both are in the magnitude of hundreds.

Surgeon: Uh, 300 or 400 cases.

Investigator: Oh, 300 or 400 cases. You have done more than others, really more than the other hospitals, then, then..

Surgeon: Uh.

Investigator: Right. The others say…

Surgeon:  Everything is as usual, okay?

Investigator: All right. Let me discuss with him, to find out if he wishes to come before or after Chinese New Year. OK?

Surgeon: Fine.

Investigator: That’s about it. May I ask your surname?

Surgeon: …..

[He hang up]

Addendum 20

Kong Defu, a Surgeon for kidney transplant operations at Renji Hospital of Shanghai Jiaotong University School of Medicine

Phone number: +86+ 18817667836

Date: 03/18/2017

Key points:

1. “In 2016, we should have done 700 cases [of organ transplantation].”
2. The hospital has done more than 100 transplants, since the beginning of year 2017.
3. There are two hospital wards for liver transplants.
4. In the past, the patients only needed a very short wait time to find a donor from the prisons.
5. [Investigator: If we pay more, can we get organs from prisoners?]  Kong: Now there are very few such opportunities.
6. “Many [organs] are from other cities. For instance, when a matching liver is found, it will be shipped to us very quickly.”
7. The hospital has the capability to form three or four teams to perform transplants simultaneously.

Phone Investigation Recordings:

Investigator: Hello, is this Doctor Kong Defu at Renji Hospital?

Kong: Yes, and this is…

Investigator: Hi, how do you do, Doctor Kong Defu? I am calling from Changzhou. A family member of mine wants to have a liver transplant. I’ve called several local hospitals and they all recommended your hospital, saying that you have done a lot of liver transplants, and the results are good. So I decided to call you. Do you still perform liver transplants?

Kong: Right, we do.

Investigator: Oh, if we come over with the patient, how long is the wait time? How long does the patient have to wait to get the transplant operation done?

Kong: We need to evaluate his situation first.

Investigator: Right. So you are not certain. Your hospital, as they have said, has done many liver transplants. [Kong Defu: Correct.] I feel that the wait time is probably shorter. Do you really perform a lot of liver transplants? Have you started performing any operation this year?

Kong Defu: Yes, we started earlier this year, very early.

Investigator: Very early this year. For the liver transplants, how many liver transplants do you do every year? They told me that your hospital has done a lot. I would like to know to what extent?  For example, in 2016…

Kong: To the extent that, in 2016, we should have done 700 cases.

Investigator: 700 cases?

Kong: Basically, we are one of the largest in terms of the volume of transplants, all over the world.

Investigator: No. 1, did you mean your hospital is ranked first?

Kong: Correct, correct!

Investigator: It is really a lot, to have 700 transplants in a year. How about this year? In the first two months, you probably have done more than 100 transplants, correct?

Kong: Yes.

Investigator: Wow, so they did the right thing in recommending this hospital to me.

Kong: Hmm.

Investigator: So you have only one ward for liver transplants?

Kong: Two for liver transplants.

Investigator: Let’s say that without any special circumstances, how long does the patient stay in hospital before being discharged?

Kong: Generally speaking, after the liver transplant, the patient needs to stay in the intensive care unit for one week. [Investigator: Oh]. Then the patient will be transferred to the ordinary ward, for another week. That’s about it.

Investigator: So that is two to three weeks.

Kong: Right, right.

Investigator: I guess the scale of your hospital is relatively big, compared with other hospitals?

Kong: The primary focus of our liver department is this thing...

Investigator: Oh, then…

Kong: It’s liver transplantation.

Investigator: Doctor Kong, I would like to ask you a question. [Kong: Hmm, go ahead] A friend of mine received treatment here about seven or eight years ago in your hospital. He said that he only stayed in the hospital for a short period of time before a donor was found for him. As it was mentioned before, the donor was a death-row prisoner, [Kong: Right] or someone in jail [Kong: Right, you are right]. Was it true in the past?

Kong: Presently, we get livers from relatively normal channels. I mean, now there are very few such cases.

Investigator: So the channel from prison, people say that after the operation…

Kong: It is forbidden now. Now the state disallows this way now.

Investigator: So [this type of organs are] forbidden to be used. Then where are the donor sources from? Did you find livers locally?

Kong: Um, if in the case… basically it’s from normal and standard channels.

Investigator: Oh, oh, oh.

Kong Defu: Hmm, you don’t need to worry about that.

Investigator: The death row prisoners, the channel you used before, I guess there are still such opportunities. If we pay more, can we get organs from prisoners? 

Kong: Now there are very few such opportunities.

Investigator: [Regarding the liver extraction], do you do it inside your hospital, or do you remove the liver in the city, where the donor is.

Kong: Because, in regards to where we do it, right, almost all livers are from other areas, from other hospitals.

Investigator: Are they mostly in the same province, or within Shanghai?

Kong: It depends. There are all kinds of scenarios. Many are from other cities. For instance, when a matching liver is found, it will be shipped to us very quickly.

Investigator:  Oh, if we come to your hospital to look for you, are you the chief surgeon in the operation, for liver transplants?

Kong: Hmm, my credential is not good enough (to be the chief surgeon). All transplants are performed by our hospital’s president.

Investigator: Oh, the president? So when we arrive, we ask for the president? Who is your president? His name?

Kong: Hmm, we have directors and president. Our president is Xia Qiang, the president of our hospital.

Investigator: Oh… so you have several teams doing liver transplants?

Kong: Right, you are right.

Investigators: So considering the scale of your transplants, there should be more than two teams, right?

Kong: Three, three or four.

Investigator: If needed, can the three or four teams perform operations at the same time?

Kong: Hmm, there should be such occasions.

Investigator: Oh, so if we are lucky, maybe as soon as we arrive you will have…

Kong: Right, correct, some patients had the transplant the day they became hospitalized, because it was easy to find a matching liver.

Investigator: Oh

Kong: Hmm.

Investigator: When we arrive, shall we register at the hospital’s outpatient services or come look for you directly?

Kong: Uh, let me give you a phone number, okay? My supervisor’s, my teacher’s phone number.

Investigator: Oh, good.

Kong: You can give him a call. He offers specialist clinic outpatient services, every Tuesday morning. You may call him now, asking for the basic information.

Investigator: Oh, give me the number, please.

Kong: Let me read the number for you, wait a moment. Hmm.

Addendum 21

Director Hang Hualian of the Liver Transplant Division at Renji Hospital of Shanghai Jiaotong University School of Medicine

Phone number: +86+ 18616206806

Date: 03/25/2017

Key points:

1. “For [Blood] Type B, it should take less than two weeks [to find a donor].”
2. “We did 521 cases last year. We have performed nearly 100 operations this year. We almost perform two transplants a day.”
3. [Investigator: When a patient is in critical stage and identified as brain-dead, do you use them as donors?] Hang: That is the usual situation for us…
4. [Investigator: Do you excise livers in your own hospital? Or do you procure (livers) from other hospitals?] Hang: Both situations exist.

Phone Investigation Recordings:

……

Investigator: Hello, how are you? Is this Director Hang Hualian?

Hang: Yes, and this is?

Investigator: A relative of mine wants to have a liver transplant. I called your hospital last week, and I was told that Director Hang is in charge. I found your hospital through my friend’s recommendation. They told me that in Shanghai, your hospital has done the most and best liver transplants. So I decided to call you. Is it true that your hospital, Tongji Hospital, has done a lot of liver transplants?

Hang: Yes, right. [Our hospital name is] Renji, Renji.

Investigator: Renji, I often make this mistake. My nephew contracted hepatitis B before. He runs his own factory, his own company. He is often on business trips to meet with business partners and customers. Then two years ago, he was diagnosed with liver cirrhosis, and it is getting more and more serious. So I would like to know, for his situation, if he comes for an operation here, how will he be doing in terms of recovery after operation? 

Hang: With regard to liver cirrhosis, a liver transplant would be the most effective and the best treatment for advanced and mid-late period liver diseases.

Investigator: So for this kind of situation, usually the prognosis after the transplant is good, correct?

Hang: Well, since I have not seen the patient, I cannot give you a definitive answer. Can you ask them to come and ask to see me?

Investigator: Oh, come to see you. The thing is, when we arrive at the hospital, we will probably wait in line [for registration].

Hang: Ah, no problem. You, you have my phone number. You may come to see me directly.

Investigator: Oh, how long would the wait time be? His family will be anxious [if the wait time is long].

Hang: What is his blood type?

Investigator: Type B.

Hang: So Type B. Anyway, I will try to get a donor as quickly as possible. If there is nothing unusual, for Type B, it should take less than two weeks.

Investigator: Oh, would you say, Director Hang, would you tell me, your hospital is such a big hospital, how many liver transplants do you do in a year? Do you have a lot of operations?

Hang: We did 521 cases last year.

Investigator: Oh, that’s really a lot.

Hang: We almost perform two transplants a day. For us, it is a routine technique.

Investigator: Oh, then you must have performed many operations this year?

Hang: We have performed nearly 100 operations this year. Think about it, this year, we’ve performed nearly 100 cases. The quality of the liver sources is basically guaranteed. We don’t accept any poor quality livers, or problematic livers.

Investigator: There is such a situation, as they said, for example, in many hospitals, when a patient is in critical stage and identified as brain-dead, do you use them as donors?

Hang: That is the usual situation for us…You don’t have to worry too much as this. We did 521 cases last year, more than 500 cases. We usually don’t have any problem with the donors. Presently, donor is almost never an issue. Eh~ almost no issue. [Investigator: That’s great.] Because now we are removing the livers from donors inside hospitals. We would also examine the livers after we excise them, to make sure that there’s no problem, before we use them. If there’s a problem…

Investigator: Do you excise livers in your own hospital? Or do you procure [livers] from other hospitals?

Hang: Both situations exist, okay? [Investigator: All right…] In my opinion, it is not a problem in this respect. We will be responsible in getting the donor for you. The key issue right now is that the patient should come and we will evaluate his situation. He will be put on the waiting list for an operation.

Investigator: Are there a lot of people on the waiting list?

Hang: You worry too much. You just come over. As you have contacted me directly, just rest assured that I will arrange everything for you.

Investigator: Good. Thank you very much!

Hang: When do you think you will come over? I will help reserve a hospital bed for you.

Investigator: Hmm, I will discuss with my nephew when I get home, and see how it goes.

Hang:  Sure, go discuss with him. He is male, right?

Investigator: Male. It is because he is currently in Hong Kong. I came to Hong Kong to visit him, and I am calling you from Hong Kong. I need to find out how his schedule is before we can make decision. All right, when he is ready to come…

Hang: That’s all right.

Investigator: Good.

Hang: Could you give me your contact information? In case I have a suitable liver source or have a hospital bed available, just in case, I can contact you. What is your contact information?

Investigator: Hmm, let’s do this. I need to discuss it with my nephew. So I will not contact you again, and he will be in contact with you directly. I have to go back after I discuss with him, I have work to do. Okay?

Hang: Hmm, that’s all right.

Investigator: Thank you, Director Hang. Goodbye. Bye.

Addendum 22

Doctors’ Office of the Liver Transplant Division at Huashan Hospital Affiliated to Fudan University in Shanghai

Phone number: +86 2152887174

Date: 11/02/2016

Key points:

1. “We have done a lot [of liver transplants]! We have done more than 100 cases [this year].”
2. The hospital has an ample supply of donors.
3. “We did two transplants just today.”
4. “Our hospital is among the top three in Shanghai [in terms of liver transplants].”

Phone Investigation Recording:

[The doctor on duty picked up the phone.]

Surgeon: Hello?

Investigator: Is this the Liver Transplant Division at Huashan Hospital?

Surgeon: Hello, who is calling?

Investigator: I am the relative of a patient. I am a resident of Changzhou. May I ask you if you still do liver transplants?

Surgeon: Yes, no problem.

Investigator: OK. If we come, is the wait time very long?

Surgeon: There is uncertainty. Cannot give you a definitive answer. You need to discuss with our director about the wait time. Even our director does not know the origin of the liver sources. So that’s a tough question.

Investigator: Have you done [any transplants] this year?

Surgeon: We have done a lot! Really a lot. We have done more than 100 cases [this year]. We did two transplants just today.

Investigator: Oh, you have an ample supply of donors, right?

Surgeon: Yeah.

Investigator: So you have done more than 100 cases so far? This year we cannot…

Surgeon: I would suggest to you that for more details, you may come over to meet with professor Wang, [to register for] Wang Zhenxin’s outpatient services, okay?

Investigator: Can you tell me the price? The price?

Surgeon: I am not very clear about that. You need to ask Director Wang for specifics.

Investigator: Oh. The source of the donors is also unclear, right?

Surgeon: Right, unclear.

Investigator: Uh, did you say you do transplants every week?

Surgeon: Correct, correct.

Investigator: Have you done 200 cases this year? It’s already the end of the year now.

Surgeon: Let me put it this way, our hospital is among the top three in Shanghai.

Investigator: Oh, nationwide?

Surgeon: In Shanghai.

Investigator: Oh, all right.

Surgeon: If you have any questions, ask Professor Wang, OK?

Investigator: Sure.

……

Addendum 23

Doctor-on-duty (liver transplantation) at Huashan Hospital Affiliated to Fudan University in Shanghai

Phone number: 2152887174

Date: 03/07/2017

Key points:

1. “Last year we did more than 100 cases. Some people did it as soon as they arrived.”

2. “We’ve always been doing it. We’ve never stopped doing it.”

3. “We’ve been doing it almost every day. Now, [such operations] have been routinely carried out.”

Phone Investigation Recording:

Doctor: Hello?

Investigator: Hello! Hello! Is this Huashan Hospital, in Shanghai? This is the family member of a patient. Is that Qian Jianmin still doing surgeries in your hospital?

Doctor: Oh, I’m not clear about this. Can you call back tomorrow? I’m the doctor-on-duty, okay?

Investigator: Doctor-on-duty, then I would like to ask you, does this hospital still do liver transplants right now? Because I have a family member, who is preparing to do a liver transplant. Since I have a friend, who did it in your hospital before, I would like to ask [you].

Doctor: We do, we do. We have outpatient services on Wednesdays, Thursdays and Fridays, or you can come directly to our wards for consultation. Ok？

Investigator: Because I live far away from here, I am not in Shanghai, I live in Changzhou. So I have to ask first, are you still doing it now? If yes, I will come over.

Doctor: We do, we do, we still do it right now.

Investigator: Still do it? Are there a lot? That is, how long does it take [for patients] to wait? Is it fast or not?

Doctor: Well, it’s hard to say, last year we did more than 100 cases. And then, basically, this depends on the opportunities [available]. Some people did it as soon as they arrived. It depends on the situation.

Investigator: That is, this hospital now…after the Chinese New Year, has been keeping doing it, right?

Doctor: We’ve always been doing it. We’ve never stopped doing it, okay?

Investigator: Oh, you do it every day?

Doctor: Every day, almost every day, we’ve been doing it. Now, [such operations] have been routinely carried out.

Investigator: Routinely carried out. What do you mean by “routinely”? It’s every day…

Doctor: “Routinely” means that we have this program. We’ve always been doing it. It’s not something that we do today but not tomorrow. We do it routinely. Basically, we’ve always had this [medical] specialty.

Investigator: Oh, how many cases like ours can you do per week? If I go, the wait time will be short, right?

Doctor: If you have any questions, then please come to consult with our outpatient services. I can’t tell you more.

Addendum 24

Wang Ping, liver transplantation director at Jiangsu Province Hospital

Phone number: + 86 + 13951873090

Date: 07/24/2016

Key points:

1. “[To change the liver], no problem. You just come, and directly come to see me.”

2. “We often do this. This is our routine work, a routine thing.”

3. “Patients of blood Type B can obtain a liver after waiting for one month.”

4. “I can figure out a solution for you. Including Shanghai, these things all belong to one system of ours!”

5. “This is a very mature technology.”

6. “The price is 500,000 yuan.”

Phone Investigation Recording:

Wang Ping: Hello

Investigator: Hey, hello, hello. Is this Director Wang Ping at the province’s hospital? Hey, I’m the one from Changzhou.

Wang Ping: Which one?

Investigator: Hey, I’m from Changzhou, and, I have a nephew, who has end stage cirrhosis, and he wants to change his liver.

Wang Ping: Uh.

Investigator: He is now in Hong Kong, and so am I right now.

Wang Ping: Your phone number seems to be a foreign number?

Investigator: I am now living in Hong Kong, because why…because I went to see him. I find him to be not energetic right now. I, I am thinking that if it is not improving, we should go back to do a liver transplant. Now I am actually calling you to ask whether your hospital still does it or not. How many [liver transplant operations] do you do? That is, after I come back, how long do I need to wait? I’d like to learn more about your situation.

Wang Ping: Okay, no problem. You just come, and directly come to see me, okay?

Investigator: Ah, what did you say?

Wang Ping: ... ... directly come to me. It’s ok, we often do this. This is our routine work, a routine thing, okay?

Investigator: Oh, oh, that is to say, how long do we have to wait?

Wang Ping: After you come, we can discuss it in detail. Well, well, you’ll still have to find a solution. It’s not that simple, okay?

Investigator: Oh, no, so it cannot be done immediately after our arrival, right? That is, we still need to wait for a month or two?

Wang Ping: I need to ... know [the patient’s] blood type, understand [the patient’s] condition, and then with you...

Investigator: He… his blood type is B.

Wang Ping: Type B is okay. It is relatively better for Type B [patients]. Type O is the most difficult.

Investigator: For a Type B [patient], can [a liver arrive] after waiting for one month?

Wang Ping: The prospects should be okay.

Investigator: The prospects are okay.

Wang Ping: Tell me about his situation and the situation with his blood type. I’ll arrange it for you.

Investigator: As for us…As for me, is it better for me to go back first to show you his medical records, and then when a time is set up [for the operation], we’ll ask him to come back?

Wang Ping: Hey, yes, yes, is it okay or not?...Okay

Investigator: Did we do a lot this year? This year…

Wang Ping: We do a lot of these every year. Please rest assured. You know.

Investigator: Uh, but some hospitals [told me] ...you should wait in several queues ...to check which hospitals do more, then you would wait a shorter time.

Wang Ping: If you are really in a hurry, we can meet first, and I can figure out a solution for you, you know? Including Shanghai, these things all belong to one system of ours! I will try to help you think [of a solution], okay?

Investigator: Oh, oh, oh, that is, the technology of your hospital has no problem, you said, um.

Wang Ping: This is a very mature technology...

Investigator: ...That means, you can often…often do this type of surgeries, that is to say…

Wang Ping: We do this every week, don’t worry.

Investigator: Oh.

Wang Ping: Right, right.

Investigator: You do it every week, then that means your technology is very good. Can you tell me the price? Approximately?

Wang Ping: 500,000 [yuan].

Investigator: Uh…500,000 [yuan]?

Wang Ping: We…about 500,000 [yuan], 500,000 yuan.

Investigator: And after being hospitalized, under normal circumstances, after how long can the patient be discharged? I also consider sending someone to [take care of] him, at home…

Wang Ping: About a month

Investigator: About a month, that should work, that should work. Great, thank you!

Wang Ping: After you come here, if you need, we can talk in more detail. Please rest assured.

Investigator: ... I will call you when I go back. Now I’m using a local mobile phone in Hong Kong...

Addendum 25

A doctor at the liver transplantation department of Jiangsu Province Hospital

Phone number: +86+ 25_68136851

Date: 02/19/2017 (10:37:11)

Key points:

1. “For peak periods, there are 4-5 operations per week, and at least 2-3 operations per week.”
2. “We should have done the largest number [of operations] in our province, but certainly less than [the hospitals in] Shanghai.”
3. “If death-row prisoners sign an organ donation consent before they die…then [we] would just go to take [their organs].”
4. “Then I can take it before he dies or, when he has just died, when he is dying, and then donate it.”
5. “When the kidney source is taken here…who can guarantee that it was definitely donated, if it’s from an executed prisoner. Who knows what the kidney source is?..”

Phone Investigation Recording:

...

Doctor: Hello, hello, kidney transplantation [department].

Investigator: Hello, this is the kidney transplant department of Jiangsu Province Hospital?

Doctor: Yes.

Investigator: Hey, hey, I am from Wuxi. I would like to ask, about your kidney transplantation surgeries, are you still doing them? Can I do it? If you can do it, approximately how long will I have to wait [for the operation] after I come?

Doctor: You have to come first to consult with the director. Afterwards, you will leave your contact information. When a kidney source is found, we will inform you to come over for [tissue] typing. The transplantation can be done once the typing is successful.

Investigator: How many kidney transplants did you do last year? One year ~

Doctor: [clears his throat] I didn’t keep count. They, their team should have kept stats on them, I don’t know.

Investigator: Their team, you are not in this team. Aren’t you in the kidney transplantation department?

Doctor: Yeah, but my speciality is thoracic surgery. I am just here to listen to their cases.

Investigator: Oh you are…here to be on duty on their behalf?

Doctor: Yes.

Investigator: Oh, you said that [your hospital] has always been doing kidney transplants. And the number of cases is relatively large, relatively large, right?

Doctor: Within our province, [our number of transplants] would definitely be large... [Investigator: Oh, which kind (of operations) are you talking about? Which kind (of operations) are you talking about?] We should have done the largest number [of operations] in our province, but certainly less than [the hospitals in] Shanghai.

Investigator: The largest, then about how many can your hospital perform per year?

Doctor: I didn’t keep count of them. I see that they are able to perform quite a lot within one or two weeks. They would do a lot in two weeks.

Investigator: Oh, a lot in two weeks, then for one year ----

Doctor: ... I didn’t count the specific number. I see that they basically perform operations every week. Like this, one year should ... how many cases would there be?

Investigator: How many kidney transplant operations like this would take place every week?

Doctor: For peak periods, there are 4-5 operations per week, and at least 2-3 operations per week.

Doctor: For specific info, if you want to come over, then you can talk with the director.

Investigator: Who is the director?

Doctor: The main director is our hospital’s vice president. I forgot the name of our president... [Investigator: Gu, President Gu, Gu Ming.] Yes, one president is our highest-ranking leader. When you come later, you may only be able to meet with Director Han, uh, Director Han.

Investigator: Oh, you don’t have their phone numbers, right?

Doctor: Ah, no, I don’t have them here. Usually they would come to the office, and they are here every day, every day. Basically, you can find them, when you come here, except Saturdays and Sundays. They are also here on Saturday and Sunday mornings... Well, basically every day ----

Investigator: Then, after I come, will there be sufficient [ward] beds for hospitalization?

Doctor: As long as there is a kidney source, there will be a bed. If not, we can borrow them from the other teams.

Investigator: Oh, how many beds do you have in one ward?

Doctor: There are approximately 50 beds on one floor, but the kidney transplant ward beds are at the back, behind it. They probably have half of this number, over 20 beds.

Investigator: Ah, pardon me, what did you say?

Doctor: ... Because after you come, you’ll live here every day just to wait? No, they’ll ask you to take an extra bed here, and then you will have your blood drawn. Then they will inform you, after they get the kidney source, then when you directly have a checkup, this will save lots of time. Otherwise, if you come to register for hospitalization, after we get the kidney source, then the time will expire...

Investigator: Then, [the organ] is not taken from this hospital? In which hospital will they excise it, and take the donor [organ] back [here]?

Doctor: We send people to excise it and bring it back.

Investigator: ...I’ve heard from them that it’s like… can we still use the kind of [organs from] death-row prisoners in the past? They said that they were quite fit.

Doctor: Death-row prisoners? For this type, I didn’t… I haven’t gone to take [their organs]. I… Do they give organs from executed prisoners now? If death-row prisoners sign an organ donation consent before they die, if they also donate their organs, then [we] would just go to take [their organs], but if they don’t, how can we do this?

Investigator: Then that is, can you still take [organs] from those in prison now?

Doctor: Ah?

Investigator: In prison, uh, the death-row prisoners in prison?

Doctor: Yes, that would be the same, although he is sentenced to death in prison, it still depends on himself. If he says before his death, “I would like to donate my body and organs, to do some good things.” Then I can take it before he dies or, when he has just died, when he is dying, and then donate it…In general, if there are people, who are willing to donate [their organs], they would inform us, and we would go there to take [the organs].

Investigator: That means - like this type in the prisons. If he would like to [donate], then our hospital can go to the prison to take the donor [organs] right?

Doctor: Yes, he, if he is willing to donate and it will be the same as a normal organ donation, belonging to the same process…..

Investigator: ... Then now we can still go to the prisons and take this kind of donor [organs] from death-row inmates?

Doctor: I am not very clear about this, because, if he is willing to donate, then it’s the same as a normal person willing to donate his organs after death, the same procedure… this

Investigator: You, you, you also did this type of transplantation?

Doctor: When the kidney source is taken here, I, I don’t know how…who can guarantee that it was definitely donated, if it’s from an executed prisoner. Who knows what the kidney source is?... Normally, there are some people, who are willing to donate organs, and then the hospital would take the donor [organs]. After the organs are taken out, they are given to our hospital. This is the procedure.

Investigator: Oh, then who, who is the doctor in charge of laisoning with the donors in your hospital?

Doctor: No one.

Investigator: No person in charge of contacting them. That is, that is, who is doing this then?

Doctor: That is, they would inform us, and we are just, just waiting...

Investigator: How many years have you been doing kidney transplantation?

Doctor: How many years?

Investigator: Yeah?

Doctor: Let me see, Director Han was born in…When Director Han came here in 2002, we had already been…The director of kidney transplantation…How many years till now?

Investigator: That is, you started [performing kidney transplants] after Director Han came here?

Doctor: No, Director Han has been here for 15 or 16 years.

Investigator: That is, when he came here in 2002, you started doing this work, right?

Doctor: No, before he came here, they had already been doing this. He has been here for 15 or 16 years.

Doctor: [You can] directly come to the surgery building and find him directly...or you can get an “expert registered ticket”.

Investigator: ...Which building are you in?

Doctor: On 13th floor (Investigator: which floor) surgery building, surgery building, 13th floor

Investigator: ... No.13 building, which floor to which floor [is the kidney transplant department]?

Doctor: On 13th floor, oh no, my building is Building No.2. [The department] is on the 13th floor.

Investigator: Oh, Building No.2, 13th floor. It is to say…I thought it was Building No. 13. Oh, okay. Good. Then, tomorrow, I’ll contact them tomorrow to see how to do it specifically... Thank you. What’s your surname, please?

Doctor: Hey, you first contact the director, then we’ll do it, alright?

Investigator: Oh, what’s your surname, doctor?

Doctor: Me? I am not in this team. It will be useless for you to find me, when you come here. I’m in the urological department.

Investigator: Oh, then I won’t be talking to you, I won’t ask you questions anymore. Oh, by the way, doctor, I am also online, because I want to do some research on your hospital...I suddenly discovered that a liver transplantation surgeon in your hospital was stabbed by a patient several times with a knife. Is this true?

Doctor: Yes, you can go to our official website. The official website has given the answer.

Investigator: Yes, I read it, I read it. Hey, I was wondering what’s wrong with this hospital. A doctor was stabbed. He was a liver transplant surgeon, not a kidney transplant doctor, right?

Doctor: Right, Director Sun from the liver transplant department. He asked the registration ticket scalper to stop selling his registration numbers. Then the guy didn’t agree, so then he stabbed him.

Investigator: Didn’t registration ticket scalper want to live? If he killed the doctor, he would pay for it with his own life. Then he would not make even one penny in the future.

Doctor: Hasn’t he been arrested?

Addendum 26

A doctor-on-duty for the large department of organ transplantation at the First Affiliated Hospital of Soochow University

Phone number: + 86-51267972185

Date: 04/19/2017

Key points:

1. Question: Can we still use [the organs from] the prisons, the ones, who are sentenced to death [and who were used] in the past? Answer: Yes.

2. Question: The patient has a request to use [an organ] from someone in prison, you can help find one, right? Answer: About this, it’s not that we can help you find [one kidney]. If they have a kidney source, then they will inform our hospital… If the [blood] type matching is successful, then we use it.

Phone Investigation Recordings:

Investigator: Is this the First Affiliated Hospital of Soochow University?

Doctor: Hello?

Investigator: Is Dr. Hu Linkun available?

Doctor: Who?

Investigator: Hu Linkun

Doctor: No, he’s not.

Investigator: I am in Changzhou. I would like to ask if we are still doing kidney transplantation.

Doctor: We do, we are doing it.

Investigator: Still doing it, oh, how long will one have to wait [for the operation] after he comes?

Doctor: What do you want to consult about?

Investigator: Since one of my family members wants to do it, I want to ask how long we will have to wait for the transplantation, after we come here.

Doctor: You need to first make an appointment, and when there is a kidney source, you need to do [blood] type matching. Then if the matching is successful, if it’s suitable, then we’ll do it. This is the procedure for all cases.

Investigator: Doctor, I would like to ask you, that is, can we still use [the organs from] the prisons, the ones, who are sentenced to death [and who were used] in the past?

Doctor: Yes.

Investigator: Can still use?

Doctor: Yes.

Investigator: If we come, and the patient has a request to use [an organ] from someone in prison, you can help find one, right?

Doctor: About this, it’s not that we can help you find [one kidney]. If they have a kidney source, then they will inform our hospital. Then we will check his blood type and so on, and then we will make an appointment with the people on the waiting list. If an appointment is made, then we will do [blood type] matching for [the donor] and the person, who made the appointment. If the [blood] type matching is successful, then we use it. It’s not like that we find a kidney specifically for you. If one kidney can be used, then it would be great. Would we search for a kidney specifically for you?

Investigator: Oh, so this is the case. That is, after the blood type of the person inside the prison matches with the patient’s blood type, and after they inform you, you would be able to go to take [the organ]. Is this what you meant?

Doctor: Yes.

Investigator: How long does the patient need to stay in hospital before being discharged?

Doctor: A month.

Addendum 27

Doctor Yue of the Kidney Transplantation Ward at the Affiliated Hospital of Qingdao University, Shandong Province

Phone number: +86 + 532_82919529

Date: 11/15/2016

Key points:

1. “[The number of transplants] we did this year is among the top three in China.”
2. “Our advantage is that we have ample kidney sources. In general, if a patient’s lucky enough, then [it takes] just two weeks. Generally speaking, it’s very fast.”
3. “They have a special organ donation organization. We have abundant kidney sources.”

Phone Investigation Recording:

……

Doctor: [Telephone recording: At the Affiliated Hospital of Qingdao University, we will provide you with 24-hour...]...

Investigator: ...Hey, is this the Affiliated Hospital of Qingdao University?

Nurse: Yes, right.

Investigator: Is this the kidney transplantation department? Is Director Dong Zhen there?

Nurse: He is not. You can call again tomorrow morning after eight o’clock.

Investigator: I would like to ask you. I have a family member, who wants to do this kidney transplantation, can you still do it?

Nurse: Yes, we can do it!

Investigator: You can, oh that’s great, then if I go there, how long do I need to wait in line?

Nurse: I don’t know about this. You need to contact a doctor... I do not know how many people are on their waiting list.

Investigator: I would like to ask that do you do a lot [of operations]. Do you do them every week?

Nurse: We do them basically every week.

Nurse: ... Please hold on!

[Switches to another person to answer the phone]

Doctor: Hello, hello!

Investigator: Hello, Hello, I have a friend, who wants to do this kidney transplantation. Your nurse just said that you can also do it. I would like to ask about the price.

Doctor: Oh, ok, then ~ 400,000 yuan, about 400,000 yuan.

Investigator: Oh, 400,000 yuan. One more thing, I would like to ask about. Several hospitals in Shandong Province have done a lot of [organ transplants]. So your hospital also did a lot this year?

Doctor: We are among the top three in the country this year. [The number of transplants] we did this year is among the top three in China.

Investigator: Ah, that means, you did a lot. How long is the wait time? How long do we have to wait?

Doctor: This is hard to say. It depends on his luck. Yes, since our kidney sources are sufficient, this is our advantage. Our advantage is that we have ample kidney sources. In general, if a patient’s lucky enough, then [it takes] just two weeks. Some people are lucky, and they get [the organs] in two or three weeks. If they are unlucky, it’s possible for them to wait two or three months. It’s possible. But we have abundant kidney sources here. So generally speaking, it’s very fast.

Investigator: Oh, are they all [obtained] through the Red Cross? The Red Cross?

Doctor: Ah?

Investigator: Are they all donated through the Red Cross?

Doctors: Ah no, no, we have here…they have a special organ donation organization. We have abundant kidney sources. You come to find us during our business hours in the daytime, okay?

Investigator: What’s your last name? Then I will find you. What’s your surname?

Doctor: My last name is Yue, my last name is Yue.

Investigator: Yue, as in Yue Fei, right?

Doctor: Ah, yes, Yue as in Yue Fei. Right.

Addendum 28

Doctor Wang of the Organ Transplantation Department at the Affiliated Hospital of Qingdao University, Shandong Province

Phone number: +86 53282919528

Date: 02/11/2017

Key points:

1. “We have more [opportunities to perform organ transplants] here.”
2. “We have 300 donated kidneys, but we only performed 160 cases… The rest were sent by us to Shanghai.”

Phone Investigation Recording:

Doctor [male]: Hello, hello.

Investigator: How are you? Is Doctor Huang there?

Doctor: Hello?

Investigator: Hello, may I talk to Dr. Huang Tao?

Doctor: He’s not here.

Investigator: Not there?

Doctor: Yea.

Investigator: Oh, when will he be available?

Doctor: Well, I do not know. How may I help you? Speak.

Investigator: That is, [a patient in] another hospital, Anhui Medical University. He wants to ask your hospital about kidney transplantation.

Doctor: Well, continue.

Investigator: Does he need to register?

Doctor: Yes, he needs to register.

Investigator: Oh, what are your procedures for an outpatient?

Doctor: We try our best to accommodate the patients from other hospitals, other places. After you come, we will give you [a spot for surgery].

Investigator: Let’s say that we are on the waiting lists of a number of hospitals, to see where there is an opportunity. This is what I mean.

Doctor: Well, yes, we have more [opportunities] here. Are you referring to liver transplantation or kidney transplantation?

Investigator: Kidney transplantation

Doctor: Kidney transplantation?

Investigator: Yes.

Doctor: We have 300 donated kidneys, but we only performed 160 cases.

Investigator: 160 cases? Then wouldn’t you be able to deliver [the kidneys] to other hospitals?

Doctor: Yes, yes, the rest were sent by us to Shanghai.

Investigator: Oh, that means, [better quality] than theirs. Good. So if we get registered, there will be more opportunities, right? May I know your last name?

Doctor: My last name is Wang.

Investigator: Oh, Dr. Wang, so for outpatient services, whom should I ask for? Shall I register for kidney transplantation…..or

Doctor: Just get registered, and then come up to find me.

Investigator: Oh, just find you?

Doctors: Just register whatever.

Investigator: It is best to have a person to register for. We are from another hospital, after all. If there is a specific person for us to...

Doctor: The Huangdao District in Qingdao City is called the West Coast...

Investigator: I know that, your ...

Doctor: Oh, go directly to the 13th floor, Building A, we will have a doctor here for sure.

Investigator: Oh, the 13th floor in Building A. Doctor Wang, since I contacted you today, then I will find you at that time?

Investigator: On which days will you work next week? [Doctor: Sure, sure]

Doctor: No, you can directly come here and mention my name. [Just say that you are] looking for Dr. Wang.

Addendum 29

Doctor Yan Jieke of the Doctors’ Office in the Renal Transplantation Department at the Second Affiliated Hospital of Shandong University

Phone number: +86 531-85875622

Date: 12/20/2016

Key points:

1.  “We have done about 130 [kidney transplants this year].”
2. “In Shandong Province, we do relevantly more [cases]. Almost all of ours are allogeneic.”
3. “Today I just finished one operation. Today we performed two cases. Tomorrow we’ll also have two cases.”
4. “We are on the 13th floor in the tallest building.” The entire 13th floor belongs to the organ transplantation department.

Phone Investigation Recording:
……

Yan Jieke: Hello.

Investigator: Hey, hello, is this the Second Affiliated Hospital of Shandong University?

Yan Jieke: Yes.

Investigator: Hey, doctor, I would like to ask you. I went to Qilu Hospital [of Shandong University], because I have a family member, who wants to do kidney transplantation. He said that it seemed that [Qilu Hospital] hadn’t done a lot [of transplant cases]. And he said, “You can go to ask the Second Affiliated Hospital of Shandong University.” So I’m calling you now. I would like to ask if you do it here?

Yan Jieke: Yes.

Investigator: You do it?

Yan Jieke: Yes, we are the Transplantation Department, Kidney Transplantation Department.

Investigator: Have you done a lot this year? What’s the situation in your hospital...

Yan Jieke: We have done, 100…about 130 [kidney transplants].

Investigator: Oh yeah, right now…

Yan Jieke: Yes, because we do a lot here. In Shandong Province, we do relevantly more [cases], especially this kind. Many hospitals might do a lot [of kidney transplants], but most of them use [organs] from [the patients’] relatives. Very few of our operations use [organs] from relatives. Almost all of ours are allogeneic. So we did more than 100 [cases] this year. Almost all of them were allogeneic. So, so they’re external kidney sources. Therefore, our waiting list is definitely…People come here because of our reputation. They are from all over the country.

Investigator: Oh, then you say...

Yan Jieke: Today I just finished one operation. Today we performed two cases. Tomorrow we’ll also have two cases.

Investigator: Oh, then if we come, the beds won’t be in short supply?

Yan Jieke: It should be okay. We have more than 50 beds!

Investigator: Oh, I would like to ask you, how long is the hospitalization, under normal circumstances, how long is the patient hospitalized before being discharged?

Yan Jieke: Some hospitals require [the patients] to be discharged two weeks after [the surgery], but our hospital requires one full [month]. That is, after the organ transplantation surgery, the patient must stay in our hospital for one full month, because for our hospital, within the first month, the risk is relatively high.

Investigator: Oh...

Yan Jieke: So our, our, our department’s hospitalization time is relatively long.

Investigator: Yo, then you ... ...

Yan Jieke: Since we, we are being considerate of our patients, because many patients said, “We can be discharged after being hospitalized for two weeks. Then if there’s any problem, it’s our own [responsibility] at home.” I think, we feel that this is irresponsible [of us]. Hmm…okay?

Investigator: That, that’s fine, the price. You can tell me the price, roughly?

Yan Jieke: Well, this is inconvenient for me [to disclose].

Investigator: Inconvenient?

Yan Jieke: Yea.

Investigator: Ok, fine, that’s it. I’ll talk to the patient.

Yan Jieke: Well, good, good. Goodbye, okay

Investigator: I’ll just tell him to come to line up. What’s your last name? [Should he] come to look for you?

Yan Jieke: You, you can directly come to our department. We are on the 13th floor in the tallest building. 13th floor. Hey, you just inquire about the Kidney Transplantation Department. Any doctor should be able to [accept you].

Investigator: Uh, that is, the entire 13th floor is your transplantation department?

Yan Jieke: Well, yes, yes.

Investigator: If we want to find you, what’s your last name? I will tell him to find you.

Yan Jieke: My last name is Yan. “Yan” as in the idiom “being absent-minded”

Investigator: Which “Yan”?

Yan Jieke: “Yan” as in the idiom “being absent-minded”. [He can] look for me, or anyone else.

Investigator: Uh, yes, yes, ok, thank you. Bye.

Yan Jieke: Ok, goodbye.

Addendum 30

Doctor on duty for kidney transplant operations in the Urinary Surgery Department at Qianfoshan Hospital of Shandong Province.

Phone number: +86 53189268575

Date: 03/31/2017

Key points:

1. “Our hospital has a specific coordinator for organ [procurement]. He makes contacts [to obtain organs].”
2. “We have two wards. For both wards combined, there are more than 70 beds. In one year, we can do more than 100 cases [of kidney transplantation], including [the cases using organs from] relatives. [The doctors] are very skilled in these techniques.”
3. “We can do around 30 cases [of liver transplantation]. We rank second in the entire province.

Phone Investigation Recording:

……

Doctor: Hello.

Investigator: Hey, hello, is this Qianfoshan Hospital?

Doctors:…

Investigator: Hello?

Doctor: You, you are ... whom are you looking for?

Investigator: I’m from Yantai, from Yantai. I want to do a kidney transplant. Do you do this in your hospital?

Doctor: Yea, we do kidney transplantation!

Investigator: Oh, you do it. Oh, that’s great!

Doctor: Yes.

Investigator: If I come over. About how long, how long do I have to wait?

Doctor: You mean in the queue?

Investigator: Uh, in the queue, how long do I have to wait?

Doctor: In the queue. Your, what is your blood type?

Investigator: Type B, Type B.

Doctors: Type B, Type B… Type B is a little bit faster, anyway, you have to wait for a while. It’s hard to say.

Investigator: Hard to say? To wait for a while. How long would you say? A week or two weeks? How long is it?

Doctor: Uh, how long? Some are short, some are long.

Investigator: So, your hospital cannot make decisions regarding your donors?

Doctor: Donors? We have to ask around for them. When somebody donates a [suitable] organ, we can perform your surgery.

Investigator: That is, your hospital contacts others to find donors by yourselves?

Doctor: Yes, by ourselves... Our hospital has a specific coordinator for organ [procurement]. He make contacts [to obtain organs].

Investigator: Oh.

Doctors: They make contacts.

Investigator: Oh ...so this is the case. At your hospital, how many case do you do in one year? Like your hospital? How many [cases] did you do last year?

Doctors: In one year, we can do more than 100 cases [of kidney transplantation], including [the cases using organs from] relatives.

Investigator: All [other cases use] donated [organs]. Is there any elderly person donating his organs? Such as people of old age? Can you guarantee that they...

Doctors: The elderly are generally excluded.

Investigator: Oh, excluded. Oh, all [donor organs are] young, from young people.

Doctor: Yes, up to people in their 50s.

Investigator: Oh, that is, you have a director here called Director Men?

Doctor: Yes, Men Tongyi, Director Men.

Investigator: He, he is still here?

Doctor: He is on a business trip today. He just went on a business trip this evening.

Investigator: Oh, so he is still in this hospital. Is he still doing kidney transplantation?

Doctor: Yes, yes, yes.

Investigator: I heard that his skills are wonderful, really wonderful.

Doctor: Here, we do a lot of cases, so [our doctors] are skilled in the techniques.

Investigator: Oh, how many years have you been doing kidney transplantation?

Doctor: How many years? We didn’t specifically count them. Anyway, we’ve been doing it for many years, anyway.

Investigator: That is to say, [the doctors’ skills] are basically very mature.

Doctor: Yes, very skilled, they are very skilled in these techniques. There’s no problem with organ transplantation.

Investigator: And, I would like to ask, doctor, if we go to your hospital now, are the ward beds in short supply? The hospital beds?

Doctor: For hospitalization? It’s ok right now.

Investigator: Oh, it’s ok right now. Is there only one ward for kidney transplantation in your hospital?

Doctor: For kidney transplantation, there are many beds in total, more than 70 beds here.

Investigator: Oh, that’s a lot, more than 70 beds in a ward, so many?

Doctor: Yes, we, we have two wards. For both wards combined, there are more than 70 beds.

Investigator: Two wards with more than 70 beds. Oh, that’s right, I thought that there were so many beds in one ward... Also, I have a friend, who wants to ask if you only do kidney transplantation or not. How about liver transplantation? At your hospital?

Doctor: Liver transplantation, we also do liver transplantation. But how to put it? For liver transplantation, there are not many donors.

Investigator: Oh, it is...

Doctor: We also do it...

Investigator: Oh, yes...

Doctor: Also, and very skilled. We can do 20…around 30 cases.

Investigator: Around 30 cases? Oh, that’s also a lot.

Doctor: Yes, we rank second in the entire province, anyway…

Investigator: Ok, I will discuss this with my family, and then if…..

Doctor: OK, Director Men works on Tuesday and Wednesday mornings [Investigator: Uh] for outpatient services; and Director Wang performs outpatient services during the entire day on Mondays.

Investigator: You said who performs outpatient services on Tuesdays and Wednesdays? Is that you?

Doctors: Director Men, for outpatient services, Director Men, Men Tongyi.

Investigator: Alright, Tuesdays and Wednesdays for Director Men, Men Tongyi, oh, okay

Doctor: Yes, yes, Mondays for Director Wang, Wang Jianning to perform outpatient services.

Investigator: Ok, good, good, I see, thank you, goodbye.

Addendum 31

A ward nurse for kidney transplant operations at Shandong Provincial Hospital

Phone number: +86 531 68776161

Date: 04/07/2017

Key points:

The hospital does a lot of kidney transplants. It has done 50 cases of kidney transplantation this year.

Phone Investigation Recording:

Nurse: Hello, hello.

Investigator: Hello, is this Shandong Provincial Hospital? Is this Shandong Provincial Hospital? Is Director Meng there?

Nurse: Oh, no.

Investigator: Where did he go? Is he performing an operation?

Nurse: Yes.

Investigator: Oh, last time when I called, he was also performing an operation. Recently you are…I’m looking for him to do a kidney transplant. Recently, you’ve been doing a lot of kidney transplants, right?

Nurse: Well, yes.

Investigator: Because on that day…..

Nurse: How about this? In the future, you can make a call early in the morning, at eight o’clock, when we just get to work. He is usually here [around this time].

Investigator: Do you do more kidney transplants than other hospitals? It is said that in our Shandong Province, there are several hospitals doing them.

Nurse: Ah, yes, yes.

Investigator: Several hospitals are do them. How many kidney transplants can your hospital do per year?

Nurse: I’m not sure about the number of cases.

Investigator: Approximately, roughly, I just want to have some idea, to see…

Nurse: Around 50 cases.

Investigator: Ah?

Nurse: We do 50 cases.

Investigator: You said that [your hospital] does only 50 cases of kidney transplantation?

Nurse: Yes.

Investigator: Ah, you were saying that in this year, you’ve done 50 cases of kidney transplantation?

Nurse: Yes, yes, yes, yes.

Investigator: Are all your doctors here doing operations right now?

Nurse: Yes, right. Generally speaking, our surgeons are rarely here. They all went to do surgeries. Anyway, you can call at five o’clock or in the morning after you get up.

Investigator: Well, thank you so much, okay, goodbye.

Nurse: Well, good, goodbye.

Addendum 32

A ward nurse for kidney transplant operations at Shandong Provincial Hospital

Phone number: +86 531 68776161

Date: 04/08/2017

Key points:

1. “We’ve already done a lot [of kidney transplants] this year! We did several cases in recent several days.
2. Just come here, it’s very fast [to have the surgery].
3. [Investigator: Generally speaking, the allografts were from death-row prisoners and practitioners, right?] Nurse: Yes, they were, in the past.
4. The nurse knew that the hospital used death-row prisoner and practitioner donors in the past.

Phone Investigation Recording:

……

Nurse: Hello, kidney transplantation.

Investigator: Hello, kidney transplantation, is this Shandong Provincial Hospital?

Nurse: Yes.

Investigator: Oh, then, I would like to ask you about, do you do kidney transplantation in your hospital? I have a family member, who wants to go there to do it.

Nurse: We do.

Investigator: You do, are there a lot of people lining up for that?

Nurse: Do you do [a surgery] with a relative’s [organ] or what?

Investigator: I want to do an allogenic transplant. I don’t have a family member, who can donate a kidney.

Nurse: A lot [of people on the waiting list].

Investigator: Ah?

Nurse: A lot [of people on the waiting list].

Investigator: Yes, are you doing a lot this year? Have you already started this year?

Nurse: Oh, we’ve already done a lot this year! We did several cases in recent several days.

Investigator: In addition to kidney transplantation, you also do liver transplantation, right? I will do both.

Nurse: We do.

Investigator: Because I see now in Shandong Province, there are so many hospitals doing kidney transplantation, so I would like to know which hospital does more. So I’ll go there to get in the queue list. I’m thinking that will be a little faster.

Nurse: Just come here, it’s very fast, anyway.

Investigator: Like before, that type [of organs from] the justicial system, that type from death-row prisoners. Can you still use them? Like that type? You all used that type in the past...

Nurse: What?

Investigator: I mean, in the past, before year 2015, they all used the [organs from] death-row inmates and [Falun] Gong practitioners. Can you still use that type now?

Nurse: Now we cannot.

Investigator: Not anymore? Because previously, all hospitals were using these types [of organs from] death-row prisoners and [Falun] Gong practitioners, right? When my friend had his surgery, he used this type, from a practitioner. So after he did [the surgery], he said that his physical condition was particularly good. So now you say that you cannot use it anymore?

Nurse: No more.

Investigator: No more. [Nurse: Cannot do it anymore.] You can’t use it for how many years now?

Nurse: About two years.

Investigator: Two years. So in the past you could use them? The other hospitals also used this type?

Nurse: Yes, we used this kind, and also [the organs from patients’] relatives. Both.

Investigator: Oh, the relatives were the exceptions. Generally speaking, the allografts were from death-row prisoners and practitioners, right?

Nurse: Yes, they were, in the past.

Investigator: Oh, in the past, how did you excise donor [organs]? Did you excise them in your hospital or in prisons?

Nurse: I really don’t know about this.

Investigator: You do not know. [Nurse: Right] Anyway, you know that you used death row prisoner and practitioner donors?

Nurse: Yes.

Investigator: Ok, fine, how about this? I don’t have time tomorrow. Maybe on Monday, I will call Director Meng to ask him again, ok?

Nurse: Yes, you can.

Investigator: Ok, great, here you have only a nurses’ office. Is there a doctors’ office? And a phone number [for it]?

Nurse: This is the doctors’ office phone.

Investigator: Oh, this is the doctor... You don’t have [a separate office]. That is, the nurses and the doctors are all in the same office? [Have the same] phone?

Nurse: Ah, yes, our offices are together.

Investigator: Oh, then you, you are a doctor?

Nurse: I’m a nurse.

Investigator: Oh, ok, fine, I just want to ask about it. Then that’s all. Thank you, ok, goodbye!

Nurse: good, bye!

Addendum 33

A Doctor from the Doctors’ Office for kidney transplantation in the Urinary Surgery Department of Jinan Military General Hospital, Shandong Province

Phone number: 053151665311

Date: 04/08/2017

Key points:

1. The hospital did 200 or 300 cases last year.
2. “This kind of things are arranged by the hospital. We don’t know how long you’ll have to wait.”

Phone Investigation Recording:

Doctor: Hello?

Investigator: Hello, is this our Jinan Military General Hospital?

Doctor: Yes.

Investigator: Hello, Jinan Military General Hospital?

Doctor: Yes.

Investigator: Do you do kidney transplantation?

Doctor: What did you say?

Investigator: Kidney transplantation, can you do...

Doctor: Yes!

Investigator: Ah?

Doctor: We can do it. Correct.

Investigator: How long does it take to be on the waiting list to have the surgery?

Doctor: This kind of things are arranged by the hospital. We don’t know how long you’ll have to wait.

Investigator: Oh, you don’t know how long. That is, now, your hospital does a lot in Shandong Province, in comparison with others?

Doctor: I do not know how many cases other hospitals do. Anyway, we do more than 100 cases every year, 200 or 300 cases.

Investigator: Uh, how many? 300 cases?

Doctor: 200 or 300 cases.

Investigator: Oh, you said that you did 200 or 300 cases last year, right?

Doctor: Yes.

Investigator: This year, you have started doing [the transplants]. How many have you done, a lot?

Doctors: This year we haven’t counted yet. We will do statistics at year end. Every year, we would count in the end…

Investigator: Oh, ok, that’s it. Thank you so much. Please go ahead with your work. Okay, goodbye, goodbye.

Addendum 34

Doctor Li Facheng, Organ Procurement Coordinator for kidney transplant operations at Yantai Yuhuangding Hospital, Shandong Province

Phone number: 18660597760

Date: 04/18/2017

Key points:

1. “He can have his surgery within half a month.”

2. “Our director [Liu Dongfu] has done nearly 2,000 cases, starting from 1988.”

3. “How many this year? There have been 50 or 60 cases now.”

Phone Investigation Recording:

Investigator: Hello! Is this Dr. Li from Yuhuangding Hospital? Hello! Hey, can you hear me?

Dr. Li: I can hear you.

Investigator: ... I want to inquire about several hospitals, to see which one does better and more [organ transplants]. I want to do it, as soon as possible, after the patient comes back.Yes, yes. I would like to ask, after going to your hospital, how long does the patient have to wait before he can have [the surgery]?

Dr. Li: What is his blood type?

Investigator: His is Type B.

Dr. Li: Where are you from?

Investigator: I’m from Dezhou.

Dr. Li: Oh. What is his blood type?

Investigator: Type B, B as in AB.

Dr. Li: Oh. Type B? Type B, a lot [of donors]. He can, it’s very fast.

Investigator: How long [does he have to wait]? I hope that he doesn’t need to wait too long to do it, after going back.

Dr. Li: Hmm…Type B. We just did several cases involving Type B…About half a month.

Investigator: How long [after the surgery] can he be discharged?

Dr. Li: If you’re lucky, if a matching [organ] for him can be found. If it’s quick, if he’s lucky, it may take less than half a month.

Investigator: He can be discharged within half a month after the surgery?

Dr. Li: No, no, he can have his surgery within half a month.

Investigator: After the surgery, how long does he have to stay hospitalized? I have to consider whether his family members will need to take care of him or to look for a nursing assistant.

Dr. Li: If his recovery is normal, about ten days.

Investigator: If we go [to your hospital], should we look for you? I don’t have your name.

Dr. Li: My family name is Li.

Investigator: Dr. Li, right?

Dr. Li: Yes.

Investigator: And you say half a month. If I come back, but you can’t do it within half a month, what can we do? This is the problem.

Dr Li: How about half a month? The thing is that [the patient] hasn’t done the [tissue] typing. If you’ve done the [tissue] typing, it would be fast. It takes several days for the hospital to have the results.

Investigator: Did you say that our hospital is always doing it now? This year, it has always been doing kidney transplantation?

Dr. Li: We have always been doing it.

Investigator: Really? That is, you do it every week?

Dr. Li: Our director [Liu Dongfu] has done nearly 2,000 cases, starting from 1988.

Investigator: What is the director’s name?

Dr. Li: His last name is Liu.

Investigator: Director Liu, I see. Dr. Li, can you tell me how many cases of kidney transplantation your hospital can do every year?

Dr. Li: 300 cases, or 200 cases. Is this relevant?

Investigator: I just told you that if you do a lot, then I feel at ease.

Dr. Li: I have already told you that our director has done more than 2,000 cases of this operation. Besides, this operation is a very simple operation, not very complicated.

Investigator: How many have you done this year? A lot?

Dr. Li: How many this year? There have been 50 or 60 cases now.

Investigator: Can you tell me the price? Approximately.

Dr. Li: Price, price, you’re calling us. We don’t talk about money.

Investigator: Oh, fine. I know what you mean. You don’t want to tell me, then it’s fine.

Dr. Li: Because according to the state regulations, organs cannot be sold.

Investigator: And our donors are all very healthy? There’s no problem about this?

Dr. Li: The key is that when you come here, we’ll draw your blood to do tests. That is, if before the checkup, you do not have hepatitis B, syphilis or AIDS, but after you do the surgery, you have got these. Then what a great responsibility we’ll have to take for that?

Investigator: I mean, I heard that about the donors…They told me to ask the doctor to look for the kind of [organs from] death-row prisoners, which were used previously. They are going to be shot, anyway. They are all healthy. Can we still use this kind [of organs] right now? Can you find them?

Addendum 35

Doctor Shan Zhenfei for kidney transplant operations at Yantai Yuhuangding Hospital, Shandong Province

Phone number: +86 535 6691 999

Date: 04/25/2017

Key points:

1. “I can only tell you that this year is better than last year, [in terms of the transplant volume].” Last year, the hospital performed more than 200 cases.

2. “In general, the wait time here is very short. We have a lot [of patients] here. Some patients from other provinces are all living in our hospital here.”

3. “In due course, I will arrange Professor Liu Dongfu to personally perform the surgery for you.”

Phone Investigation Recording:

……

Doctor: [Recorded Message: Yantai Yuhuangding Hospital, to check the number...] Hey!

Investigator: Hey, hello. Is this a doctor from the urology department?

Doctor: Oh, what would you like to ask? Speak.

Investigator: Anhui, Anhui, since Anhui Medical University doesn’t do many in one year, they recommended me to ask your Yuhuangding Hospital.

Doctors: So, you are from Anhui and want to come here for [organ transplant] surgery, right?

Investigator: Yes.

Doctor: Ok, good. You need, you need…What’s your blood type?

Investigator: Not for me, for my family member.

Doctor: What’s your family member’s blood type?

Investigator: Type B, B as in AB.

Doctor: Ah, ah, then you have to come here for [tissue] typing, firstly.

Investigator: I know, he has done that in our local hospital. If you want to do it again, it’s ok. But now the key is, I want to ask, how many patients do you have waiting in line? How long is the wait time?

Doctor: The wait time here is very short. In general, the wait time here is very short. We have a lot [of patients] here. Some patients from other provinces are all living in our hospital here.

Investigator: I have heard that you have a lot [of patients] here. The patients from other provinces are all coming here. That is, you have a relatively quick process. You just told me how long we would have to wait?

Doctor: Yes, here…very quick.

Investigator: Oh, you told me that it wouldn’t take long. Then can you give me an estimate?

Doctor: Oh, most people wait seven days. Some people wait for a month, it depends.

Investigator: No more than three or four months?

Doctor: Ah, no, no, in general, it would not be [that long].

Investigator: Oh, you just said no more than two months, then we would have a clue, right?

Doctor: Oh, yes, hmm.

Investigator: And doctor, what’s your last name?

Doctors: Shan, as in the word “unit”.

Investigator: Are you Shan Zhenfei?

Doctor: Ah, yes, yes, yes.

Investigator: Can you give me your phone number? If there is anything I want to ask you, I can call you or send you text messages to ask.

Doctor: Please wait a little bit. Please don’t come in the upcoming several days. It’s almost holiday time. 186 6059 9158.

Investigator: Hey, last year your hospital…That director in Anhui saw your [data] online, he saw that you did more than 160 cases. Is it still the same situation this year? That is, in the first several months [of this year], have you done a lot? I cannot hear you.

Doctor: I can only tell you that this year is better than last year.

Doctor: Better than last year, ah.

Investigator: For surgeries, is your Director Liu doing them mostly?

Doctor: Yes, in due course, I will arrange Professor Liu Dongfu to personally perform the surgery for you.

Investigator: Ok, ok, ok. Then I will contact you after May 1, ok?

Doctor: Oh, well, goodbye.

Addendum 36

Ni Jialian, the former Director of the Kidney Transplantation Department at Jinan Military General Hospital, Shandong Province

Phone number: +86-1192017_134231

Date: 01/19/2017

Key points:

1. “It is hard to get liver donors here in Shandong now, so let me tell you, you had better go to Shanghai Changzheng Hospital!”

2. “It is hard to say. The previous donors were all prisoners.”

3. “Most of the [organs] used by every single hospital were prisoners’ organs.”

4. [Investigator: So all the ones you used in the past were the organs from Falun Gong practitioners, right?] Ni: Yes.

Phone Investigation Recording:

Ni: Hello?

Investigator：Hello, Director Ni, Ni Jialian, hello!

Ni: Hello?

Investigator: I have a patient who can’t wait to receive the liver transplantation. May I ask, are you still doing this right now?

Ni: Whom are you looking for? Whom are you looking for?

Investigator: I am looking for you, Director Ni, Ni Jialian.

Ni: Where are you from?

Investigator: I am from Qingdao. I am the friend [of…]

Ni: Let me tell you, let me tell you, I couldn’t answer you now. Because I am retired.

Investigator: Ah, you are retired. When did you retire?

Ni: It has been several years since I retired.

Investigator: Really? Could you help recommend a good doctor to me?

Ni: It is hard to get liver donors here in Shandong now, so let me tell you, you had better go to Shanghai Changzheng Hospital!

Investigator: May I ask? My friend told me that the donors we originally used were very good. Where were those donors from…?

Ni: The previous donors were excellent, but the donors that we use now are different! That is a long time ago. Do you know, it has always been changing a lot in the recent few years?

Investigator: So where were the donors you originally used from?

Ni: It is hard to say. The previous donors were all prisoners.

Investigator: Were these all from prisoners?

Ni: Now we are not allowed to use the prisoners’ organs. Now you know.

Investigator: Really? So were all the organs used by your [previous hospital] were the prisoners’ organs, during your retirement?

Ni: Alas, most of the [organs] used by every single hospital were prisoners’ organs.

Investigator: Really?

Ni: Now we can no longer use prisoners’ organs. This is already stipulated by the state regulations. We can no longer use prisoners’ organs.

Investigator: Really? Do you have any old friend, who is good at organ transplantation?

Ni: Alas, let me tell you. I have retired. Many [elderly doctors] have also retired. You look for a [good] hospital. Don’t look for [specific] doctors. Now many doctors have retired. You know? Our generation of doctors have all… Our generation of doctors have all retired. You had better find younger doctors.

Investigator: Director Ni…

Ni: I have told you that I’m retired. I am not in charge of this anymore. If I could, I would like to help you.

Investigator: Director Ni, could you help me find the organs from Falun Gong practitioners? All you used previously were that kind of organs, right?

Ni: Now, that is not allowed by the court. They don’t allow you to use them. Do you know that?

Investigator: I know. Didn’t you use organs from that type [of practitioners] before?

Ni: Yeah, I used that kind before. But they don’t allow you to use them now.

Investigator: Then how could you use them before?

Ni: At that time, the state didn’t have any law. But now the state has enacted the law. Can you use them without any consequences?

Investigator: So all the ones you used in the past were the organs from Falun Gong practitioners, right?

Ni: Yes.

Investigator: Ah, got it.

Ni: Now the state has enacted a law. The use [of them] is prohibited by the law. We all obtain the organs from brain-dead patients.

Addendum 37

A staff on duty in the Nurses’ Office at the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86+ 771_2870605

Date: 01/12/2017

Key points:

1. The hospital did around 300 cases of kidney transplantation in 2016.

2. “We have around 100 inpatients right now.”

3. The ward beds are in short supply in the organ transplantation center. “[The patient] has to live in the hallway first, if he comes.”

4. “[The building has] ten floors. Nine floors belong to our organ transplantation center.”

Phone Investigation Recording:

……

Nurse on Duty: Hello! This is the organ transplantation office.

Investigator: Hello. Is this the kidney transplantation office, the organ transplantation center at the No.303 Hospital?

Nurse on Duty: Yes.

Investigator: Oh, do you do both kidney and liver transplant operations here together?

Nurse on Duty: We are the organ transplantation department. We can do any kind of organ transplantation.

Investigator: I have a patient [in need of a kidney transplant]. Someone in the PLA’s No.181 Hospital told me that you could do more organ transplanation operations than them. Therefore, I want to ask you. If you could do a lot [of transplants], I would suggest the patient to come here. Are you still doing kidney transplantation operations?

Nurse on Duty: Yes, recently we do more transplantation operations than previously.

Investigator: How many this type of organ transplantation operations could you do in a year, for example, last year?

Nurse on Duty: Around 300 cases.

Investigator: Do we have enough ward beds in the organ transplantation center? Could I ask my patient to come over?

Nurse on Duty: He has to live in the hallway first, if he comes. We have many hallways here. He could get a ward bed in sequence, when there are ward beds available. 

Investigator: Oh, I see! How many ward beds are there in your ward? [The patients] even live in the hallways?

Nurse on Duty: Oh, we have around 100 inpatients right now.

Investigator: Not enough ward beds?

Nurse on Duty: Right.

Investigator: How many ward beds are in the organ transplantation center?

Nurse on Duty: How many? I never counted how many we have. [She is counting the floors.] We have five floors of ward beds.

Investigator: Do all five floors belong to the organ transplantation center?

Nurse on Duty: They are wards, general wards, not including those ICU Operating rooms. These are all inpatient wards on five floors.

Investigator: How many floors are in the organ transplantation center?

Nurse on Duty: Eight floors.

Investigatior: Is this floor the only floor belonging to the organ transplantation center, among all eight floors?

Nurse on Duty: The entire building [belongs to the organ transplantation center].

Investigator: Eight floors in this building!

Nurse on Duty: Yes. The entire building belongs to the organ transplantation center.

Investigator: How many floors are in this building?

Nurse on Duty: Ten floors. Nine floors belong to our organ transplantation center.

Investigator: How many ward beds are on one floor? It looks like there are many ward beds.

Nurse on Duty: We not only have general wards, but also some operating rooms, hemodialysis rooms, labs and ICUs.

Investigator: How many floors are for the ward beds?

Nurse on Duty: Five floors.

Investigator: Are there [rooms for] both kidney and liver transplants on these five floors?

Nurse on Duty: Yeah, yeah.

Investigator: You said you have 100 inpatients living in the wards, which are not enough, so some are living in the hallways. You mean the number of ward beds in your hospital is less than 100 on five floors? Do you have 100 or 200 ward beds on five floors?

Nurse on Duty: There should be more than 100 ward beds, but less than 200.

Investigator: How many floors are for the liver transplants?

Nurse on Duty: Our [ward rooms] for kidney transplantation and liver transplantation are not separated. The patients all live in the wards. It’s only that they receive [different organ transplant operations], such as liver transplantation operations.

Investigator: It means that they live together.  So there are both kidney transplantation [patients] and liver transplantation [patients] living in the inpatient wards, right?

Nurse on Duty: But normally, the liver transplantation [patients] would be put on the sixth floor, as we also have a nurse station on the sixth floor. Because there is an inpatient ward there.

Investigator: Oh, got it. Thank you so much.

Nurse on Duty: If you want to learn more, please call us during the normal business hours, to ask our doctors. Because we have less people at night.

Investigator: What’s the doctors’ phone number?

Nurse on Duty: 70635— This is the number for the doctors’ office. Or you could call the outpatient services to ask our organ transplant experts.

……

Addendum 38

Doctor Huang Xiaochun for liver transplantation in the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86+ 771_2870635

Date: 01/11/2017

Key points:

1. “In general, it needs more than a dozen days or even a month [to find a donor].”

2. “We can do about 200 or 300 kidney transplants, about 30 or 50 liver transplantation operations in one year.”

3. “There are many such organ transplantation centers in Guangdong, but they don’t have such ample organ donors as we do.”

4. [Investigator: Are the organ donors here from the Red Cross?] Huang Xiaochun: It is not convenient to talk with you about this on the phone.

Phone Investigation Recording:

……

Investigator: Hello, [Operator: Hello, the organ transplantation department.] Hello, is this No.303 Hospital?

Operator: Hello, hello.

Investigator: Hello, I have a family member, who wants to receive a liver transplantation operation. But when I went to the Guangzhou First Municipal People’s Hospital to find President Huang Dade, he told me that they basically don’t do that anymore.

Operator: Wait a second. Wait a second.

Investigator: [continued to talk, until the operator raised her voice, “Please wait a second.”]

Huang Xiaochun: Hi, hello. [The phone was switched to him.]

Investigator: Hi, hello, is this the No.303 Hospital? I have a family member, who suffers from advanced liver cirrhosis. He wants to receive a liver transplant. I asked other hospitals, and they said that your hospital is good at doing this. Therefore, I’m calling you now. I have also been to the No. 181 Hospital. But they didn’t seem to do many organ transplantation operations now. So he…

Huang Xiaochun: Hmm, hmm, [Investigator: Please go ahead], oh, so…

Investigator: Do you still receive patients right now?

Huang Xiaochun: Now it is inconvenient. What about tomorrow? Where are you from?

Investigator: What did you say? [Huang: Where are you from?] Oh, I live in Shenzhen.

Huang Xiaochun: Oh, I see.

Investigator: I wonder if I can come during the Chinese New Year period. Is it that you don’t receive patients now, because of the approaching holiday?

Huang Xiaochun: You can come. You can come. What’s [the patient’s] blood type?

Investigator: His blood is Type B.

Huang Xiaochun: Oh, you can come. Is it convenient for the patient to come over?

Investigator: If he comes to your hospital, how long shall we wait? I want to have an idea…

Huang Xiaochun: This is the situation. First we need to have a liver source. We don’t know when we will have a liver source. But we have relatively ample liver sources here. First, you have to wait. After you come over, we will tell you the details. We’ll explain to you clearly. If you are willing, then we will start the liver transplantation procedures. I am not sure about how long it will take in this case. But generally, it needs more than a dozen days or even a month.

Investigator: Oh.

Huang Xiaochun:  Basically, [the patient] needs some treatment at the earlier stage and might need to adjust his physical conditions for the liver transplantation operation. To do the liver transplantation operation is your only option, right? That means, there are no other options, right?

Investigator: Yeah, so before the operation, he needs to live in the hospital before the transplantation operation, right?

Huang Xiaochun: Yeah, first we need to learn about your situation.

Investigator: How long does the patient need to live in the hospital after the operation, before being discharged?

Huang Xiaochun: Over a dozen days, if it goes well.

Investigator: Oh, he can leave the hospital after the stitches are taken out, right?

Huang Xiaochun: Yes. But not necessarily after the stitches are taken out. As long as there’s no major problem with the liver, he can leave the hospital. There are many such organ transplantation centers in Guangdong. We have a close relationship with them. But they don’t have such ample organ donors as we do.

Investigator: Oh, is it better for us, who live far away, to leave the hospital after taking out the stitches?

Huang Xiaochun: It is ok. It’s a small thing.

Investigator: They all say that your hospital does a lot. How many liver transplants can you do in one year?

Huang Xiaochun: We can do about 200 or 300 kidney transplants, about 30 or 50 liver transplantation operations in one year.

Investigator: Do you mean that you did 300 kidney transplantation operations last year?

Huang Xiaochun: Yes. We are an organ transplantation center here. We do heart, liver, lung, kidney and pancreas transplantation operations. We don’t only do liver transplantation, which is only one of our projects.

Investigator: You mean that you did 300 kidney transplantation operations in 2016?

Huang Xiaochun: Last year, we did 35 cases…30 or 50 cases [of liver transplantation].

Investigator: You mean you only did 30 or 50 liver transplantation operations. Didn’t you say that you do many liver transplantation operations here?

Huang Xiaochun: Yeah. You thought there were many organ transplantation centers in the entire country doing 30 or 50 cases? Hehe, there are not many at all!

Investigator: You mean 30 or 50 cases in one year would be considered a lot?

Huang Xiaochun: A lot!

Investigator: There are some, which can do several hundred cases. I’ve heard that the First Affiliated Hospital of Sun Yat-sen University could do several hundred cases, and some [hospitals] could do even over 1,000 cases in a year. I thought…

Huang Xiaochun: It is impossible to do over 1,000 cases per year. They can do 100 operations in the First Affiliated Hospital of Sun Yat-sen University. You can think about going there to take a look. But [their number] wouldn’t reach your figure.

Investigator: You only have a small number of liver transplantation operations. How come you do more kidney transplantation operations than liver transplantation operations?

Huang Xiaochun: Each person has one liver, but two kidneys. One person would have two kidneys.

Investigator: So it’s for sure that there are more kidney transplants than liver transplants?

Huang Xiaochun: Yeah.

Investigator: Now [other hospitals] would do several dozen kidney transplants, at least over 100.

Huang Xiaochun: You want to consider this more seriously?

Investigator: It is OK. I want to learn about the situation. I will come home [to talk to him]. If he’s willing [to do the transplant], we will come after the Chinese New Year. The New Year is approaching.

Huang Xiaochun: Ok, ok.

Investigator: Right?

Huang Xiaochun: Would you like to leave your phone number [with me]?

Investigator: I will talk about it with my nephew…

Huang Xiaochun: In our Organ Transplantation Center, I am in charge of doing liver transplantation. I am Doctor Huang. [Investigator: What’s your family name? I’ll come to find you. What’s your family name?] I am Doctor Huang. [Investigator: Oh, Huang, ok]. Huang Xiaochun. Doctor Huang Xiaochun.

Investigator: Oh, good, good. I will ask him to call you if he comes over.

Huang Xiaochun: Sure.

Investigator: Are the organ donors here from the Red Cross?

Huang Xiaochun: It is not convenient to talk with you about this on the phone. I don’t know if you have……

Investigator: Oh, ok, ok. That’s all for now. Thank you, Doctor Huang. Bye!

……

Addendum 39

Director Huang Pinghua of Outpatient Service ICU in the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86+ 771_2870029

Date: 01/24/2017

Key points:

1. “We’ve done all kinds of organ transplantation operations, including liver, heart, lung, kidney and pancreas transplants. We are quite powerful, as we can do any organ transplantation operations. We can do all the [organ transplant] operations available.”

2. “There are many chances to receive the liver transplantation operations. And it would be very fast. Please come over immediately. We might do [transplants] before the Chinese New Year, during the New Year…at any time.”

3. “[We can do] about several dozen operations in a year. We have been doing them for a long time, eight to ten years.”

Phone Investigation Recording:

……

Doctor: Hello.

Investigator: Hello, can you hear me now?

Doctor: Hello.

Investigator: Can you hear me now?

Doctor: Please speak.

Investigator: I’m calling you, because I have a nephew, who wants to receive a liver transplant. Could you still do it now?

Doctor: What illness? What illness?

Investigator: He had Hepatitis B before. But now it is advanced hepatocirrhosis.

Doctor: Oh, a liver transplantation would yield the best results, since he has hepatocirrhosis.

Investigator: Really? So…

Doctor: Yeah, yeah.

Investigator: One of his friends received his liver transplant in your hospital. So he wants to know if you can do it here. If so, he’ll come over.

Doctor: Sure, we can, no problem.

Investigator: You can. After we go to your hospital, how long does he need to wait before he can have the liver transplant surgery?

Doctor: It depends. It depends. Some can be fast. Maybe in a dozen or 20 days.

Investigator: He is of Type B blood. Would that be a little faster?

Doctor: Yeah. Some patients had their operations five days after they came into our hospital.

Investigator: Oh. It depends. The supply of donors is uncertain. We don’t know what kinds [of donors]...

Doctor: Yes, yes. But there are many chances to receive the liver transplantation operations. And it would be very fast. [Investigator: You said that the wait time is approximately less than…] Please come over immediately. Please come over immediately. We might do [transplants] before the Chinese New Year, during the New Year…at any time.

Investigator: You might do transplants. That is, you are about to have a holiday. Is it possible that after we come…?

Doctor: We won’t take any days off for the holiday season. I explained this to you very clearly. Please come over, if you want to do the transplantation operation. [You] might be able to do it even during the New Year period.

Investigator: Oh, Your No.303 Hospital is categorized to be a military hospital. Have you been doing organ transplantation operations for a long time? There shouldn’t be any problem with the transplantation techniques, right?

Doctor: There is nothing perfect in medicine, not 100%. Our [success rate] is about 95%. To be honest with you, I cannot guarantee you [a successful surgery].

Investigator: Have you been doing liver transplantation operations for many years and become quite experienced?

Doctor: Uh, we have been doing them for a long time, almost eight, nine, ten years.

Investigator: How many liver transplantation operations can you do in one year, compared to Zhongshan School of Medicine, Sun Yet-sen University?

Doctor: [We can do] about several dozen operations in a year.

Investigator: Only several dozen, not even 100 cases?

Doctor: We’ve done all kinds of organ transplantation operations, including liver, heart, lung, kidney and pancreas transplants. We are quite powerful, as we can do any organ transplantation operations. We can do all the [organ transplant] operations available. Just think about it, okay?

Investigator: Oh, I got it. I have another question about the donors. Like, it costs so much money, so I hope that we can get a healthy donor. His friend told him, “When you call them, tell the doctor that even if you have to pay more money [he is quite rich], try to get that kind of donors used in the past, that is, that type of executed prisoners”…Can you still…

Doctor: Right, oh, let’s see if there are opportunities…We don’t have these, we don’t have these. This is not allowed by the state now, okay?

Investigator: Regarding the hospitalization, I would like to ask you. How long will he have to stay in the hospital after the surgery, before being discharged?

Doctor: It depends on each person’s recovery.

Investigator: Under general circumstances, how long will he have to stay? I have to think about how our family members should take care of him.

Doctor: There are no general circumstances.  Each case is very specific. Nothing is general, okay?

Investigator: Okay. I will discuss with him to see if we come before or after the New Year. The New Year is approaching. It is the best to go after the New Year. Otherwise, coming before the New Year seems to be kind of...

Doctor: There will be many opportunities during the New Year period. There will be a lot of operations.

Investigator: Really? Good, I will discuss with him to see what he thinks.

Doctor: Ok, ok.

Addendum 40

Doctor Nie Feng for liver transplantation at the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +8613907867158

Date: 06/02/2017

Key points:

1. “It would be very fast, very fast [to find organ donors]!”

2. “We received around 100 donated organs last year. So there was on average one operation every three days. We did more than 200 kidney transplantation operations [last year].”

3. “There are should be more organ transplantation operations this year. In the first half of the year, we should have received more than 80 cases [of liver donations]. We did approximately more than 30 cases of liver transplantation. Now we may have done more than 100 kidney transplantation operations. There have been many [organs] distributed elsewhere.”

4. “We have more than 110 special ward beds for organ transplantation operations.”

Phone Investigation Recording:

……

Investigator: Doctor Nie. This is the case. I want to refer some patients to you. Our local hospital has these patients, who need to receive liver transplantation operations. Could you help refer them to your hospital? Is it easy for you to find liver sources there? Because it is hard for us to find them here.

Nie: Ok.

Investigator: How long should I wait? How is the quality of your liver sources? Where are the donors from? For example…

Nie: The organs are all donated. The organs are all donated.

Investigator: What did you say? Now…

Nie: Organ donations. There is no question about the quality of donors. Their quality can be guaranteed.

Investigator: It is guaranteed. But are the wait times very long?

Nie: No, no, not at all. It would be very fast, very fast!

Investigator: Then they need to consider the costs. How long will they wait for the liver transplantation under normal circumstances?

Nie: For now, we received around 100 donated organs last year. More than 100 cases, so there was on average one operation every three days.

Investigator: You mean the successful organ donations last year?

Nie: Yes, yes. More than 100 cases [of liver transplantation]. We did more than 200 kidney transplantation operations.

Investigator: You mean that you did more than 200 cases in this year?

Nie: No. It is last year, last year. There are should be more organ transplantation operations this year.

Investigator: Oh. How many organ transplantation operations have you done in the first half of the year?

Nie: In the first half of the year, we should have done…let me see…more than 80 cases. It should be.

Investigator: In more than half of the year, [you mean] the number of liver transplantation operations, right?

Nie: It’s not yet half a year. Now we just entered June.

Investigator: Yeah. You mean that you have done more than 80 liver transplantation operations?

Nie: No, no. We did approximately more than 30 cases of liver transplantation. 30 cases, right.

Investigator: You mean that includes kidney [transplants]?

Nie: There have been many [organs] distributed elsewhere.

Investigator: You said many [organs] were distributed elsewhere?

Nie: What? What? I couldn’t hear you clearly.

Investigator: Do you also do kidney transplants? What did these over 80 cases include?

Nie: Kidney transplants.

Investigator: Ah, kidney transplants.

Nie: The “more than 80” is the number of donated organs. Now we may have done more than 100 kidney transplantation operations.

Investigator: That is, if the patients come, is there any special doctor looking for liver sources?

Nie: Yes, yes, definitely, definitely.

Investigator: Oh, you have a special doctor looking for those? How many stationary beds are in your organ transplantation department?

Nie: We have more than 100 ward beds.

Investigator: No. I mean how many stationary beds are there only for organ transplants?

Nie: Now we have more than 100 beds. We have around 110 stationary beds throughout the year.

Investigator:  Are those beds only for organ transplants?

Nie: Yeah, yeah. We have more than 110 special ward beds for organ transplantation operations. [Investigator: Only over 100?] Yes, yes.

Investigator: Who is mainly responsible for the liver transplantation operations? Like, who is in charge of looking for liver sources?

Nie: Liver transplants? Do you mean after the surgery or what?

Investigator: I mean, assuming that our patients come here to be hospitalized. They should at least know who will be looking for liver sources. And how about the quality of donors? And through what channels do you find them?

Nie: Nobody is specifically looking for liver sources only. They look for liver and kidney sources together. It doesn’t make sense for one to look for only liver sources.

Investigator: So they can use them at the same time?

Nie: Yes, yes, yes.

Investigator: How long should we wait for the liver and kidney sources? Because I need to tell them to prepare the fees.

Nie: Well, it depends on the patients’ blood types. Like now, every month we basically would have more than a dozen liver donations, more than a dozen liver sources. Then it may be possible that they are all Type A, Type B or Type O. It is hard to say, right?  But we should have some more [organ sources] than before.

Investigator: In terms of the donors, are there more young people or old ones? What are their ages?

Nie: In general, there are more young people, because they would [die] of injuries, car accidents and high-altitude falls more [than older ones]. There are not many elderly people.

Investigator: Basically, last year you did more than 100 organ transplantation operations. Will you do more and more operations this year?

Nie: Yeah. There will definitely be more and more [organ transplantation operations].

Investigator: More and more. How much does it cost to have one liver transplantation operation?

Nie: This is also hard to say. Every patient is different.

Investigator: Who is in charge of the organ transplantation department? Who are doing a good job? For example, the person, who’s mainly in charge of this aspect?

Nie:  Sun Xuyong. Sun Xuyong. Director Sun does them in person.

Nie: What about Ma Jianhua, who did [transplants] previously? What is he doing now?

Nie: He is still here. He still works in our hospital.

Investigator: Is he the director? Does he do operations?

Nie: No, no, he’s not.

Investigator: Does he do liver transplants?

Nie: He still does them, but he is not the key person.

Investigator: Ok. I’ll contact you later. Okay.

Nie: OK.

Addendum 41

A Nurse on duty for kidney transplantation at the Organ Transplant Department of the People’s Liberation Army No. 303 Hospital in Nanning, Guangxi Province

Phone number: +86+ 771_4978171

Date: 06/30/2017

Key points:

1. [Investigator: You have four kidney transplantation operations today, right?] Nurse: Yes, yes! He is still doing the operations now, and he hasn’t finished yet.
2. [Investigator: Did the four patients (who are being operated on) wait for a long time?] Nurse: Not very long, just several months.

Phone Investigation Recording:

……

Investigator: Hello! Is this the sixth floor for kidney transplantation?

Nurse: Uh, doctor, sixth floor.

Investigator: I look for Doctor Gao. Because a patient from Fujian wants to find [Doctor] Gao Zhao. Is he performing an operation now?

Nurse: Yeah, he’s performing an operation.

Investigator: He hasn’t finished the operation?

Nurse: Hello. Why are you looking for Doctor Gao? Please call the doctors’ office.

Investigator: Hello. Right, I called them, but they said that he was doing the operation, so they hurriedly hang up the phone. So I’m calling back because I know that it is easier to find Doctor Gao here.

Nurse: Here? He is not here. He is doing the operation now. You now should…

Investigator: Oh, this is the situation. Since Doctor Gao used to look after this patient from Fujian in the past, I want to find him, to check out the situation of your kidney transplantation here. Well, I’m contacting him on behalf of that patient from another province. You have four kidney transplantation operations today, right?

Nurse: Yes, yes! He is still doing the operations now, and he hasn’t finished yet.

Investigator: He is particularly busy. I’ve heard that you have four kidney transplants today, so you might be relatively busy. Maybe there is no doctor [available to talk to me]. Are you a doctor?

Nurse: No, no.

Investigator: Could you give me Doctor Gao’s phone number? Could I send him a text tomorrow?

Nurse: Well, please call the doctors’ office tomorrow.

Investigator: No, I am afraid that I won’t be able to find Doctor Gao. It doesn’t work to keep making phone calls.

Nurse: You have to call the doctors’ office tomorrow to find him.

Investigator: Oh, it is not convenient for you to give me his phone number, right?

Nurse: Yes, yes.

Investigator: Tomorrow I’ll call the number [starting with 605] to find him, right?

Nurse: Yes, yes. Please call later in the day tomorrow, to check if he is there or not.

Investigator: Have you started doing the kidney transplantation operations or not?

Nurse: We’ve just started doing the second batch right now.

Investigator: Oh, the second batch has just started. It need two…around four hours to finish the operations, right?

Nurse: Yeah.

Investigator: Did the four patients [who are being operated on] wait for a long time?

Nurse: Not very long, just several months.

Investigator: Oh, are they also from other provinces or your Guangxi Province?

Nurse: I don’t know about this. Because there are a lot of people. You can ask Doctor Gao about the details.

............

Addendum 42

Doctor Yang Zhijian of the Hepatobiliary Surgery Department at the Chinese People’s Liberation Army No. 181 Hospital in Guilin, Guangxi Province

Phone number: 134 7135 6190

Date: 09/01/2016

Key points:

1. “It costs 400,000 or 500,000 yuan [to do a liver transplant]. Then you need to take medication. You have to prepare 700,000 or 800,000 yuan at least.”
2. “Starting from April 1, [2017], it’s not allowed to use organs from executed prisoners.”
3. “[In the past,] the [organs] they used were all from executed prisoners.”
4. [Investigator: Where were those executed prisoners from? Do you have so many executed prisoners locally and in prisons?] Yang Zhijian: It is true. There were so many [of them]. What could you do? They had so many!
5. “We did around 30 kidney transplantation operations in July.”
6. “If there are 30 kidneys, there would be at least 15 livers. We do a small number of liver transplantation operations. Nobody is doing them. [People in] Guangxi are poor. They cannot afford to do that.”
7. “In the past, they [i.e. the organs] were all excised in the prisons. Now they’re all excised in the hospital.”
8. [Investigator: Oh, do you have a special department [excising organs] in the hospital? Not done by yourselves?] Yang Zhijian: The hospital is doing it. It’s the hospital doing it. It has a set of specific procedures.
9. “In the past, we went to the execution grounds to excise organs… [After the use of executed prisoners’ organs became prohibited,] we do more [transplants] than before.”
10. “They do a good job. Let me tell you, all over the world, the largest number of donated corpses can be found in Guangxi.”
11. “I know that a person went to Guangzhou to have a liver transplantation operation. First, he paid 500,000 yuan to the hospital and then paid another 500,000 yuan to the professor. That was the red envelop for the professor.”
12. “The most kidney transplantation operations we did [in one year] were more than 180 cases. We would have excised 90 livers, half [of the 180 cases].”
13. “Frequently, people would bring patients from Shanghai and Beijing here to receive [liver] transplantation operations.”

Phone Investigation Recording:

……

Investigator: Hello. Is this Doctor Yang Zhijian of the PLA No.181 Hospital?

Yang Zhijian: Yes.

Investigator: I want to ask you. I called Professor Liu Xiangde, who works in the Third Military Medical University, several days ago. He…

Yang Zhijian: Yes?

Investigator: He recommended me to go to your No.181 Hospital to do a liver transplant operation. I am not sure about the situation he mentioned. I’m a bit concerned. How come he [would recommend me to] come here to do the organ transplantation operation, because his Medical University is also very large. He said that you have more organ donors. So he suggested me to come here.

Yang Zhijian: Yeah. It’s guaranteed that we have a lot of organ donors.

Investigator: Ah? He said you have more organ donors than them. So he recommended me to come to your hospital to do [a transplant].

Yang Zhijian: Yes, we do have more, we have more.

Investigator: Is that right?

Yang Zhijian: Yeah. Why? Don’t you believe him?

Investigator: I just want to confirm what he said is true, because…

Yang Zhijian: It is true. Why? Don’t you believe him?

Investigator: To be honest, I think his military medical university is so large. How come he would [recommend people to] come here to do organ transplantation operations? So I want to confirm with you again.  It costs a lot of money to do a liver transplantation operation. So I have to confirm with you, to have a peace of mind.

Yang Zhijian: 400,000 or 500,000 yuan. 400,000 or 500,000 yuan. Then you need to take medication. You have to prepare 700,000 or 800,000 yuan at least.

Investigator: Yeah, that is why I feel uneasy, and I need to confirm. Why do we have more organ donors than the military medical university? It’s so big…

Yang Zhijian: You don’t have to worry about that. People, who do the organ transplantation operations, don’t know. Now the organs are all donated, not from executed prisoners [anymore].

Investigator: Are all the organs donated here? Are there still organs from executed prisoners [which were used] in the past?

Yang Zhijian: No. It seems no.

Investigator: Maybe you have.

Yang Zhijian: Starting from April 1, it’s not allowed to use organs from executed prisoners. It is illegal. [If you use them], you’ll be jailed.

Investigator: From April 1, when? This year?

Yang Zhijian: Yeah, April 1 of this year.

Investigator: Oh, this is the case. Starting from April 1…

Yang Zhijian: [The legislation] has been passed on the two sessions [The National People’s Congress and the Chinese Political Consultative Conference]. The Vice-Minister of Health Department, Huang Jiefu, has mentioned that if you do it again, you would have committed a crime!

Investigator: You mean that the hospitals could use organs from executed prisoners before April 1?

Yang Zhijian: In the past, most organs were from executed prisoners. But now most organs are donated, with a small number from executed prisoners.

Investigator:  You mean that your hospital could use this type before April 1.

Yang Zhijian: Not [our] hospital [alone]. It is nationwide.

Investigator: Oh, you mean not only this hospital. It’s for all hospitals in China? All hospitals in China.

Yang Zhijian: The [organs] they used were all from executed prisoners.

Investigator: You mean the organs were all from executed prisoners, before April 1 of this year, right?

Yang Zhijian: Yeah. Basically they were from executed prisoners.

Investigator: Where were those executed prisoners from? Do you have so many executed prisoners locally and in prisons?

Yang Zhijian: It is true. There were so many [of them]. What could you do? They had so many!

Investigator: They had [such organs]?

Yang Zhijian: Yes.

Investigator: Then in these cases, in general, they were all healthy. In the past, a friend of mine…

Yang Zhijian: All [organs] needed to be examined. We didn’t use unqualified ones.

Investigator: Really? Oh, this is the case.

Yang Zhijian: Yeah. The organs are donated now.

Investigator: Oh, you mean before April 1 of this year, we could all use this type, but we cannot use them after April 1.

Yang Zhijian: Before April 1, basically there were few donations. But now basically, the organs are all donated.

Investigator: Then can you still do many organ transplantation operations after April 1?

Yang Zhijian: Yes, many.

Investigator: Many…

Yang Zhijian: We did transplantation operations in July. We did around 30 kidney transplantation operations in July.

Investigator: 30 transplantation operations in a month?

Yang Zhijian: Yeah

Investigator: Where could you get so many donated organs?

Yang Zhijian: If there are 30 kidneys, there would be at least 15 livers.

Investigator: Yeah, [the number of] kidneys is doubling [that of the livers].

Yang Zhijian: Yeah.

Investigator: So do you also do many liver transplantation operations?

Yang Zhijian: No. We do a small number of liver transplantation operations. Nobody is doing them. [People in] Guangxi are poor. They cannot afford to do that.

Investigator: They cannot afford. You said you did 30 liver transplantation operations in July. If there were 30 livers, how many kidneys were there?

Yang Zhijian: [I said] 30 kidneys. 30 kidneys.

Investigator: Oh, 30 kidneys. So did you do more than a dozen liver transplantation operations?

Yang Zhijian: We didn’t do liver transplantation operations. Our patients don’t have the money to do them. We sent them all to other hospitals.

Investigator: You sent them all out. To which hospitals did Dr. Liu Xiangde send the organs? You mean the local hospitals?

Yang Zhijian: They are all distributed in a unified way by the Ministry of Health.

Investigator: Then Liu Xiangde said that he helped you do the liver transplantation operations?

Yang Zhijian: Yeah. The hospital needs to make up the number [of liver transplants].

Investigator: Make…make up…

Yang Zhijian: To make up the number [of liver transplants]. That is, whichever professors have patients, they can come here to perform the surgeries. They make their own arrangements.

Investigator: You said that your doctors have specific quotas [to meet] for this year?

Yang Zhijian: We don’t have any quota. Our hospital just wants to do more.

Investigator: The hospital wants to have [a better] work performance. Doing more improves its work performance.

Yang Zhijian: Yes, this is the point. It would make our hospital [appear to] have performed many [liver transplants]. We would call others to [come and] perform liver transplants. In fact, they are all those professors, who have a relationship with you. For example, Professor Zhang San is in Beijing. He has a personal relationship [with a hospital] in Shandong or Heilongjiang. If he has connections there, and if there are livers, he would bring his patients there and do organ transplantation operations. Isn’t it the same in your case?

Investigator: He said that he had done a number of organ transplantation operations, and that would be his own work performance.

Yang Zhijian: Yeah. The hospital wants this. But you’re not affected at all. It’s the same [for you].

Investigator: Your hospital has been doing this for such a long time. Yet you still uses Professor Liu from the Third Military Medical University.

Yang Zhijian: Because we have no patients, no patients.

Investigator: He can refer patients to you. That is why he referred us here.

Yang Zhijian: Yeah. It is also good for you. How could you get the liver donors from the Third Military Medical University?

Investigator: What?

Yang Zhijian: You will be the first one in line [here]. But in their hospital, there are lots of people [waiting ahead of you].

Investigator: Is the wait time here very short?

Yang Zhijian: Once we get [a liver], we can do the organ transplantation operation for you.

Investigator: Not because…

Yang Zhijian: If there’s [a liver], it will be yours, [because] there’s nobody waiting [for liver transplants].

Investigator: Does the hospital get the organs from executed prisoners by themselves?

Yang Zhijian: Yeah. It was all excised by themselves.

Investigator: Did you get all organs in the hospital or in the prisons?

Yang Zhijian: In the past, they were all excised in the prisons. Now they’re all excised in the hospital.

Investigator: The hospital would drive the person [i.e. donor] here to excise [his organs] now.

Yang Zhijian: You don’t need to concern yourself with that. The Red Cross has a set of complete procedures. It has a complete set of modules.

Investigator: Oh, do you have a special department [excising organs] in the hospital? Not done by yourselves?

Yang Zhijian: The hospital is doing it. It’s the hospital doing it. It has a set of specific procedures.

Investigator: With the procedures, you mean that after the executed prisoners are shot, you can immediately….

Yang Zhijian: No. Now there are no more executed prisoners. Now there are no more executed prisoners. We did that before.

Investigator: I mean executed prisoners…

Yang Zhijian: In the past, we went to the execution grounds to excise organs.

Investigator: You went to the execution grounds to get organs. What about the people on the execution grounds?

Yang Zhijian: Now there are no more executed prisoners.

Investigator: There are no more. Then the state would still need to shoot prisoners. How come there are no more?

Yang Zhijian: [The organs of] the prisoners shot to death are not allowed to be used. It would be against human rights.

Investigator: Oh, that’s the case. So after April 1, you would do less transplantation operations. But you did a lot on April 1.

Yang Zhijian: No. We do more [transplants] than before.

Investigator: Why?

Yang Zhijian: They do a good job. Let me tell you, all over the world, the largest number of donated corpses can be found in Guangxi.

Investigator: Wow, awesome!

Yang Zhijian: It’s Guilin. The city with the largest number in the entire world.

Investigator: Wow, awesome!

Yang Zhijian: Yeah. In terms of city, then it would be Guilin.

Investigator: Oh.

Yang Zhijian: Then, Barcelona in Spain is comparable to Guilin.

Investigator: Oh, I see.

Yang Zhijian: In the whole world.

Investigator: Wow, awesome! You said [that’s because]…

Yang Zhijian: Because we do a good job!

Investigator: Oh, then in this case, how many liver transplantation operations have you done this year?

Yang Zhijian: I don’t know about the specific quantity of liver transplantation operations. We did around 100 kidney transplantation operations.

Investigator: You mean this year until now?

Yang Zhijian: Yeah, this year.

Investigator: Then half of these 100 cases would be 50 [livers transplants].

Yang Zhijian: Yeah, but didn’t I tell you? Nobody has money to do liver transplants here.

Investigator: Oh, then…alas!

Yang Zhijian: Yeah.

Investigator: I feel sorry for you. That is, even with donors, [you cannot do the surgeries]…

Yang Zhijian: So Professor Liu told you that we have more livers here. No one is competing with you [for livers], if you come here to do it. If you were in Beijing or Shanghai, then you [would wait a long time and pay a lot]. I know that a person went to Guangzhou to have a liver transplantation operation. First, he paid 500,000 yuan to the hospital and then paid another 500,000 yuan to the professor. That was the red envelop for the professor.

Investigator: Wow, amazing.

Yang Zhijian: The professor would only do the operation by being paid 500,000 yuan. We have many livers here.

Investigator: Then you would earn a lot of money by doing transplants.

Yang Zhijian: They do them. It has nothing to do with us.

Investigator: Yeah?

Yang Zhijian: They just come here to do the operations [with our donor livers].

Investigator: How many liver transplants can you do in one year?

Yang Zhijian: We can do several dozen operations in our hospital. It’s mainly because the patients don’t have money.

Investigator: For kidney transplantation operations, you can at least do…

Yang Zhijian: We do more than 100 kidney transplantation operations.

Investigator: Oh, that’s about right.

Yang Zhijian: The most kidney transplantation operations we did [in one year] were more than 180 cases.

Investigator: Ah?

Yang Zhijian: The most kidney transplantation operations we did [in one year] were more than 180 cases. We would have excised 90 livers, half [of the 180 cases].

Yang Zhijian: Frequently, people would bring patients from Shanghai and Beijing here to receive [liver] transplantation operations.

Investigator: You mean, because you have liver donors, while other hospitals don’t, they would refer their patients here.

Yang Zhijian: Yeah.

Investigator: This is the case.

Yang Zhijian: Yeah.

Investigator: Oh, I see.

Yang Zhijian: Yeah. They would come here to do organ transplantation operations.

Investigator: Yeah.

Yang Zhijian: There won’t be much difference if you do the operation in Shanghai. You just go home after you finish the operation [here].

Investigator: You mean the doctor….

Yang Zhijian: You will still have your follow-up visits at home.

Investigator: Oh, this way. I am still confused about this. Our Chinese people generally have ideological obstructions about organ donations.

Yang Zhijian: That’s why I tell you that Guilin is the city with the largest number [of organ donations] in the entire world. He Yue [a pupil from Guilin] was one of the top 10 people, who were selected by [the TV program] “Touching China”. You can look her up online.

Investigator: What’s her name?

Yang Zhijian: He Yue.

Investigator: What did she do?

Yang Zhijian: She was a pupil. She got a meningioma, so she donated her remains. She was one of the 10 people, who moved the entire China, a few years ago. Her parents also received an award on stage. The people from the No.181 Hospital went [to take her organs]. You can look her up online.

Investigator: Although there are a lot of donations, why would they give all of them to you?

Yang Zhijian: I told you that [people at] this place have very good morals. [Guilin is the city with] the largest number [of organ donations] in the entire world. I told you.

Investigator: You said….

Yang Zhijian: The city has the largest number of organ donations, the same as [the number] in Barcelona, Spain.

Investigator: How many organ donations in a year?

Yang Zhijian: I don’t know about the specific donation number. It is the highest in the world, anyway.

Addendum 43

Chen Huaizhou, Director of the Organ Transplant Department at the Chinese People’s Liberation Army No. 181 Hospital in Guilin, Guangxi Province

Phone number: 13087737632

Date: 01/18/2017

Key points:

1. [Investigator: Why does your hospital have more organ donors than such a big medical university?] Chen: Well, every hospital is different.
2. “Sometimes [the organ] becomes available, as soon as the patient comes. Very fast.”
3. [Investigator: Does the Red Cross provide the donors?] Chen: You don’t have to care about the donors. All organs are donated now.
4. “You can receive the operation, if there is a [suitable] organ, anyway. For now we don’t have many people in line.”
5. “It may cost more than 300,000 yuan here.”

Phone Investigation Recording:

Investigator: Hello. Is this Director Chen Huaizhou of the No. 181 Hospital?

Chen: Hello, who’s calling?

Investigator: I am in Chengdu and am a family member of a patient. I went to the Third Military Medical University and [met] Liu Xiangde. My family member has advanced liver cirrhosis and wants to receive a liver transplantation operation. But in the end, Liu Xiangde recommended your No. 181 Hospital to me. So I felt very strange. I am in Chengdu, so far [away from] Guangxi. He said you have more organs here than them. He said that he could come here if [my family member] wants to receive the organ transplantation operation. So I’m calling you to confirm that. I still cannot believe [what he said].

Chen: Yeah!

Investigator: Ah?

Chen: He, Prof Liu is one part-time deputy director of the organ transplantation center in our hospital.

Investigator: You mean Liu Xiangde?

Chen: Yeah.

Investigator: Is he a professor?

Chen: Yeah. We ask him to provide some technical support.

Investigator: Oh, does he come here often? Nowadays, people’s words are untrustworthy. I’m calling you to confirm if what he said is true. Why does your hospital have more organ donors than such a big medical university? I’m still a little…

Chen: Well, every hospital is different. Every hospital is different.

Investigator: Different? If I come over, how long should we wait for the liver transplantation operation, in general?

Chen: Well...

Investigator: Approximately, about how long?

Chen: What is your blood type?

Investigator: Type B. Type B.

Chen: Normally, we can do [transplants] if there are suitable organs. As the Chinese New Year is approaching, basically, there are not many patients.

Investigator: Oh, that is, the ward beds are not in short supply now?

Chen: Yeah. It’s ok. Will you come during the Chinese New Year period?

Investigator: I have to discuss with him again. If you say that it’s fast during the Chinese New Year period, then it doesn’t matter whether it is the holiday season or not. How long should we wait for the organ transplantation operation?

Chen: About a month.

Investigator: About a month?

Chen: It depends on your luck. Sometimes [the organ] becomes available, as soon as the patient comes. Very fast.

Investigator: In our case…

Chen: You can receive the operation, if there is a [suitable] organ, anyway. For now we don’t have many people in line.

Investigator: Does the Red Cross provide the donors? Or they are from other places?

Chen: What?

Investigator: Does the Red Cross provide the donors?

Chen: You don’t have to care about the donors. All organs are donated now.

Investigator: So aren’t the organ donations all through…I saw a story online sometime earlier. Two people are fighting to get a [critically ill] patient. I felt so weird, and I found it inconceivable. Does this phenomenon exist? Some people would fight over critically ill patients? Also…

Chen: Humph, I don’t know. I don’t know.

Investigator: Do you do the organ transplantation operations yourself?

Chen: The professors do the liver transplantation operations. It’s all Liu… They come here to do that.

Investigator: Oh, great. Because he said that he would come here if we decide to receive the organ transplantation operation. So, Professor Liu Xiangde would come.

Chen: Yeah. If you come and we have suitable organs for you at that time, he will come here. He can just fly over, as a patient will be waiting for him.

Investigator: Ok, got it. Could you tell me how much it costs? Approximately…

Chen: Professor Liu will tell you about the costs, OK?

Investigator: Approximately how much is that? You will tell me later, right?

Chen: It may cost more than 300,000 yuan here.

Investigator: More than 300,000 yuan Ok, ok.

Chen: You can contact and ask Professor Liu about the fees, okay?

Investigator:  If I know the rough figure, I can tell him to prepare the money.

Chen: You can ask him. You can ask him, okay?

Investigator: Ok, ok.

Chen: Could you ask him about the fees, okay?

Investigator: OK. If it doesn’t work, I will come after the New Year. Thank you!

Chen: Ok, ok, bye.

Addendum 44

Yang Ming, President of the Chinese People’s Liberation Army No. 181 Hospital in Guilin, Guangxi Province

Phone number: +86 13977320723

Date: 01/21/2017

Key points:

1. “Now the organs are from brain-dead or cardiac dead people.”
2. [Investigator: If the organs are from donation, are there enough people to donate locally?] Yang: Now there are a lot of donated [organs]. We generated the stories featured on the TV program “Touching China”.

Phone Investigation Recording:

Investigator: Hello. Is this President Yang Ming of the No.181 Hospital?

Yang Ming: Hello, who is calling?

Investigator: Hello!  I am a patient’s cousin. Professor Liu Xiangde talked with him. He wondered why he should come [here] to do [the organ transplant], since he is in Sichuan, which is far away. He doubted this. I just want to confirm with you. Is that true? Professor Liu Xiangde of the Third Military Medical University would come here to do the liver transplantation operation [for him]?

Yang Ming: When? Where are you from?

Investigator: Professor Liu Xiangde said that he would come here, if we want to do the organ transplantation operation. Is that true?

Yang Ming: Yeah, yeah. He will follow [you] to come here.

Investigator: Oh, he would follow [us] here. Why do you have more donors than the Third Military Medical University?

Yang Ming: We do organ donations, OK?

Investigator: I know. Could we use the previous type of donors?

Yang: What? Previous donors?

Investigator: That is…[the type you used] before they disallowed the use of organs from executed prisoners.

Yang: No, we don’t use organs from executed prisoners anymore.

Investigator: You used that kind before, right? Now can’t we use those? Not even a few of them?

Yang: Now it is not allowed to use them.

Investigator: Since which year the use of them has become illegal? I didn’t hear anything about that.

Yang: Several years ago. About two or three years ago.

Investigator: Oh. Two or three years ago. Now I….

Yang: Now the organs are from brain-dead people.

Investigator: Only from brain-dead people, right?

Yang: Brain-dead or cardiac dead people, now.

Investigator: There are so many donors here. There are many transplantation operations here. If the organs are from donation, are there enough people to donate locally?

Yang: Now there are a lot of donated [organs]. We generated the stories featured on the TV program “Touching China”.

Investigator: You mean you have many donations in this province?

Yang: Yes, yes, yes, okay?

Investigator: You do a good job in our province, right?

Yang: Yes, yes.

Investigator: The previous President Xiang has retired, right?

Yang: Yes.

Investigator: We live close to the No. 309 [Hospital].

Yang: The No. 309 [Hospital]?

Investigator: We live close to them.

Yang: Isn’t Cai Ming working in the No. 309 Hospital?

Investigator: Yeah, and Shi Bingyi is also there.

Yang: Shi Bingyi and Cai Ming are both there.

Addendum 45

Director Sui Weiguo of the Organ Transplantation Center of the Chinese People’s Liberation Army No. 181 Hospital in Guilin, Guangxi Province

Phone number: 13907735881

Date: 01/31/2017

Key points:

1. “We do more than 200 cases of kidney transplantation in a year, and about 30 to 40 cases of liver transplantation in a year.”
2. “We started [doing organ donations] early in the country, because [we are] advanced. So, we have many [donated organs] a year.”
3. “We have more than 100 [organ donors] every year. As for every week, there would be one or two [donors].”

Phone Investigation Recording:

……

Investigator: Hi, Happy Chinese New Year! Hi, Director Sui, Happy New Year! Is this Director Sui Weiguo at the No. 181 Hospital? That I would like to ask ~

Sui Weiguo: Who’s calling?

Investigator: My brother-in-law’s suffering from advanced liver cirrhosis. He went to the Third Military Medical University to prepare for a liver transplant, but Professor Liu Xiangde told him to come to [your] No.181 [Hospital]. So my sister is a little uneasy. She asks why he should go to do liver transplantation at a place so far away.

Sui Weiguo: This is the situation. Ah, yes, Professor Liu Xiangde is our distinguished professor. We are an organ transplant center for the entire military. Basically, the patients for liver transplants would go to the places, where there are donors. It is generally the case. However, in terms of organ donations, our Guangxi is in the forefront of the country. So, locally, they have very few donors. They have few [donors] in one year. So the vast majority of the patients and emergency cases would be sent to our hospital for surgeries. It is basically like this.

Investigator: I know that your hospital is the organ transplant center of the entire army, and you do relatively more kidney transplants. So do you also do a lot of liver transplants, too?

Sui Weiguo: It’s the same. We also do that. Yes, also do that, also a lot. We do more than 200 cases of kidney transplantation in a year, and about 30 to 40 cases of liver transplantation in a year.

Investigator: Oh, you also do a lot.

Sui Weiguo: Yes, right, right, also do a lot [of liver transplants]. Correct.

Investigator: Why do they want to do [the transplants] at your No. 181 Hospital? I would not say that it is remotely located, but it is not a particularly large city, I was a bit ~

Sui Weiguo: No, it is like this. As for the donors, it has a principle of proximity, when it comes to distribution. If a donor is in the same city as the patient, then this patient can claim precedence [over others]. For example, if our No. 181 Hospital has this donor, and you want to give it to Chengdu, it’s not necessarily assigned to Chengdu. It will be given to Guilin, which has priority. If Guilin cannot [use it], it will then be given to other cities in Guangxi Province. If other cities still [cannot use it], it is generally assigned to Guangzhou, which is nearby, and then even further away…Anyway, it is difficult to have it assigned to Chongqing or Chengdu. So, they simply send their emergent patients to us in Guilin.

Investigator: Don’t they have any donors locally? That is, our No. 181 [Hospital]… that is, Guangxi has more donors than them. Is this what you mean?

Sui Weiguo: Yes, right, right. That’s it. Because we started [doing organ donations] early in the country, because [we are] advanced. So, we have more than 100 donors a year. Chengdu, ah, or the like, has very few donors a year. They haven’t made much effort in organ donations. That is, for organ donations, there needs to be a lot of people making contacts outside. For instance, at the Southwest Hospital, they have no one working on this outside, so they receive only a few donors a year.

Investigator: So the donors are not necessarily local. There may be donors from other places?

Sui Weiguo: From other places? Many of the recipients come from other places, but the donors are certainly local. The donors are generally found locally.

Investigator: Then you said that the cases done in Guilin all used donated organs from the Red Cross?

Sui Weiguo: Yes, all are donated.

Investigator: [The hospitals] all used the organs from death-row inmates in the past. Can we still use those now?

Sui Weiguo: No, the state forbids this. It’s strictly prohibited. No, no. Not at all.

Investigator: If we go to [your hospital] to wait, how long do we have to wait before having the surgery?

Sui Weiguo: Well, [it depends on] the [patient’s] blood type and the specific circumstances. I do not know them at all. Anyway, we have always been doing these till the recent couple of days, okay? We [do them] throughout the year, anyway. You can calculate it like this. We have more than 100 [organ donors] every year. Yes, yes, we do it all the time. As for every week, there would be one or two [donors]. So you can calculate it like this. We have one or two donors every week. Or else we couldn’t do so many [transplants], right? Anyway, there are certainly many more opportunities here than in Sichuan Province. We have more than 100 donors a year. It is basically like this.

Investigator: Thank you very much, goodbye!

Sui Weiguo: Okay, good, after all, we’ll try out best to take care of it after you come.

Addendum 46

Doctor Liu Yifan in the doctors’ office for liver transplantation at the First Affiliated Hospital of Zhengzhou University, Henan Province

Phone number: +86 37167967127

Date: 12/16/2016

Key points:

1.  “We did 16 cases [of liver transplantation] in November, and in [December], we did 6 cases.”
2. “This year, from January 1, 2016 to the present, we have done 139 cases.”

Phone Investigation Recording:

Liu Yifan: Hi, hello!

Investigator: Hello, doctor, this is the First Affiliated Hospital of Zhengzhou University, right?

Liu Yifan: Yes.

Investigator: Ah, I want to ask, that is, are we still doing liver transplantation?

Liu Yifan: You…shouldn’t you be contacting Teacher Guo? Is that...?

Investigator: May I ask, do we have many patients recently or not?

Liu Yifan: [The number of] patients is alright.

Investigator: On the other day, I called and asked a young nurse of yours [about it], but Director Guo’s phone was often difficult to go through. Let me ask you, that is, if you have many patients, how long do I have to wait [for the surgery]? Generally, how long do I have to wait?

Liu Yifan: This is hard to say. In terms of liver sources, sometimes, maybe you can do [the transplant] on the same day, when you arrive.

Investigator: Then may I ask, that is, how many have you done since last month?

Liu Yifan: Since last month?

Investigator: Yes.

Liu Yifan: I told you that we did 16 cases [of liver transplantation] in November, and in this month, we did 6 cases. This year, from January 1, 2016 to the present, we have done 139 cases.

Investigator: Really? Then your ward beds should be in very short supply.

Liu Yifan: Beds, if you come, you should be able to have a bed.

Investigator: Really? What’s your name?

Liu Yifan: I’m surnamed Liu, the “Liu” composed of the two characters “Wen” and “Dao”, “Yi” as in “the No. 1”, and “Fan” as in the word “ordinary.” My name is Liu Yifan.

Investigator: Liu Yifan, ah, then you do the surgeries, right?

Liu Yifan: Yes, I am in their… we are a team, but Teacher Guo is the operator, you know? I have to deal with the patients now…

Investigator: Good, good, good.

Addendum 47

Doctor Yuan for liver transplantation at the First Affiliated Hospital of Zhengzhou University, Henan Province

Phone number: 0371-67967127

Date: 03/03/2017

Key points:

Doctor Yuan answered the phone, and said that they are doing liver transplantation, and the wait time is uncertain. “If being lucky, in fact, you can do it on the same day, when you arrive here. Last year, we did over 140 cases, basically one case every two days. A liver transplant costs around 550,000 yuan.” There are no more living donors, like the death-row prisoners in the past. They have less patients than the hospitals in Beijing, Shanghai and Guangzhou.

—— —— —— ——

1. “You have to wait [for donors] wherever you go, but our hospital is ok, a little bit better than [the hospitals in] Beijing, Shanghai and Guangzhou.”
2. “If being lucky, in fact, you can do it on the same day, when you arrive here.”
3. “Last year, we did over 140 cases, basically one case every two days.”
4. “A liver transplant costs around 550,000 yuan.”
5. “There is a specialized agency of the state to distribute [organs] to us. Nobody knows when there will be donors.”
6. Investigator: The [use of the] kind of [organs from] those death-row prisoners in the past. Yuan Bai: No, those were all banned in the country. Very interesting!
7. “Our liver transplantation techniques can absolutely rank among the top five in the country.”

Phone Investigation Recording:

Investigator: Hello, is this the organ transplantation division of the First Affiliated Hospital of Zhengzhou University?

Yuan: Who is that?

Investigator: I am from Anyang. I would like to ask if you are still doing liver transplantation right now.

Yuan: Yes ~ we are doing it. What’s the matter? You say…You want to come to do liver transplantation, don’t you?

Investigator: Well, yes, we want to do liver transplantation, because my family member has advanced liver cirrhosis, because he had Hepatitis B, when he was young.

Yuan: Then you come over early if you want to.

Investigator: Oh, I want to inquire about how many people queuing up in the past, now and in the future. Do we have to wait for a long time?

Yuan: You have to wait wherever you go, but our hospital is ok, a little bit better than [the hospitals in] Beijing, Shanghai and Guangzhou.

Investigator: Approximately how long will I wait?

Yuan: Nobody can give you a definite answer. Sometimes if you are in bad luck, you have to wait for a long time; sometimes you can do it the next day after arriving here. It is hard to say.

Investigator: Oh, how fast can it be, if we are lucky?

Yuan: If being lucky, in fact, you can do it on the same day, when you arrive here.

Investigator: I find it strange. How can it be unknown? There are so many patients waiting, you surely know where the donors are and arrange the patients to have the transplants.

Yuan: Donors…Who knows when there will be a donor? The main problem is that nobody knows when donors will arrive.

Investigator: Which entity provides the donors? Is it the Red Cross?

Yuan: There is a special organization for donors, a specialized agency of the state to distribute [organs] to us. The distribution center would allocate them, if someone is willing to donate his/her organs. It is a special [organization]. Nobody knows when there will be donors.

Investigator: That is, how many do you do in this hospital, such as liver transplants?

Yuan: Last year, we did over 140 cases, basically one case every two days.

Investigator: Oh, that is to say, our ~

Yuan: A liver transplant costs over 550,000 yuan, around 550,000 yuan.

Investigator: When I called, she asked me, “Can you ask them if they can still use the kind [of organs from] prisons?” She said that kind [type of organs] were certainly healthier than the people with illnesses now.

Yuan: Do you mean living donors?

Investigator: Well, the kind of [organs from] those death-row prisoners in the past.

Yuan: No.

Investigator: What about if we pay some more money?

Yuan: No, you mean those death-row prisoners before?

Investigator: Well, yeah.

Yuan: No, those were all banned in the country.

Investigator: Oh ~ ~

Yuan: Very interesting!

Investigator: We still cannot [have such donors], if we spend some more money?

Yuan: No, do not ask too much.

Investigator: An extra bed? That is, your ward doesn’t have so many beds. You mean there are very few [of them]?

Yuan: Right.

Investigator: Oh, I see. Doctor, what is your last name? He may call you later.

Yuan: I’m surnamed Yuan. “Yuan” as in “Yuan Shikai”. You write down my phone number?

Investigator: What did you say?

Yuan: You can write down my phone number, and tell him to call me.

Investigator: Ok, good, good. Please go ahead.

Yuan: 13027606185.

Investigator: How many years have you been doing the transplantation?

Yuan: Our liver transplantation techniques can absolutely rank among the top five in the country. 

Investigator: Oh, wow, then there’ll be no problem with your techniques. Do you have the director or the doctors doing the transplants?

Yuan: To operate the surgeries, it is mainly the director, who operates. You will know about this when you come.

Investigator: Yes, thank you, okay, goodbye!

Addendum 48

Doctor on duty for kidney transplantation at the First Affiliated Hospital of Zhengzhou University, Henan Province

Phone number: +86+ 371_66862191

Date: 05/09/2017

Key points:

1. “We did more than 300 cases [of kidney transplantation last year].”
2. “We already did more than 100 cases this year.”
3. “We have a special kidney transplant ward, where there are more than 50 beds.”

Phone Investigation Recording:

……

Nurse: Hello, kidney transplantation.

Investigator: Hello.

Nurse: Hello?

Investigator: Is this the kidney transplant department? I’m calling from another province. Hello!

Nurse: How can I help you?

Investigators: I’ve that heard the wait time for kidney transplantation in your hospital would be a little bit shorter [than that of the other hospitals]. How can I be put on your waiting list?

Nurse: Please wait a moment!
[Switched to a different person]

Doctor: Hello!

Investigator: Hello!

Doctor: Hello!

Investigator: Hello! I was asking, how can a patient from another province to be put on your hospital’s [donor] waiting list?

Doctor: Where are you from?

Investigator: Anhui Medical University.

Doctor: Anhui Medical University, then you’ve already done the [tissue] typing, etc., right?

Investigators: [We did,] since this is also a Grade A tertiary hospital. However, after doing [all the checkups], there were so many people waiting [for organs], and their hospital didn’t do many cases. I’ve heard that they had a meeting with one director in your hospital, and that your hospital did over 200 cases of kidney transplantation last year, is that correct?

Doctor: Yes. We did more than 300 cases [of kidney transplantation last year]. Well, I don’t want to talk about that.

Investigator: Well, I was told that maybe your hospital would have more opportunities. They told us to come here, to see if it’s possible to do it. So...

Doctor: Yes. No problem. You can come and get registered someday.

Investigator: Good, from Monday to Friday?

Doctor: Yes, from Monday to Friday.

Investigator: As long as during your business hours, right?

Doctor: Yes, anytime. You don’t have to register with the outpatient service. You can directly go to our ward, which is located on the 19th floor of Building 1.

Investigator: OK. I know, that patient already told me how to get to your [ward].

Doctor: Yes. No need to register [with the outpatient service].

Investigator: They did few in Anhui Medical University this year. How about your hospital? Have you done as many [cases] as last year?

Doctor: We already did more than 100 cases this year, more than 100 cases this year.

Investigator: Oh, more than 100 cases. Okay. I have some idea now. Okay, in due course, I will directly come to your hospital then. Which doctor should I talk to?

Doctor: Ok, just come.

Investigator: Okay. Your ward beds are quite in short supply, right?

Doctor: Right.

Investigator: Do you have a special kidney transplant ward or [the ward beds] are mixed with the [ones of] the urinary surgery department?

Doctor: We have a special kidney transplant ward.

Investigator: Well, how many beds are there in your kidney transplant ward?

Doctor: We have more than 50 beds.

Investigator: More than 50 sheets?

Doctor: Yes. More than 50 beds.

Investigator: Okay, then I’ll let my family members know, after consulting with you…

Addendum 49

Doctors on duty for kidney transplantation at the First Affiliated Hospital of Zhengzhou University, Henan Province

Phone number: +86-37166862192

Date: 06/28/2017

Key points:

1. “Our hospital has relatively more ample kidney sources than the other hospitals.”
2. “[From the beginning of this year till now, we should’ve done 200 to 300 cases [of kidney transplantation].”
3. “Last year we did more than 300 cases [of kidney transplantation].”  

Phone Investigation Recording:

……

Investigator: Hello, hello, is this the kidney transplant office? Kidney transplantation ward?

Doctor: Yes. Kidney transplantation [department].

Investigator: One of my family members wants to do a kidney transplant surgery. Can you please tell me how long we will have to wait for the transplantation, after we come here?

Doctor: How long? [With an organ] from a relative or someone else?

Investigator: Not [from] a relative, an allograft.

Doctor: From someone else, right?

Investigator: Yes, yes.

Doctor: Okay, please wait a moment.

[Switched to another female doctor.]

Doctor: Hello!

Investigator: Hello, hello! [Doctor: Hi, hello!] Doctor, I’m from Handan.

Doctor: Where are you from?

Investigator: Handan, Hebei Provence.

Doctor: From Hebei Provence, right?

Investigator: Yes, Hebei Provence.

Doctor: Are you consulting for your family member, yourself, or your friend?

Investigator: A family member. A family member.

Doctor: No. Well, we can’t explain clearly on the phone. How about you coming to our hospital to consult for detailed information?

Investigator: [Yes.] But I still want to know how long would I wait for the surgery? If your hospital performs a lot of kidney transplant surgeries, we wouldn’t wait too long for our turn, right? Do you do a lot [of kidney transplant surgeries]?

Doctor: Oh, relatively speaking, our hospital has relatively more ample kidney sources than the other hospitals. That’s means that the probability of a patient obtaining a matching [organ] is a bit larger.

Investigator: Okay. So have you done a lot of kidney transplant surgeries this year? From the beginning of this year to the present?

Doctor: By now, we should’ve done 200 to 300 cases [of kidney transplantation].

Investigator: Okay. 200 to 300 cases. Then your hospital can do 500 or 600 cases per year, right?

Doctor: Well, last year we did more than 300 cases. We don’t know about this year yet. Because we don’t know whether we can get a lot of kidney sources or not in the latter half of the year.

Investigator: Okay. So it’s impossible to estimate. Only the first half of the year…

Doctor: Yes. This is impossible to estimate, as it’s not based on human [factors].

Doctor: Well, we are particularly busy here. If you have other questions, I suggest you to come to our hospital in person, okay? Because we can’t explain clearly on the phone. It’s particularly noisy on our side, too.

Investigator: Okay.

Doctor: Okay. Goodbye.

Addendum 50

Doctor on duty in the organ transplantation department at the People’s Hospital of Zhengzhou, Henan Province

Phone number: +86+ 371_67077512

Date: 12/17/2016

Key points:

1. “Some [donor organ] wait times are long and others short. Shouldn’t be more than three or five days, or a week or half a month. It should be relatively fast.”
2. “[We’ve done] more than 200 cases [this year]…basically non-stop…In December, we did several dozen cases.”
3. The hospital has a large department for liver and kidney transplantation, which is an organ transplant center.
4. There are two wards, with more than 60 beds each.
5. “For us now, organ transplantation surgeries are very common. Sometimes, we can perform two, three or four surgeries back-to-back.”
6. Now all donor organs are DCD (Donations after Cardiac Death).
7. The hospital has five or six organ transplant teams. Director Qu is leading one team, and Director Miao is leading the other one. “We have many directors and deputy directors now.”
8. All the teams should be able to perform surgeries at the same time.
9. “[The organ sources] are DCD now. It’s unsteady. It’s not like the type in the past. That kind of kidney sources had time limits. This type [of organs] basically come very randomly and intermittently.]
10. “We basically can do five or six [operations] back-to-back within 24 hours. Two liver [transplants] and four kidney [transplants].”

Phone Investigation Recording:

……

Nurse: [machine recording] People’s Hospital of Zhengzhou organ transplant department, please wait ... [human voice] Hello, organ transplant department.

Investigator: Hello, is this the organ transplant department of People’s Hospital of Zhengzhou? Is Director Qu Qingshan here, in this hospital?

Nurse: Director Qu is here.

Investigator: So he is. He does kidney transplants, right?

Nurse: Well, kidney and liver transplantation.

Investigator: Both liver transplantation and kidney transplantation?

Nurse: Yes.

Investigator: I have a kidney transplant patient here. So I suggested him to go to your hospital to do the transplantation. I asked several hospitals, and they all had so many patients waiting [for organs], so I’m checking out your hospital...

Nurse: Please wait a minute. I will transfer you to one teacher [i.e. doctor] to answer your question.

Investigator: Oh, thank you.

... [waiting for a doctor to pick up the phone]

Doctor: Hey, hello!

Investigator: Hello, hello, this is a doctor. I have a patient in need of an organ transplant. I’m in Anyang. Just now, the nurse told me that Director Qu is still here...

Doctor: Yes.

Investigator: Good, thank you. About the kidney transplant, I asked other hospitals, and they have many patients waiting [for surgeries]. It seems that they don’t do as many as your hospital does. They suggested to me, “You can ask People’s Hospital of Zhengzhou.” Is your number of kidney transplantation cases relatively large?

Doctor: Yes, yes.

Investigator: Okay. How long should the patient wait, if we send him here?

Doctor: What is his blood type?

Investigator: Type B.

Doctor: Type B, might be a little bit faster, because now our ward basically has more [organs of] Type A. The other blood types should be okay. Some wait times are long and others short. Shouldn’t be more than three or five days, or a week or half a month. It should be relatively fast. It should be relatively fast.

Investigator: Your hospital does relatively more [cases]. So how many cases of kidney transplantation have you done this year?

Doctor: Yes. More than 200?

Investigator: More than 200?

Doctors: We do the most in the entire Henan Province… We did lots.

Investigator: More than 200. That’s really a lot, that is because I have Type B blood. You said there are more Type A patients waiting right now? Type B patients are less, that is to say...

Doctor: Yes, less. That means, you have more chance after you come.

Investigator: Oh, how many do you do every month?

Doctor: Ah, basically non-stop, anyway, [we do transplants] intermittently. And recently we did a lot, about 5 or 6 cases.

Investigator: How many cases did you do last month, approximately?

Doctor: Last month? Anyway, in December, we did several dozen cases.

Investigator: Ah, December?

Doctor: No. October, November, now is December. We’ve done about a dozen in December.

Investigator: That’s really a lot, you have relatively ample kidney sources. Where are these from? Are these kidneys healthy?

Doctor: All DCD (Donations after Cardiac Death).

Investigator: Oh, all DCD... I was wondering why you have so many [kidneys]. I think that you have an effective way to do this...

Doctor: Well.

Investigator: Then if I tell him to come here, are your ward beds in short supply?

Doctor: Anyway, the beds are always in short supply.

Investigator: I know that this year you have just set up an organ transplant department. Last year, when I called Dr. Chen Guoyong, at that time, you didn’t have an organ transplant section. Now you have a large liver and kidney transplantation department, which is equivalent to an organ transplant center?

Doctor: That’s right, right.

Investigator: Are the beds divided between liver transplants and kidney transplants?

Doctor: No, no, we are all together.

Investigator: Oh, how many ward beds are there now?

Doctor: There are more than 100 beds in two wards.

Investigator: More than 100 beds, there are more than 50 beds in one ward, right?

Doctor: Two wards.

Investigator: More than 50 beds in two wards. No, I mean, 50 or 60 beds in one ward?

Doctor: Well, one ward has more than 60 [beds].

Investigator: I heard this from other hospitals. Do you know the price of a kidney transplant?

Doctor: Well, the prices are different. They are set according to the specific situations. There might be some differences.

Investigator: Oh, so Director Qu’s specialty is kidney transplantation, right?

Doctor: We do both kidney and liver transplantation.

Investigator: All together?

Doctor: Yes.

Investigator: I also know Director Miao in your hospital…

Doctor: Oh yes, Director Miao is also here.

Investigator: Oh, you have a lot of transplant teams.

Doctor: Yes. For us now, organ transplantation surgeries are very common. Sometimes, we can perform two, three or four surgeries back-to-back.

Investigator: How many attending physicians, how many attending physicians, uh, how many teams do you have?

Doctor: We have five or six teams, nowadays.

Investigator: Five or six. So Director Qu is leading one team, and Director Miao is leading the other one, right?

Doctor: Well. We have many directors and deputy directors now.

Investigator: Many. All these teams can perform at the same time?

Doctors: Should be okay.

Investigator: Alas, that is, do you do more in the first half of the year or in the second half?

Doctor: Anyway, [the organ sources] are DCD now. It’s unsteady. It’s not like the type in the past. That kind of kidney sources had time limits. This type [of organs] basically come very randomly and intermittently. You know the situation is…it is not like that in the past, so…well.

Investigator: In general, this kind of donor [organs] are excised in local [hospitals] or at other places?

Doctors: Basically all locally. They have divided into different areas.

Investigator: Oh, your local area is the region of Zhengzhou?

Doctor: Well, from this province, it seems…

Investigator: In the past, I sent some patients…several years ago. [The donors] were death-row prisoners and also that kind of [Falun] Gong practitioners. One of my friends did his organ transplantation here previously. Now, do you have…

Doctor: Well.

Investigator: Can you still get this kind [of organs from] prisoners?                        

Doctor: Not now, they’re all [from] DCD now.

Investigator: Now all are DCD?

Doctor: Yes.

Investigator: Since when have we stopped using that kind [of organs from] prisoners?

Doctor: Well, when did the state policy start to change? Was it in 2016? I can’t remember.

Investigator: In the recent couple of years?

Doctor: Anyway, four or five years ago, maybe. Anyway, it was in the recent couple of years. For this type of things, just follow the state policy.

Investigator: Huang Jiefu, Huang Jiefu seemed to have announced it in January of 2015. It should be…

Doctor: Yes, yes.

Investigator: So last year you announced to disallow the use of prisoners’ [organs]. So did you do many kidney transplants last year?

Doctor: Well.

Investigator: More in last year than this year?

Doctor: Well, how about this? Shall I give you Director Qu’s phone number? You can ask him for more details.

Investigator: Okay.

Doctor: He should be more professional, okay?

Investigator: Yes, right, yes.

Doctor: Please write down his phone number ... 137 0371 7386

[The two were proofreading the phone number.]

Investigator: Who is the main director, Miao?

Doctor: Director Qu is the main director.

Investigator: Okay. So Miao is a deputy director?

Doctor: Yes.

Investigator: Last year, when I called, it was Chen, Chen Guoyong was the director here.

Doctor: Well, yes.

Investigator: Did he get transferred to another place?

Doctor: Yes.

Investigator: Oh, he is not here? Oh, where did he go?

Doctor: He was transferred to the provincial hospital? It seems.

Investigator: The provincial hospital.

Doctor: Yes.

Investigator: Hey, I estimate that you are capable of performing 300 cases this year.

Doctor: Well, we’ll have to see [how we do] at the end of the year.

Investigator: Now the year end is approaching fast. Only in a dozen days.

Doctor: Oh, yes, yes.

Investigator: Basically, you are doing it every week, right?

Doctor: Yes.

Investigator: Have there been occasions, where the surgeries were being performed simultaneously? Five or six teams were performing operations at the same time?

Doctor: Well, not at the same time. Maybe within the same day, yes.

Investigator: How many can they do at most in one day, three or four operations?

Doctor: We basically can do five or six [operations] back-to-back within 24 hours. Two liver [transplants] and four kidney [transplants]. How is this?

Investigator: Then several people…several teams were working at the same time?

Doctor: Yes, they would perform [operations] back-to-back.

Investigator: Okay, good. Thank you.

...

Addendum 51

Liang Jianzhong, Liver Transplant Department at Zhejiang University International Hospital

Phone number: +86+ 13516703061

Date: 07/25/2016

“Everyday, we do 2-3 cases [of liver transplant surgeries]. We have both domestic and foreign patients.”

Key points:

1. “If it’s really urgent, we can certainly do the surgery immediately.”
2. “Our doctors’ team is relatively strong. Our medical team is relatively strong, too. Liver transplantation is [our] preponderant discipline.”
3. “If it’s liver transplant, it should be Dean Zheng Shusen, who personally operates the surgery.”
4. “Every day, we do 2-3 cases [of liver transplant surgeries].”
5. “The liver sources are relatively easy to find.”
6. “The information is mainly circulated through WeChat or some social circles, so you probably can’t see things you want to see on the Internet.”

Phone Investigation Recording:

……

Investigator: Hello.

Person on Duty: Hello.

Investigator: Is this Mr. Liang Jianzhong?

Person on Duty: Yes, it’s me.

Investigator: I heard that this international hospital does liver transplants, is that right?

Person on Duty: Yes, that’s right.

Person on Duty: Well, uh, I just checked on you. Are you calling from the USA?

Investigator: Yes, because I’m overseas, so I said “international”. My understanding is that for overseas [patients], compared to [domestic patients], there will be some…

Person on Duty: Yes, just register at the hospital like normal, because it’s not really troublesome.

Investigator: Relatively speaking, you probably receive more Chinese people from Taiwan, Hong Kong, Macau and USA, right?

Person on Duty: Yes, yes, that’s right.                                                              

Investigator: In that case, there is such consideration.

Person on Duty: Ah.

Investigator: Can you, if the patient comes to your hospital…don’t worry about the cost, the key is to make an arrangement for hospitalization, and then do this surgery quickly?

Person on Duty: It’s possible to do the surgery. You first send the patient over. After he is transferred to us, the doctors will do an assessment. For example, when do you plan to do it? If it’s really urgent, we can certainly do the surgery immediately.

Investigator: So, do I come to the hospital ward to find you directly or what?

Person on Duty: It’s fine to contact me directly, or you can ask the patient to contact me directly.

Investigator: Oh.

Person on Duty: Liver transplant. You were talking about a liver transplant, right?

Investigator: That’s right.

Person on Duty: As for liver transplants, our doctors’ team is relatively strong. Our medical team is relatively strong, too.

Investigator: Which director is mainly responsible for this?

Person on Duty: If it’s liver transplant, it should be Dean Zheng Shusen, who personally operates the surgery.

Investigator: So Dean Zheng will personally operate the surgery, right?

Person on Duty: Yes, it should be the president, who personally operates the surgery. If the surgery is done over there, at Zhejiang University International Hospital, you should contact the international hospital, right?

Investigator: That’s right.  I heard that the facilities at international hospital are better.

Person on Duty: Yes, the medical facilities here are quite good.

Investigator: The problem is, I can only see things on the Internet because your hospital was newly established, right?

Person on Duty: There isn’t much stuff on the Internet. The information is mainly circulated through WeChat or some social circles, so you probably can’t see things you want to see on the Internet. 

Investigator: How many cases of liver transplantation has this international hospital done? Do you know?

Person on Duty: Well…everyday, we do 2-3 cases. We do it every day. We do it every day. That’s right.

Investigator: So you do 2-3 cases every day. Oh, perhaps you mainly treat patients from overseas, such as patients from Hong Kong, Taiwan and Macau? 

Person on Duty: Yes, we have both [domestic and foreign patients]. We don’t only target patients from overseas. There are quite a lot of domestic patients, too.

Investigator: Oh, domestic ones.

Person on Duty: Then, we are mainly facing the entire world. If you have any questions, we can do it, like in the US, France and other countries, their medical teams…

Investigator: So, there will be no problem. You just said you probably do liver transplants every week, and every day?

Person on Duty:  Yes, we do them every day. Our liver transplant [techniques] are relatively mature, because liver transplantation is his preponderance, preponderant discipline.

Investigator: Preponderant discipline. Oh, then, can you give me an estimated wait time?

Person on Duty: I can’t give you [an estimate for] the wait time. The liver sources are relatively easy to find, because [the livers’] adaptability is quite strong. Their adaptability is quite strong.

Investigator: The call is not very clear. It’s hard for me to hear your voice clearly.

Person on Duty:  Yes.

Investigator: Then I will get in touch with you later.

Person on Duty: Hmm, good, good. All right for now.

……

Addendum 52

Dr. Wu Weilin, Liver Transplant Department at Zhejiang University International Hospital

Phone number: +86 +15958185259

Date: 07/28/2016

Key points:

1.  “Zhejiang University International Hospital was just established this year… We have already done more than 50 cases [of liver transplantation].
2. The wait time varies. Emergency cases are the priority.
3. They are waiting for the approval of transplant qualification. But the authorities have tacitly approved it.
4. “About over 100 beds are used for hepatobiliary and pancreatic surgeries.”
5. “We have about 100 inpatients [for liver transplants]. We do transplants every day.”

Phone Investigation Recording:

……

Wu Weilin: Hello!

Investigator: Hello, is this Dr. Wu Weilin?

Wu Weilin: Yes, yes.

Investigator: I see that there is an international hospital, Zhejiang International Hospital. This hospital was newly established, right?

Wu Weilin: Yes, Zhejiang University International Hospital was just established this year.

Investigator: I saw on the Internet that Zheng Shusen is now the president of the international hospital, right?

Wu Weilin: Yes, Dean Zheng built a hospital in the society. It’s called Shulan Hospital.

Investigator: So, can you do liver transplants now? Now?

Wu Weilin: We can. We have already done more than 50 cases.

Investigator: I see. I have a nephew. Because I’m calling …

Wu Weilin: Umm.

Investigator: …from Hong Kong. My nephew’s liver cirrhosis is at the terminal stage. I’m contacting hospitals. I wanted to go to the First Affiliated Hospital of Zhejiang University. Then I suddenly saw the international hospital and I thought that the international hospital is newly established and there are quite many beds there.

Wu Weilin: Yes.

Investigator: Is that so? I see there are quite many beds. I saw on the website that there are 500 beds. I thought that the scale of the hospital is quite large. So I am calling to check out. If the hospital has already started [performing transplant operations], and has been running smoothly according to standards, then I think it’s better to go to a new hospital, where the expert Zheng Shusen is also there. I mean if I go…

Wu Weilin: Yes, that’s right. His main focus now is here.

Investigator: Oh, his main focus is here. So are all 500 beds used for liver transplants?

Wu Weilin: No, about over 100 beds are used for hepatobiliary and pancreatic surgeries.

Investigator: Oh, so not all 500 beds are used for liver transplants?

Wu Weilin: No. Our main focus in the future is transplantation.

Investigator: I see. If my nephew goes to the hospital, how long does he need to wait before he can have the liver transplant surgery?

Wu Weilin: It’s hard to say. Some people may need to wait for several weeks. Some may need to wait for several months. In general, compared to… the wait time is shorter.

Investigator: I see. Since this hospital is relatively large, and it’s an international hospital, does it have more donor sources than other places?

Wu Weilin: About the donor sources, how can I put it? Domestic liver transplants… domestic liver transplants…recipient registration…he is responsible for you, so they may have a little more donor sources than other places. This is the case.

Investigator: So a bit more. I heard that your hospital was newly established. What qualifications do they [i.e. the doctors] have? So you have already applied for liver transplant qualifications, as a newly founded [hospital]?

Wu Weilin: It’s still getting approved. But [our performance of] liver transplant [operations] has already been recognized by the higher-ups. Why is that? Because the president of the national committee proposed, that many liver transplants can’t be helped, and must be treated immediately or else [the patients] would die. Under the circumstances of saving people, right now, they just silently approve it and follow doctors’ instructions. It’s for saving people. We can’t wait for some of the livers to be approved. So there is no problem…in China.

Investigator: So the Zhejiang University hospital does fewer liver transplants than here and has fewer patients?

Wu Weilin: It should be less than here. Here (international hospital) does more than over there (the university’s hospital).

Investigator: From what I see, if Dr. Zheng came over, the doctors over there would come over, too?

Wu Weilin: Yes, yes, yes. Why do you care about things over there? You need to come over and get checked out by our hospital first.

Investigator: So, you have over 100 beds, but the beds are quite in short supply. It means that you guys have been doing quite well.

Wu Weilin: We have about 100 inpatients. We do transplants every day.

Investigator: It’s very good. I will bring back some information as soon as possible.

Wu Weilin: The liver sources are quite in short supply.

Investigator: I know. That’s why I’m calling you.

Wu Weilin: Good, good.

Addendum 53

Doctor Zhao for liver transplant operations at the Third Hospital of Hebei Medical University

Phone number: +86-31188603029

Date: 03/13/2017

Key points:

1. “We do a lot [of liver transplants].”
2. “For last year, I don’t remember the exact number clearly. However, our overall number is among the top 10 in the entire country.”
3. “If you can wait until the surgery time, it will be about a month or so.”
4. “We started [conducting liver transplants] in 2003.”
5. “We are now all [using organs] donated by brain-dead donors.”

Phone Investigation Recording:

Doctor Zhao: Hello!

Investigator: Hey, hello! Is this the hepatobiliary surgery division?

Doctor Zhao: Hello?

Investigator: Is this the Hepatobiliary Surgery Outpatient Services? The Third Hospital of Hebei Medical University, right?

Doctor Zhao: Yes, this is the Third Hospital of Hebei Medical University.

Investigator: Oh.

Doctor Zhao: How are you? How can I help you?

Investigator: I would like to ask if you are still doing liver transplantation. I am from Handan.

Doctor Zhao: Yes, we do.

Investigator: I would like to ask you, now, are there a lot in your hospitals, like liver transplants?

Doctor Zhao: We do a lot.

Investigator: That is, last year, how many liver transplants? You must have done a lot for sure [Doctor Zhao: Last year ...].

Doctor Zhao: For last year, that is, I don’t remember the exact number clearly. However, our overall number is among the top 10 in the entire country. Since there are lots of patients, the key issue now is the donors.

Investigator: Oh, the donors, you have less donors now, right?

Doctor Zhao: Yes, that’s right.

Investigator: In the past...

Doctor Zhao: Because we have to wait for someone to donate.

Investigator: Oh.

Doctor Zhao: We are now all [using organs] donated by brain-dead donors.

Investigator: Oh, oh, oh, I see. That is to say, you have started doing it this year anyway, right?

Doctor Zhao: We do it every year. Normally, about… say if you can wait until the surgery time, it will be about a month or so.

Investigator: This is for sure, right? How many years has your hospital been doing this kind of liver transplantation? Like this kind of liver transplants?

Doctor Zhao: We, uh ... we probably started from 199..., we started in 2002, started in 2003.

Investigator: Oh yeah, that is pretty long. OK! Thank you so much!

Doctor Zhao: Uh, uh.

Investigator: Doctor Zhao, goodbye!

Doctor Zhao: Yeah, no problem, no problem, bye.

Addendum 54

Doctor Jiang Jianwen for liver transplant operations at the First Affiliated Hospital of Zhejiang University

Phone number: +86+13588449092

Date: 02/28/2017

Key points:

1. The First Affiliated Hospital of Zhejiang University has been conducting more than 200 cases of liver transplants each year. The wait time can be one, two or three months, as the time varies.
2. Zheng Shusen has newly established a hospital called Shulan Hospital [i.e. Zhejiang University International Hospital]. To find Zheng Shusen to perform surgeries, the patients can go directly to Shulan Hospital.
3. Zhejiang University International Hospital has done more than 100 cases of liver transplants.   

Phone Investigation Recording:

……

Investigator: Hello, hello, hello! Is this Doctor Jiang Jianwen of the First Affiliated Hospital of Zhejiang University?

Jiang Jianwen: Uh, speaking.

Investigator: I would like to ask you… I am from Changzhou, I have a nephew, who needs to do liver transplantation, and wants to come here, do you still do it? How long do we need to wait?

Jiang Jianwen: If you wait, you wait about a month, two months or three months. The time varies, because the liver donors now are all…all brain-dead or cardiac dead. That is, the time is uncertain, but we have been doing 200 cases each year.

Investigator: Oh, that is to say, you still have done more cases than the other hospitals ~ ​​

Jiang Jianwen: Right, right, right, right.

Investigator: It is said that this Jiang (Zheng) Shusen is in your hospital, isn’t it?

Jiang Jianwen: Zheng Shusen is here, Zheng Shusen is in our hospital. He also has another hospital called Shulan Hospital.

Investigator: Oh, that is to say, he does not, not work in your hospital now.

Jiang Jianwen: Uh, he’s working in both hospitals. He…they also opened another hospital called Shulan Hospital. Shu as in the word “tree”, Lan as in the colour blue, [no] “orchid”, Shulan Hospital, you can search it online.

Jiang Jianwen: Well, we have now done more than 2,000 cases, right? In this hospital.

Investigator: Oh, ten years, that is, your hospital has been carrying out liver transplants for ten years.

Jiang Jianwen: Well, more than a dozen years, right.

Jiang Jianwen: If you want to learn more about Shulan Hospital, you can call Shulan Hospital. Search it online, to learn about the hospital.

Investigator: Oh, the number of cases they did in one year in their hospital, the liver transplants were not as many as those in your hospital, right?

Jiang Jianwen: More than 100 cases, more than 100 cases. They did more than 100 cases.

Investigator: More than 100 cases, oh, that is not ~

Jiang Jianwen: That Academician Zheng, Academician Zheng has been doing them in person, Academician Zheng has been doing them himself.

Investigator: Oh, all right. Well, all right, thank you so much. Well, goodbye.

Jiang Jianwen: Ah, you said…If you really want to do the transplant, you can personally come here to see it, to learn about it. It is not a small thing to do transplantation, okay?

Investigator: Yeah, yeah, right, right.  So I want to ask you about it. All right, thank you so much. Well, goodbye.

Jiang Jianwen: You are welcome. Good, good.

Addendum 55

A ward nurse for kidney transplant operations at the Second Affiliated Hospital of Guangzhou Medical University

Phone number: +86+ 20_34153251

Date: 01/06/2017

Key points:

1. The hospital is still open during the Chinese New Year period.
2. “We do [kidney transplants] at any time. There are donors all the time, we do it at any time, as long as there are materials.”
3. “Tomorrow there will be four operations.”
4. The hospital performed about 260 cases [of kidney transplantation] in 2016.

Phone Investigation Recording:

……

Nurse:…

Investigator: Hello! Is this the second affiliated hospital in Guangdong? Uh, uh, I have a family member, who needs to do a kidney transplant. Is director Chen Zheng still in your hospital?

Nurse: Uh, yes.

Investigator: OK, he is here, is he still the operator?

Nurse: Correct.

Investigator: I want to ask, if you still receive patients at the end of the year?

Nurse: Yes, we will still open (then).

Investigator: Still open.

Nurse: Open, right.

Investigator: Still doing it, right?

Nurse: Yeah, yeah, yeah.

Investigator: Well, after the Chinese New Year, we…

Nurse: Tomorrow there will be four operations, four operations tomorrow.

Investigator: Oh, there are four cases tomorrow. So you only do these four cases after the Chinese New Year?

Nurse: Not after the Chinese New Year. We do it at any time. There are donors all the time, we do it at any time, as long as there are materials.

Investigator: Oh ~ you say that tomorrow there will be four operations. Yesterday…do you do it almost every day?

Nurse: Correct.

Investigator: Oh, you must have done a lot after January 2017.

Nurse: Ah ~ yes.

Investigator: When I called at the end of February, [they] had done over 50 cases. [They] told me at that time. Last year, in 2016, what is the number of kidney transplants performed in your hospital?

Nurse: Well, last year, how many kidney transplants have we done in this hospital last year? About 260.

Investigator: Oh, 260 [cases]. So will the beds be in short supply, after we come over?

Nurse: Yes, yes, [the ward] is all full.

Investigator: All full, we are…

Nurse: Full, so if you want to come over, you will do four diagnoses, right...

Addendum 56

Doctor Pu Miaoshui for liver transplant operations at Guangzhou Military Region General Hospital

Phone number: +86+13682253550

Date: 01/23/2017

Key points:

Liver transplants are normal operations for this hospital. They perform about 50 or 60 cases a year. The donor wait time is about a month. Currently, there are four hospitals in Guangzhou that are doing liver transplants, and they did more cases in the past. According to Pu, previously, the use of organs from death-row inmates and [Falun] Gong practitioners was legal. Now it is not illegal, but as the state forbids it, such organs cannot be used.

—— —— —— —— ——

1. The donor wait time is about a month.
2. “There are now temporarily four hospitals in Guangzhou [doing it]. Our General Hospital, two hospitals affiliated with Sun Yat-sen University, and in Zhongshan, China Southern Airlines Hospital, a total of four hospitals.”
3. “[The use of organs from death-row inmates and (Falun) Gong practitioners] was legal before, now it is not illegal, but now it has been forbidden by the government. It does not work when the state says no. It is not an issue of legality.”

Phone Investigation Recording:

……

... [No one answered the phone...noises]

Doctor Pu: Hello?

Doctor Pu: Hello?

Investigator: Hello!

Doctor Pu: Hi!

Investigator: Hi, Doctor Pu, Doctor Pu, my Wi-Fi got disconnected just now...So it has not gone through later on... Hello

Doctor Pu: ... The signal was not good just now.

Investigator: Yeah, yeah, my Wi-Fi got disconnected just now, suddenly got disconnected. I was still talking to you, and didn’t know it was disconnected. Then I thought why there was no sound?

Doctor Pu: ... The signal was not good, so I hanged up...So you can send your information [to me] on WeChat, and then we can contact again.

Investigator: Right, right, right. That is, your hospital is very… [Organ transplants are] normal [operations]?

Doctor Pu: We are doing OK now, about 50 or 60 cases a year. For Hepatitis C, there is an anti-Hepatitis medicine, and the treatment’s effect is alright. There are imported, domestic and jointly produced [drugs], and they are all OK. You can use them first. That drug has no side effects.

Investigator: That is to say.... If he wants to do it, I’ll have to discuss with him when I go back. If we go to your hospital, how long does he have to wait before doing [the surgery]?

Doctor Pu: Uh, generally, about a month or so.

Investigator: A month or so, right?

Doctor Pu: A month or so, yeah, yeah, yeah.

Investigator: Guangzhou Military Region General Hospital…You see, now there are so many [hospitals] in Guangzhou doing it. Does your hospital do a lot and well?

Doctor Pu: There are now temporarily four hospitals in Guangzhou [doing it]. We are one of them. Our General Hospital, two hospitals affiliated with Sun Yat-sen University, and in Zhongshan, China Southern Airlines Hospital, a total of four hospitals.

Investigator: Oh, four hospitals, and this is one of them.

Doctor Pu: Correct.... Later on there may be more...These four hospitals have done more.

Investigator: If we give them more money, can we still use the kind [of organs], uh, we used previously, that is, uh, the kind of [organs from] death-row-inmates or [Falun] Gong practitioners?

Doctor Pu: Now we don’t have them. They have been abolished a long time ago, no.

Investigator: Can’t do it? Then, if we give more [money] ---

Doctor Pu: Now this has been abolished by the state policy...

Investigator: Oh more money still won’t do, right?

Doctor Pu: It was legal before, now it is not illegal, but now it has been forbidden by the government.

Investigator: It is illegal now, it was legal before, but now illegal?

Doctor Pu: ... It does not work when the state says no. It is not an issue of legality.

Investigator: But you see, I find this so strange. If you say that if we have so many hospitals doing it, how can there be so many donors, and they don’t have this kind of [organs]…?

Doctor Pu: there is a lack, lack of donors. The donors are certainly in shortage.

Investigator: Oh ~

Doctor Pu: .... Just send your information over. When necessary, if you really need to do the transplant, I will contact you again for registration.

Investigator: …okay, I will talk to my nephew about this...

Doctor Pu: .... Then you send the information over first, OK?

……

Addendum 57

Doctor Zhao Jiqiang for liver transplant operations at Guangzhou Military Region General Hospital

Phone number: +18002262868

Date: 03/10/2017

Key points:

1. “[In terms of liver transplantation,] the Guangzhou Military Region General Hospital is also one of the top three organ transplant centers in southern China, its rank is also relatively high.”
2. “[The death-row prisoner donors] have all been abolished, no more. There are still a lot [of liver transplants], in comparison with the previous situation.”

Phone Investigation Recording:

……

Investigator: Hello?

Zhao Jiqiang: Hello, Hello!

Investigator: Is this Doctor Zhao Jiqiang at Guangzhou Military Region General Hospital?

Zhao Jiqiang: Yes, hello!

Investigator: I have a relative, who wants to come to your hospital to do liver transplantation, do you still do it now?

Zhao Jiqiang: Yeah, yeah, we still do it!

Investigator: [You still] do it? That is, my relative lives in Hong Kong. I came to Hong Kong to see him... Then I called a hospital, and they said their donors were very few, so we would need to wait very long to do it. Later, he said, “You go to the Guangzhou Military Region General Hospital to ask.” So I’m calling you now. That is, if we come over, is the wait time long?

Zhao Jiqiang: It depends on the diagnosis.

Investigator: Do we do a lot in this hospital? Like liver transplants?

Zhao Jiqiang: Ah, it’s all right, all right, yes.

Investigator: How many can we do in a year, compared to other hospitals? How many liver [transplants] can we do in a year?

Zhao Jiqiang: Ah~ the Guangzhou Military Region General Hospital is also one of the top three organ transplant centers in southern China, its rank is also relatively high.

Investigator: How about comparing to the First Affiliated Hospital of Sun Yat-sen University? Do we do more than them?

Zhao Jiqiang: Ah ~ they do a little more than us.

Investigator: So your hospital can’t even do 100 or 200 cases a year?

Zhao Jiqiang: Oh ~ no, a little bit less than the First Affiliated Hospital of Sun Yat-sen University.

Investigator: How much less could it be? Anyway, I still trust you.

Zhao Jiqiang: The number of cases is not very important. Let me tell you, if you want to do organ transplantation here, you still have a very good chance!

Investigator: In addition, they also told me of such a situation, that is, we also know that people used organs of death-row prisoners previously. They said that those are relatively healthy.

Zhao Jiqiang: Impossible, no, impossible [to obtain]. [Investigator: That kind used before ...] No more in mainland China. They’ve all been abolished, no more.

Investigator: Is it because this cancellation, that we do relatively less [cases] now? There are less donors?

Zhao Jiqiang: It isn’t because this part, that there are less. There are still a lot, in comparison with the previous situation.

Investigator: Do you do the operations in person?

Zhao Jiqiang: Of course, I do them in person!

Investigator: Oh, good, good, shall I find you when I come?

Zhao Jiqiang: Yes, please come to me, OK, no problem.

……

Addendum 58

Nurse on Duty in the Nurse’s Station of the First Ward of the Liver Transplant Department at the First Affiliated Hospital of Sun Yat-sen University in Guangzhou

Phone number: +86 20_28823388

Date: 02/02/2017

Key points:

1. Deputy President He Xiaoshun does liver transplantation.
2. “It should be more than 100, around 200 [cases of liver transplantation done in 2016].”
3. “For some people, the longest [wait times] were two or three months. For some people, with the shortest [wait times], it could be done in a few days or a week, after they came into the hospital.”

Phone Investigation Recording:

……

Automated Voice: The First Affiliated Hospital of Sun Yat-sen University, please dial the extension number. For directory, please press zero.

Nurse: Hello, hello, liver transplant division.

Investigator: Hi, hello, Happy Chinese New Year! This is the liver transplant division of the First Affiliated Hospital of Sun Yat-sen University, right?

Nurse: Yeah, yeah.

Investigator: Oh, that…I am a family member of a patient. My family member wants to do a liver transplant, as he is in the advanced stage of liver cirrhosis. Can we do it here?

Nurse: Oh, where are you from? Where?

Investigator: Oh, I am in Hong Kong right now.

Nurse: Oh, Hong Kong.

Investigator: So you are still doing it, right? I mainly have to learn about the situation first, so you are still doing it. Do we do a lot, just like they say?

Nurse: Oh, yes, right. I am now still, still dealing with a patient, who’s also from Hong Kong, for re-examination. So, how about this? Since I am a nurse, I don’t know the specific situation.

Investigator: Which professor is doing the liver transplants?
Nurse: You can call the deputy president, President He... President He, He, He, He.

Investigator: Oh, President He. Is he He Xiaoshun?
Nurse: Yes, right, right, you call him, OK?

Investigator: OK, I just would like to ask, that is, last year, how many cases of liver transplantation did you do in 2016? Were there a lot?

Nurse: More than 100, more than 100. It should be more than 100, around 200, it should be.

Investigator: Oh, that is, I have friends, who have done it here before, but he waited for a very short period time. After they came, within about a week, several days, he had his surgery. Do you now still ~

Nurse: This is based on, not like this… The assessment is based on the various aspects of your situation. So some people can do it early, some later.

Investigator: For the wait time, can we have the surgery done soon after we come? Are there any cases like this?

Nurse: It depends, it depends on all aspects of your situation, all factors. Yes, some are long, some short. For some people, the longest [wait times] were two or three months. For some people, with the shortest [wait times], it could be done in a few days or a week, after they came into the hospital. So it depends.         

Investigator: So, it depends on your blood type.

Nurse: Yes.

Addendum 59

A Ward of the Kidney Transplant Department at the Third Affiliated Hospital of Sun Yat-sen University in Guangzhou

Phone number: +86-76089880660

Date: 03/15/2017

Key points:

The hospital has always been performing kidney transplants. They have done more than 10 cases in 2017, and about 80 cases in 2016. The ward for kidney transplantation is on the ninth floor of the outpatient services building. And the department has opened a special place to do transplants there.

—— —— —— —— ——

1. “We do an average of 80 cases [of kidney transplantation] per year.
2. “We have always been doing them, even during the Chinese New Year period.”
3. “If you want to do the transplant, we will definitely give you a bed in a higher priority.”
4. “We have opened a new place to do kidney transplants…in another building. It’s a special place to do transplants. It’s like a small hotel, [with all single rooms].”

Phone Investigation Recording:

Investigator: Hello, is this the Third Affiliated Hospital of Sun Yat-sen University?

Nurse: Hello, how do you do!

Investigator: Hi, hello, hello, is this the kidney transplant division?

Nurse: Yes.

Investigator: I’m calling from Hong Kong. So can your hospital still do kidney transplants? I have a nephew, who wants to do kidney transplantation. If you can do it, then I’ll be able to come over.

Nurse: Yes, we can, we have some [cases] in progress right now.

Investigator: You do them. So have you done a lot already this year?

Nurse: We have done about 80 or 90 cases. In fact, we do about 80 or 90 cases every year. We’ve done about 70 or 80, 80 [cases] or so [each year].

Investigator: Have we begun doing them this year?

Nurse: We have always been doing them, even during the Chinese New Year period.

Investigator: After the Chinese New Year, have we done about a dozen cases, about 10 or 20 cases?

Nurse: More than a dozen cases after Chinese New Year, I guess.

Investigator: Oh, I see, do you know if Director Zheng Decheng still does it in person right now?

Nurse: Yes, yes, he is our director.

Investigator: There is also a doctor called Jiang Nan. Is he still doing it or not? He’s not called Jiang Nan, but Sun Qiquan. Is he also doing kidney transplants?

Nurse: No, he isn’t. He is now working at the Department of Nephrology.

Investigator: He got transferred?

Nurse: Now, it is mainly Director Zheng, Director Zheng and other doctors.

Investigator: Just this one team?

Nurse: Yes, now we only have one team here.

Investigator: Oh, so your hospital has done relatively a lot. You did more than 80 cases last year?

Nurse: An average of 80 cases per year.

Investigator: Good, good. How many beds do you have in this ward?

Nurse: Our ward? You can rest assured. If you want to do the transplant, we will definitely give you a bed in a higher priority.

Investigator: OK, OK, so, thank you, I will try to come over and have a look as soon as possible, thank you, well, goodbye.

Nurse: We are here on the 9th floor of the emergency department’s building.

Investigator: Which floor? Could you repeat it?

Nurse: It is on the 9th floor of our outpatient services building.

Investigator: Oh, 9th floor, on this floor. The entire floor is for kidney transplantation, right?

Nurse: No, we have opened a new place to do kidney transplants, but we are still receiving patients here first. And then if there is a surgery, it is done in another building, a special place to do transplants.

Investigator: Oh, that is, after a patient is accepted on the 9th floor, he would then go to another new, newly built… [Nurse: place] to be hospitalized. Is it not in this hospital?

Nurse: It is in our hospital, we have the same headquarters.

Investigator: You said another place, you said it’s not in this hospital?

Nurse: It is in our hospital, but that place is more suitable for kidney transplant patients to stay. That is, one person in each room. In our regular wards, there are three patients living in one room.

Investigator: Oh, this is the case. That’s good. Is it far from your building?

Nurse: No, not far. We all have doctors on duty. We are in the same hospital.

Investigator: Oh, not far away. So it is in one hospital, but just in a separate area?

Nurse Yes, it is, just in another building.

Investigator: Then there is one room for each person. That’s great. The rooms are definitely big, right?

Nurse: Yes, it’s like a small hotel. You can even cook there. There are all kinds of facilities.

Investigator: Great. On one floor, all rooms are like this?

Nurse: First, there are not a lot of kidney transplant patients, so we still have a few ward beds to use, but they should be enough, [because] not a lot of people want to do it…

Investigator: Great, thank you, nurse, goodbye.

Nurse: You are welcome.

Addendum 60

A Nurse in the Nurses’ Office for kidney transplantation at the First Affiliated Hospital of Jinan University

Phone number: +86 + 20_38688524

Key points:

1. The hospital has two operators here, Chen Jie and another surgeon.
2. The hospital performs around 100 cases of kidney transplantation a year.
3. The nurse is not clear about their kidney sources.

Phone Investigation Recording:

……

Person on Duty: Hello, how do you do?

Investigator: Hey, hello. [Person on Duty: Hello, how do you do?] Is this the affiliated hospital of Jinan University? Well, I would like to ask, if you do kidney transplants here?

Person on Duty: Yes, we can.

Investigator: That, that, is that Professor Chen Jie still in your hospital?

Person on Duty: Yes, right.

Investigator: Oh, is he the operator?

Person on Duty: Uh, we have two transplant surgeons here, him and another one.

Investigator: Oh, that is to say, like your hospital, how many kidney transplants did you do last year? A lot?

Person on Duty: Yes, a lot.

Investigator: Oh, your hospital did a lot in the past. I know that. So the kidney sources are not as many as before, right?

Person on Duty: Right, right.

Investigator: So for those [organs] from the prisons in the past, can we still use them?

Person on Duty: Isn’t this forbidden by the government policy? We cannot use them anymore? Hasn’t this been forbidden since year 201(*)?

Investigator: So without the use [of this type of organs], the patients have become less, right?

Person on Duty: Yeah, less.

Investigator: Oh, so you cannot do more than 100 kidney transplants a year? It should be around that number, right?

Person on Duty: Well, almost.

Investigator: Yes, that’s fine. It is because in Guangzhou, a lot of hospitals can do it, because I know a patient, who has done surgery here, so he told me to inquire about your hospital. So, so this is the situation. Uh, how long will it take to be discharged like this?

Person on Duty: If he recovers well, he can be discharged three months after the surgery.

Investigator: Oh, three months. Oh, to stay for three months before being discharged. That long?

Person on Duty: Is it long?

Investigator: Oh, it is a long time. In some hospitals, patients stay for only two weeks, but they have to stay here for three months. Then you must be short of ward beds, because they stay for so long.

Person on Duty: Well, [we require a patient to stay for] a long time, because we’re afraid that his lung functions haven’t recovered at the time of discharge, so he would be susceptible to pneumonia or pulmonary infection. So we generally wait until his condition stabilizes, then we discharge him after his condition has stabilized.

Investigator: Oh, I see. So your hospital is really responsible. I see that some of the hospitals discharge patients two weeks after their surgeries, and some even ~

Person on Duty: Yes, some are very fast. We don’t allow them to be discharged so soon, because his condition has not become stable yet. He is susceptible to lung infection, which is very serious, and then he would come back, and that would also become very serious, so we need to send him to the ICU. It’s true ~

Investigator: Oh, you are afraid that his condition is not stable?

Person on Duty: We are afraid that his exclusion reactions are very severe.

Investigator: Correct.

Person on Duty: Well, so it has to be stabilized.

Investigator: In general, how long will the exclusion reactions last? When are they the most severe, after the surgery?

Person on Duty: It depends on the acuteness or chronicity. Sometimes if it is acute, then he immediately can, can, can [become dead]…

Investigator: Oh, how about the chronic ones? Sometimes it takes a long time to have this kind [of reactions] to emerge…

Person on Duty: Then it would go slowly. For the acute cases, [the reactions would take place] all of a sudden, then the patient may not live.

Investigator: Oh, like this, can we guarantee the livers to be healthy? You cannot use people from the prisons, those are very healthy, in general, like this, um, what are you using now? All donated organs, or something else?

Person on Duty: Donated.       

Investigator: Donated. Are there so many donations? That is, is it ~

Person on Duty: I am not very clear about it, for these physical aspects, only the doctors know about them. We just carry out their orders, but for them… I, we aren’t clear about it.

Investigator: Oh ~

Addendum 61

Head nurse Nie Menghua in the Third Ward of kidney transplantation at the Second Xiangya Hospital of Central South University, Hunan Province

Phone number: 073185296141

Date: 04/18/2017

Key points:

1. “We may indeed have shorter wait times here than those of other places.”
2. “Last year we did 300 or 400 cases [of kidney transplantation].”

Phone Investigation Recording:

……

Nurse: Hello, kidney transplant special ward.

Investigator: Hi, hello, can you hear me?

Nurse: Hello?

Investigator: Hi, hello!

Nurse: Hello!

Investigator: Hello, I’m calling from another place. Does Tan Liang still work here?

Nurse: Tan Liang, he, he is not here. He is the coordinator of our division.

Investigator: Oh, he usually is not in the ward?

Nurse: No, he usually is not here.

Investigator: Oh, do you have his phone number? I just want to ask him, if he can help coordinate a surgery in your hospital.

Nurse: Then can you talk to our head nurse?

Head Nurse Nie: Hi, hello, who is that? Hello!

Investigator: Head nurse, are you the head nurse surnamed Nie?

Head Nurse Nie: Yes, yes, who is that?

Investigator: This is from Sichuan, Yunyang in Sichuan...

Head Nurse Nie: Who is that? Hello!

Investigator: Ah, Sichuan, Yunyang in Sichuan, uh, why I’m calling you is that a fellow townsman of mine has done surgery in your hospital, and he said that you might have relatively short wait times here.

Head Nurse Nie: You now have a patient, who wants to do a transplant, right?

Investigator: Yes.

Head Nurse Nie: Am I right?

Investigator: Yes, right.

Head Nurse Nie: And then, then, has the patient’s information been registered with Teacher Jiang?

Investigator: No, we have not come over yet, have not come over yet.

Head Nurse Nie: It is like this. Wherever you are, whatever diagnoses you have done, you first come to register with Teacher Jiang. We may indeed have shorter wait times here than those of other places, because we, we may, because last year we did 3...3…300 or 400 cases.

Investigator: He only remembers Doctor Tan, and he told me to go to find him. And then just now that young lady said that Doctor Tan is not here, Tan Liang.

Head Nurse Nie: Tan Liang is here, but Tan Liang is not in the ward.

Investigator: Oh, then I will ask you, because our fellow villager also mentioned you, and Tan Liang.

Head Nurse Nie: It will be OK, OK, you can go to ... Let me tell you, after you come here, come to the urinary organ transplant [department], tell the people in the third ward of kidney transplantation to look for me. I will then take you to Teacher Jiang, okay?

Investigator: Oh, okay, good, good.

Head Nurse Nie: Uh, good, good.

Investigator: Okay, okay, okay, that’s all right. Great.

Addendum 62

Doctor Liu in the liver transplantation ward at the Third Xiangya Hospital of Central South University, Hunan Province

Phone number: 073188618236

Date: 04/17/2017

Key points:

1. “We do a lot of liver transplants. We’ve already done a total of over 1,000 cases of liver transplantation.”
2. “We did kidney transplants last year, more than 200 cases. The liver transplants were slightly less than the kidney transplants, but we still did 80 or 90 cases [last year]!

Phone Investigation Recording:

Investigator: Hi, doctor, how are you?

Doctor Liu: Hello?

Investigator: This is the Third Xiangya Hospital, isn’t it?

Doctor Liu: Yes.

Investigator: So, if patients from other hospitals come to your hospital to do liver transplant registration, to get into the queue, will it be OK? Can you do it?

Doctor Liu: Yes, it’s OK.

Investigator: Oh, your hospital doesn’t do a lot [of liver transplants] now, doesn't it?

Doctor Liu: We do a lot of liver transplants.

Investigator: You do a lot of liver transplants?

Doctor Liu: Yes, yes, anyway, we’ve already done a total of over 1,000 cases of liver transplantation. We do kidney transplantation, we did kidney transplants last year, more than 200 cases. The liver transplants were slightly less than the kidney transplants, but we still did 80 or 90 cases [last year]!

Investigator: Oh, you did 80 or 90 cases of liver transplantation. It sounds better than those in Jiangxi Province.

Doctor Liu: Yes.

Investigator: Well, doctor, may I know your last name?

Doctor Liu: My last name is Liu.

Investigator: Oh, Doctor Liu. Oh, that’s OK, we’ll see.

Doctor Liu: OK, OK.

Investigator: Oh, good, goodbye!

Addendum 63

A nurse in the kidney transplant ward at Yiyang Central Hospital in Yiyang City, Hunan Province

Phone number: +86-737 4230527

Date: 01/10/2017

Key points:

1. “As long as you do the surgery, we can arrange [a bed for you].”
2. “We did more than 100 cases [in 2016].”

Phone Investigation Recording:

……

Investigator: [Nurse: Hello.] Hi, how do you do? Is this Yiyang Central Hospital in Hunan Province? I have a family member, who is suffering from renal failure, and he has been doing dialysis for over a year now. Can we still do a kidney transplant here, now?

Nurse: Yeah, where are you from?

Investigator: Pardon?

Nurse: Where are you from?

Investigator: Oh, I am in Henan Province. I called the Third Xiangya Hospital. However, they had too many patients. He said, “You can also go somewhere else, lower-level hospitals might...”

Nurse: Oh, Henan Province, right?

Investigator: Yes, I originally called the Third Xiangya Hospital. A doctor told me, “You could go to Yiyang Central Hospital. They are very good at it, and their wait time may be short.” Because I am in a great hurry and want to do it very soon.

Nurse: Oh, then I’ll give you the phone number of Director Xiong. You can contact him yourself, OK? [Investigator: OK, please.] 135…

Investigator: Whose phone number is this? Which person did you say?

Nurse: Director Xiong, Director Xiong.

Investigator: Which Xiong?

Nurse: Xiong, like a panda.

Investigator: Oh, Director Xiong. Oh, OK. What is it?

Nurse: 135 7471 2884.

Investigator: This is Director Xiong’s, right?

Nurse: Yes, Xiong like a panda. You just consult with him, OK?

Investigator: Uh, nurse, I want to ask you if you are short of beds now.

Nurse: Ah, beds, anyway, as long as you come to our hospital, as long as you do the surgery, we can arrange it.

Investigator: Say, for kidney transplants, is this the only room? Do we only have one kidney transplant room?

Nurse: A ward, not a room.

Investigator: Oh, oh, a ward, only one ward?

Nurse: Yes.

Investigator: Don’t we have hundreds of beds in this ward?

Nurse: Not that big, that is impossible.

Investigator: How many beds do we have in this ward?

Nurse: There are 20 or 30 beds.

Investigator: 30?

Nurse: That’s quite a lot, yes.

Investigator: Are there 30 beds?

Nurse: There are about 20 or 30 beds, uh, that’s all.

Investigator: Oh, I see, so, so [the beds] must be a little bit in short supply. Then it means you do…Did you do a lot in 2016?

Nurse: We did more than 100 cases, right. [Investigator: Ah, more than 100.] Yes, you consult with director Xiong for details, all right?

Investigator: Then for the hospital stay, for example, with this illness, how long should the patient stay here before being discharged in general?

Nurse: Generally, about 15 days.

Investigator: Oh, oh, I see. 

Nurse: OK.

Investigator: You said you did more than 100 cases in 2016, right?

Nurse: Yes, you can ask for details later, you consult with Director Xiong, OK?

Investigator: Good, good, good, thank you!

Nurse: Okay, bye!

Addendum 64

Doctor Mao in the Liver Transplantation Team of the Organ Transplant Department at Tongji Hospital in Wuhan

Phone number: +862783665363

Date: 06/07/2017

Key points:

1. “Last year, we did over 100 cases [of liver transplantation].”
2. “[The donor organ wait time] is probably about a month or so.”
3. “Specifically, about the other aspects [of the donors], we do not know. This information is also confidential.”
4. The hospitals organ transplant division mainly conducts liver transplantation and kidney transplantation operations.
5. Last year, the hospital did 400 or 500 kidney transplants.

Phone Investigation Recording:

Doctor Mao: Hello!

Investigator: Hi, how are you, is this Tongji Hospital?

Doctor Mao: Yes, go ahead.

Investigator: Ah, I would like to ask, that is, uh, I am also working for a hospital. That your, that is, the liver transplantation in Tongji Hospital, is it better than others? We have a patient, and he is now also looking for a hospital, which could do it better. And I want to refer him there. For liver transplants, do you still accept patients?

Doctor Mao: Yes, we do.

Investigator: Oh, then if we go, how long is the wait time? For example, the patient needs to consider the costs.

Doctor Mao: In general, it will not be long.

Investigator: Ah, in general, how long?

Doctor Mao: Probably about a month or so.

Investigator: Do you do a lot? That is, you ~

Doctor Mao: We do a lot!

Investigator: How many did you do last year?

Doctor Mao: Last year, we did over 100 cases.

Investigator: Over 100 cases, these, basically, ah, all, uh, [used] the kind of donors provided by the justice department?

Doctor Mao: No, the kind from donation.

Investigator: But you don’t know about the quality of the donated organs.

Doctor Mao: Quality, ah, we use only qualified ones for you. Specifically, about the other aspects, we do not, we do not know. This information is also confidential.

Investigator: Oh, this is not the transplant division. Is this the hepatobiliary surgery division, or organ transplant division?

Doctor Mao: The organ transplant division.

Investigator: Do you just do liver transplantation? Or do you do all types of organ transplantation?

Doctor Mao: Liver transplantation, kidney transplantation, we do both.

Investigator: Are these two in ~

Doctor Mao: These two are the main ones, we do a lot, basically. Others are few, like pancreas transplants, which are relatively few in number.

Investigator: Only one ward for liver and kidney transplant [patients]?

Doctor Mao: Correct.

Investigator: Then you said last year, you did over 100 cases of liver transplantation, then how about kidney transplants, how many did you do?

Doctor Mao: 400 or 500 cases.

Investigator: Oh, in comparison [with other hospitals], you do a lot.

Doctor Mao: For renal transplantation, we rank first in the country, in terms of the volume.

Investigator: Oh, first in the country, then you, then you may do ~

Doctor Mao: Our liver transplantation is among the top ones in the country, anyway, it seems to be among the top three, in terms of the volume.

Investigator: Well, then these [organs] were all donated, you said, the kind [of organs] from the judicial channels, can you still find any? Aren’t those of good quality? That kind from the judicial channels.

Doctor Mao: Judicial channels, that is, the kind [of organs] from death-row prisoners?

Investigator: Yes.

Doctor Mao: Now, now, now, how can there be any death penalties? Now all…no, basically very few, basically I ~

Investigator: They are not, not the death-row inmates. For example, a few years ago…we were, were all working for hospitals…there were many that type [of organs]. [The donors] were not necessarily executed prisoners. They were those being imprisoned, for example, in the forced labor camps, prisons and detention centers…those were imprisoned. And also this kind [of organs]. Can you still use this kind [of organs] to do surgeries? That kind of [organs from] [Falun] Gong practitioners, didn’t we do this previously?

Doctor Mao: Well, now they’re basically gone.

Investigator: Oh, didn’t we do it before? I saw a lot of hospitals were all…

Doctor Mao: What’s past is past. Now, now, it is not the same.

Doctor Mao: You look for, you should look for Professor Wei. Their team’s liver transplants are relatively… OK? They do it better.

Investigator: You say Wei, Director Wei? Wei, is it right?

Doctor Mao: Ah, yes.

Investigator: Wei, Wei what? Could you tell me his name?

Doctor Mao: Wei Lai.

Investigator: Wei Lai, right?

Doctor Mao: Yes, yes, yes.

Investigator: Oh, oh. You just said that you did over 100 cases. Were those done by them or you? Or together?

Doctor Mao: By our entire division, our entire division.

Investigator: Your entire division, oh, oh, I see. Okay, good. Uh, uh.

Doctor Mao: Yes, yes. Okay.

Investigator: Ah. Thank you so much.

Addendum 65

The Person in charge of the registrar at the Tongji Hospital Transplantation Institute in Wuhan (A)

Phone number: +86 + 2783665283

Date: 06/13/2017

Key points:

1. “We’ve ranked first nationwide, in terms of the kidney transplant volume, in the recent two years.”
2. “In the past few years, it was about 400 cases [per year].”

Phone Investigation Recording:

……

Investigator: Hello, hello, hello! Is this….

Doctor: Hi!

Investigator: Hi, is this a doctor in Tongji Hospital?

Doctor: Whom do you want to speak to?

Investigator: Hi, I would like to ask, I am the family member of a patient! I would like to ask if you ~

Doctor: What’s up?

Investigator: Can you do kidney transplants?

Doctor: Yes, we can. You can register at the outpatient service and be put into the queue.

Investigator: Do we do a lot here?

Doctor: Yes, a lot. We’ve ranked first nationwide, in terms of the kidney transplant volume, in the recent two years.

Investigator: Oh, then how many have you done this year? This year, 2017?

Doctor: Oh, this, I cannot tell you the figure. You have to ask the professionals, you can ask the professionals, Okay?

Investigator: Oh, it is about, doctor, about how many you can do in one year? You say that so many people are queuing right now. About how many [operations] can you do in one year?

Doctor: In the past few years, it was about 400 cases [per year].

Investigator: Oh, 400 cases, now, do we do more than before?

Doctor: I cannot give you a definite answer.

Investigator: You say ~

Doctor: All right!

Investigator: You, you just said that 400 cases last year, right?

Doctor: It was this number last year and the year before last year.

Addendum 66

The Person in charge of the registrar at the Tongji Hospital Transplantation Institute in Wuhan (B)

Phone number: +86 + 2783665283

Date: 06/13/2017

Key points:

1. “We do liver transplants, approximately over 100 cases a year.”
2. A kidney transplant costs 400,000 yuan, and liver transplant costs 600,000 yuan.

Phone Investigation Recording:

……

Doctor: Hello?

Investigator: Hello!

Doctor: Ah! Your signal was not good, very noisy! What is it? What did you want to say?

Investigator: Oh, I mean, I just called you. It was not me, who asked you about the kidney transplants. I have a friend, who told me to ask you that if you do liver transplants in the hospital.

Doctor: Yes, we do!

Investigator: So Tongji Hospital does both liver transplants and kidney transplants, doesn’t it?

Doctor: Correct!

Investigator: Oh, so I forgot to ask, he told me to ask, but I forgot, that ~

Doctor: Do you want to do liver and kidney [transplants]?

Investigator: Ah, ah, you also do liver transplants here?

Doctor: Yes, yes, yes. Right.

Investigator: Do you also do a lot of liver transplants?

Doctor: Yes, we do liver transplants, approximately over 100 cases a year.

Investigator: So, not as many as kidney transplants?

Doctor: Oh? Correct!

Investigator: I’ll go back and tell him! Because my friend in Hong Kong said to me, “When you make the call, please also ask if they do liver transplants”. That is, you do more than 100 liver transplants every year ~.

Doctor: For Hong Kong, overseas [patients], they also need to report to the Department of Health, where the procedures are very complex, a little complicated, right.

Investigator: Good, good. I would like to ask, because I forgot to ask you just now, the kidney transplant price, how much?

Doctor: Kidney transplant price?

Investigator: Yes.

Doctor: Price, regularly hundreds of thousands yuan? Maybe, 400,000 [yuan]. 

Investigator: Oh, how about liver [transplants]? How much is a liver [transplant]?

Doctor: About 600,000 [yuan] for a liver [transplant].

Investigator: Oh, okay. I see. You told me the information, so we can get prepared. Hey, well, thank you!

Doctor: [The same price] during all the surgery periods, almost [the same], hello ~ ~ ~, your signal is not good, hello ~ ~, OK!

Addendum 67

Doctor Zhang for Liver Transplantation at Zhongnan Hospital of Wuhan University

Phone number: 18942924741

Date: 09/12/2016

Key points:

1. The donor organ wait time is usually a month.
2. Every year, the hospital does more than 100 cases of liver transplantation.

Phone Investigation Recording:

Investigator: Hello? Hello! Is this Doctor Zhang at Zhongnan Hospital?

Doctor Zhang: Yes?

Investigator: Oh, I have a friend, who wants to do a liver transplant. Can you do liver transplantation in this hospital?

Doctor Zhang: Yes.

Investigator: Oh, you can. Oh, then how long does he have to wait after coming here, about how long?

Doctor Zhang: He’ll need to wait for one month.

Investigator: Can he have the surgery done in one month?

Doctor Zhang: Yes. We should be able to perform it. Should be very quick.

Investigator: That is, in general, the patients wait for a month to do it?

Doctor Zhang: Right.

Investigator: Oh. Have we done a lot of liver transplants this year?

Doctor Zhang: Well…for liver transplants, there seems to have been several dozen [cases] already.

Investigator: You said, in this year, you’ve done…

Doctor Zhang: The situation is different every year…

Investigator: Oh, you said you could do approximately over 100 cases a year?

Doctor Zhang: Almost, should be.

……

Addendum 68

A kidney transplantation doctor in the Organ Transplantation Division of Renmin Hospital of Wuhan University

Phone number: +86 2788041919

Date: 04/16/2017

Key points:

1. “We did more than 100 cases [of kidney transplantation] last year!”
2. The hospital has done at least 30 or 40 cases, which would the doctor’s lowest estimate. He said, “[It should be] more than that. We even did two cases today.” 

Phone Investigation Recording:

Doctor: Hello, how do you do? Organ transplant division.

Investigator: Hi, Hello. I would like to ask about the queuing for kidney transplants in your hospital. If the patient is from another hospital, how can he contact you? Which doctor or which division?

Doctor: From another hospital, right? It is like this, you have to come to our ward to get registered first before getting into the queue.

Investigator: Well, well…our director said that we do not have to go through the outpatient service, that we can just come to see a doctor or director of your ward, and then transfer [the patient] to your hospital. The patient may have to do some diagnoses, and stay in your hospital for two days, is that right?

Doctor: Yeah, but you still have to go to the outpatient service to see the director first, because [although] you can come to the ward, there is only the doctors on duty in the ward, do you understand? The doctors in different divisions are not here, do you understand? In fact, they may be in the wards, performing a surgery or something. If you come, you must go to the director to take a look at your situation, which would certainly be better, right?

Investigator: Oh. Well, did you do any this year?

Doctor: We did a lot, in January and February. We did about a dozen or 20 cases in one month.

Investigator: You did about a dozen or 20 cases in a month?

Doctor: We did less in these two months, but relatively speaking, each hospital would have relatively less [operations] during this period. We even did two cases today. 

Investigator: Uh, uh, that is, you may have done 30 or 40 cases this year, right?

Doctor: At least 30 or 40 cases, that’s the least. It should be more, right?

Investigator: More than that? Well, our local doctor, who had referred patients to you before, said that you did about 80 cases last year, didn’t you?

Doctor: We did more than 100 cases last year!

Investigator: Oh, you did 30 or 40 cases in only two or three months this year, so it is certainly more than last year, right?

Doctor: I do not know about this. Anyway, if you have to do it, you can come on Tuesday or Wednesday morning for Director Zhou’s outpatient consultation. You can register with him, OK?

Investigator: So he is mainly doing [the transplants], right?

Doctor: He, it is definitely him doing it. For the specific situation, you still have to ask him to take a look, right?

Investigator: I see, I see, good, good. That’s all for now. At that time, I… uh.

Doctor: OK.

Investigator: Okay, bye!

Addendum 69

Doctor Chen in the Kidney Transplantation Division of Renmin Hospital of Wuhan University

Phone number: 88041919--81848

Date: 04/26/2017

Key points:

1.  “Our hospital did 130 cases [of kidney transplants] last year.”
2. “Up to April this year, we have done more than 60 cases.”

Phone Investigation Recording:

Doctor Chen: Hello!

Investigator: Hi, hello, may I ask if this is the kidney transplant division?

Doctor Chen: Yes, what’s up?

Investigator: Well, I have a family member, I have a child in need of kidney transplantation. Can you do it here?

Doctor Chen: Yes, we can!

Investigator: You can, can do it. We have to queue up, how long should we wait?

Doctor Chen: This is hard to say. Generally, here is relatively…as for the wait time, a little bit faster than other hospitals.

Investigator: Oh, that, so, so I’ll just come. Others say so, too. Well, his blood type is B. Would you say that it will be fast? Can you give me an approximate timeline? Or...

Doctor Chen: I cannot give you a specific time.

Investigator: Oh, say...

Doctor Chen: Three to six months.

Investigator: Three to six months, oh, that is, we must first come here to queue up, right? [Doctor Chen: Yes.] We, now for the people currently in the queue...

Doctor Chen: Where are you from?

Investigator: I am from this city. [Doctor Chen: Oh, yes, yes.] Just say, like in this hospital, do you do a lot [of kidney transplants] in a year? This Renmin Hospital of Wuhan University…

Doctor Chen: Our hospital did 130 cases last year, and then up to April this year, we have done more than 60 cases.

Investigator: Then I will talk with my child at home, if that ...that he goes there himself to queue up, can he bring his materials for you to take a look first, or…?

Doctor Chen: So, let’s do it like this, you bring your materials here first. We will have a look at it, and see if it is enough, okay?

Investigator: Ah, thank you very much, then I will find you when I come, what is your last name?

Doctor Chen: My surname is Chen.

Investigator: Chen, oh, Doctor Chen, oh, okay, thank you so much!

Doctor Chen: Well, you’re welcome.

Investigator: Doctor Chen, let me I ask you…

……

Addendum 70

Doctor Chen Kai, Hospitalization Director for liver transplantation at Sichuan Provincial People’s Hospital

Phone number: +86 17708130503

Date: 03/29/2017

Key points:

1. “Only our hospital and West China Hospital are doing [liver transplantation].”
2. “This year, we might have already done more than 30 cases.”
3. “This donor information is confidential on a national level. We, we do not know about the donor’s information.”
4. “We have special personnel in charge of procuring donor [organs]. Even we organ transplant doctors do not know the specific information of these donors.
5. “[Organs] are distributed by the state’s specialized distribution system. You need to submit those materials to our hospital. There are people specifically responsible for uploading them to the network.”
6. [Investigator: I can see the donor’s information in advance?] Chen Kai: You cannot see it. No one can see the donor information by themselves… Only the official people can see it.

Phone Investigation Recording:

……

Investigator: Hello, how do you do? Is this Doctor Chen Kai at Sichuan Provincial People’s Hospital? ... Hi, hello, hello!

Chen Kai: Go ahead.

Investigator: Yes, I, I have a family member, who wants to do liver transplantation, that is, previously, there was a doctor called Zhu Shikai, I used to…, Since I am a doctor myself, I had contacted him before, but now I cannot get through his phone. I would like to ask for your provincial hospital, if we go there now, to do…, how long should we wait for the liver transplant?

Chen Kai: You should register at China’s Organ Distribution Network.

Investigator: That is to say, your hospital is still doing it, right? Liver transplantation?

Chen Kai: Yes, we do, we are doing it. We are doing liver transplantation!

Investigator: You are doing it, say, we, like in our hospital, do we do a lot [of liver transplants]? Now in this hospital? Because there are several hospitals in Sichuan doing it, [but] since they recommended your hospital to me first, so I’m calling you.

Chen Kai: In Sichuan Province, only two hospitals are doing it.

Investigator: Ah, what did you say?

Chen Kai: We only have two hospitals doing it in Sichuan Province.

Investigator: Oh, are you the only one?

Chen Kai: Only our hospital and West China Hospital are doing [liver transplantation].

Investigator: Oh, West China Hospital is doing it. Then you, in your hospital and West China Hospital, for example, in this hospital, how many [cases of] this kind of liver transplantation can you do in a year?

Chen Kai: We ... ranging from 50 to 100 cases.

Investigator: 50 to 100 cases. Oh, that is, in this year, you have already done some. This year?

Chen Kai: This year, we might have already done 30…more than 30 cases.

Investigator: Oh, wow, then in this year, you will do more than last year?

Chen Kai: Basically it depends on, depends on this, uh ...whether there are a lot of donors or not.

Investigator: Moreover, Doctor Chen, we, first the patient particularly wants to find a good donor liver source, like a healthy, young [donor]. Can you generally guarantee it?

Chen Kai: This donor information is confidential on a national level. We, we do not know about the donor’s information.

Investigator: You, even you do not know where the donors come from, either?

Chen Kai: Correct.

Investigator: Oh, so the donors are not in your hospital. They are all from other places?

Chen Kai: Regarding the donor procurement, we have special personnel in charge of procuring donor [organs]. We now, even we organ transplant doctors do not know the specific information of these donors. [Organs] are distributed by the state’s specialized distribution system...

Investigator: Oh, someone is specifically doing this. You are specifically performing surgeries, right?

Chen Kai: Yes, if you want to do it, you have to come to our hospital to register first. You have to register on China’s Organ Distribution Network. If you don’t register, then you will never have a chance...

Investigator: That China’s Organ Distribution Network, that network, what kind of network is it? Can you tell me?

Chen Kai: It is an official network set up by the state, specifically, well, in charge of organ distribution, organ distribution and registration.

Investigator: Oh, that is, I can see the donor’s information in advance? That is, to decide if we want it or not, right?

Chen Kai: You cannot see it, cannot see it. No one can see the donor information by themselves.

Investigator: Then didn’t you say...

Chen Kai: Only the official people can see it.

Investigator: Which website should my information be published?

Chen Kai: It’s not that you go to a website. You need to submit those materials to our hospital. There are people specifically responsible for uploading them to the network.

Investigator: Oh, oh, oh, I see, ah, I thought, I thought that I should go, go to that…, I see, OK, thank you, I will try to act as soon as possible, OK, thank you, goodbye.

Addendum 71

Doctor on Duty for Liver Transplantation at Sichuan Provincial People’s Hospital

Phone number: +862887393722

Date: 03/29/2017

Key points:

1. “Last year, it seems to be more than 60 cases [of liver transplantation]…A little bit more [cases] in the recent months in this year. For example, last Sunday we did one, today [Wednesday] we did another one.”
2. “Since we excised [some organs] last night, so we have both liver and kidney transplants today.”

Phone Investigation Recording:

Investigator: Oh, well, he said that there was a hospitalization director called Chen Kai. Doctor Chen is responsible for your hospitalization department, right?

Doctor: Now the hospitalization director is that, is Chen Yunfei, Chen Yunfei.

Investigator: Oh, changed to another one.

Doctor: Yes, yes, yes, he also went to do surgeries. They went to do kidney transplants.

Investigator: Wow, you have both liver and kidney transplants today.

Doctor: Ah, yes, since we excised [some organs] last night, so we have both liver and kidney transplants today.

Investigator: Oh, he is mainly…Doctor Chen is mainly working in the kidney transplant team, not the liver transplant team?

Doctor: He is, he is now the boss, so he can manage them both. You can talk to him, he, he, he should also be able to [do it].

Investigator: Hello, how many liver transplants did you do last year?

Doctor: Last year, it seems to be more than 60 cases, or several dozen cases, I am not quite sure.

Investigator: More than 60 cases. Oh, and then this year may…it seems that there is a little bit more [cases] in recent months, right?

Doctor: A little bit more [cases] in the recent months in this year... For example, last Sunday we did one, today [Wednesday] we did another one.

Investigator: Oh, that’s good, then I will contact Director Chen, Doctor Chen.

Doctor: Yes, you contact [him], well.

Investigator: Okay, okay, good, good, good, thank you, goodbye!

Doctor: All right!

Investigator: I’ll ask him and see. Let’s see, OK, goodbye.

Addendum 72

Doctor in the Doctors’ Office for Liver Transplantation at Sichuan Provincial People’s Hospital

Phone number: +862887393722

Date: 03/30/2017

Key points:

1. “We usually do three kidney transplants. That is, three pairs [i.e. six] of kidney transplantation operations.”
2. “[In terms of the wait time,] it is quite fast in general.”
3. This hospital does “several hundred operations” a year.

Phone Investigation Recording:

……

Investigator: Hey, hello, Sichuan Province People’s Hospital? I would like to ask, because I have a family member, who wants to do kidney transplantation. Do you do transplantation here?

Doctor: Yes.

Investigator: You can do kidney transplantation. Oh, that’s great, suppose we go to your hospital, will there be many people waiting in line now for kidney transplants?

Doctor: OK, you can come first, bring the [patient’s] medical examination results for us to have a look. And then we will evaluate them. After the evaluation, we can check the donor availability. What is your [family member’s] blood type?

Investigator: Type B.

Doctor: Ah?

Investigator: Type B, Blood Type B.

Doctor: Type B? We usually have relatively more donors of Type B blood. If you come, you have to get in the queue first to wait for your registration. Well, in general, this is relatively fast.

Investigator: In general, how long do we need to wait before the operation takes place?

Doctors: Sometimes we have organs. Well, it’s uncertain. Anyway, relatively, it is quite fast in general. We usually do three kidney transplants. That is, three pairs [i.e. six] of kidney transplantation operations.

Investigator: Oh, as we know, there is another hospital, West China Hospital, which is also doing [kidney transplantation]. My friends told me to also consult your hospital, since your hospital also does a lot of transplants. So how many kidney transplant operations can your hospital do every year?

Doctor: Several hundred operations. Bring your exam results to our outpatient clinic for checking. Let’s not talk much on the phone.

Investigator: Which doctor should I consult when going to the outpatient clinic?

Doctor: Director Yang.

Investigator: Ok, Director Yang, on which days of the week is he available in the outpatient clinic?

Doctor: Monday, Monday afternoons.

Investigator: Only Monday, every week only Monday, right?

Doctor: Yes, on other, other days, there are other doctors, that is, for our organ transplant, organ transplant center.

Investigator: There are this kind of organ [transplant department service] in the outpatient clinic, right? So we can get registered at the outpatient clinic for an appointment, right?

Doctor: Yes.

Addendum 73

A ward nurse on duty of the kidney transplant department at West China Hospital, Sichuan University

Phone number: +86 28-85422925

Key points:

1. The hospital did “300 or 400 cases [of kidney transplantation] last year.
2. “Now our departments are divided into very specific sections. We also do liver transplantation, heart transplantation, brain transplantation and kidney transplantation here.”
3. “Teacher Lin Tao or Teacher Wang Li. We have only two doctors performing such operations.” And each one of them is leading one team.

Phone Investigation Recording:

Nurse: Hello, hello.

Investigator: Hey, hello, is this West China Hospital in Sichuan?

Nurse: Yes.

Investigator: Oh, I have a family member, who wants to do kidney transplantation. Does your hospital do it?

Nurse: We can do kidney transplantation here.

Investigator: Ah, you can do kidney transplantation?

Nurse: Yes.

Investigator: That is, do you do a lot of kidney transplants here?

Nurse: I do not know, but we are doing many here.

Investigator: Your hospital does many transplants, right?

Nurse: What we are doing now are not so [many], but in fact, compared with other hospitals, we do relatively more.

Investigator: You have done a lot of transplants this year, right?

Nurse: We do a lot every day.

Investigator: Oh, a lot every day, then I assume if I go to wait in line, it must be promising and quick. Can you…

Nurse: There are also a lot of patients lining up every day.

Investigator: Oh, there are a lot of patients waiting in line. So like the kidney transplants, in one year, how many hundreds you can do in one year?

Nurse: Not sure right now.

Investigator: Approximately?

Nurse: Because the number is increasing every year.

Investigator: Uh, what did you say, [the number] is increasing?

Nurse: Is increasing every year.

Investigator: So the ward beds must be in short supply?

Nurse: In very short supply.

Investigator: In very short supply. You are saying that you don’t have many beds, right?

Nurse: We have too many patients queuing up.

Investigator: Too many, is there only this ward doing kidney transplants?

Nurse: Yes, there is only one ward doing kidney transplantation.

Investigator: Oh, you only do the kidney transplants here in your hospital, right?

Nurse: We do liver transplantation, as well. It’s that only our ward does kidney transplantation. Now our departments are divided into very specific sections. We also do liver transplantation, heart transplantation, brain transplantation and kidney transplantation here.

Investigator: Oh, so the liver transplantation and kidney transplantation are in the same section or in different ones?

Nurse: Not in the same section. Our department here does only kidney transplants.

Investigator: Not in the same section?

Nurse: Right.

Investigator: So, I’m thinking, nurse, would you please do me a favor? You know it’s not very easy to call long distance from so far away. Can you give me a rough idea of the number of cases you have done? So I would have an idea, to see which hospital does more, then I will decide to go to that hospital. You say that it’s increasing. One of my friends said last year that Doctor Lu Yiping once said, your hospital could do 300 [cases] in one year. So last year, it should be more than 300 [cases], since you said it’s increasing?

Nurse: Approximately 300 cases, around 300 or 400 cases.

Investigator: 3…You said this year, you did more than 30 transplants, right?

Nurse: 300 or 400 cases last year. I mean, for the entire year...

Investigator: Oh, last year, 300 or 400 cases, ah, OK. Which director should I talk with if I go to [your hospital] to do the transplantation, can you tell me?

Nurse: Teacher Lin Tao or Teacher Wang Li. We have only two doctors performing such operations.

Investigator: Oh, that is, there are two teams doing these kidney transplants.

Nurse: Yes.

Addendum 74

Doctor on duty of the liver transplant department at West China Hospital, Sichuan University

Phone number: +86 18980601479

Date: 06/06/2017

Key points:

1. There is someone in charge of finding organ donors in this hospital.
2. “The [functions of operating surgeries and finding donors] have always been separate.”
3. “There are some people specifically doing evaluations.”
4. “No one else knows the specific situation about the donors. They only announce to us the results regarding whether [the organs] can be used or not. The organ recipients’ family members are not allowed to know anything about the donors. And it’s the same for the donors’ family members, who are not allowed to know anything about the recipients.”
5. The hospital is doing a lot of liver transplants.
6. The doctor refused to disclose the numbers of liver transplants performed in 2016 and in 2017.
7. “The Red Cross helps play a coordinating role [in donor procurement].” It doesn’t play a leading role.
8. The donors are allocated by the state, not by the Red Cross.

Phone Investigation Recording:

Investigator: Hi! Is this Doctor Ma, Ma Yucheng?

Doctor: No.

Investigator: Hi, [Doctor: This is not him.] Hello, a family member of mine wants to do a liver transplant. I want to ask you if a lot of people are waiting in line for this. How long does he have to wait?

Doctor: I am not sure about that.

Investigator: Ok, I still want to ask Dr. Ma if these donors, who turn up suddenly, are healthy. With this much money we’re spending, I really care about that…

Doctor: I am really not sure about that, I am really not sure about that…

Investigator: So you’re not sure. I want to know about the donor sources, I want to know whether the donors are young or old…

Doctor: I really don’t know. I am just responsible for informing people.

Investigator: Ok, but you do participate in the operations.

Doctor: Yes, I do.

Investigator: So that means you only do the transplants, but you are not the one, who is in charge of finding the donors, is that correct?

Doctor: These [functions] have always been separate anyways. They have always been separate.

Investigator: Oh, so there is someone that is in charge of finding the donors then?

Doctor: Yes.

Investigator: So that person should tell you about the donors’ situation. Otherwise, how can you be so sure about the donors’ health…

Doctor: There are some people specifically doing the evaluations. Some people are specifically doing the evaluations.

Investigator: So you don’t even participate in the evaluation process? There is a specific group of people doing the evaluations?

Doctor: Yes. There are some people specifically doing evaluations. No one else knows the specific situation about the donors. They only announce to us the results regarding whether [the organs] can be used or not. The organ recipients’ family members are not allowed to know anything about the donors. And it’s the same for the donors’ family members, who are not allowed to know anything about the recipients.

Investigator: So, we don’t need to know anything about them. All we need to do is to come here, and you will make arrangements for us. So at least you would know where the donors are from, right? Whether they are from other places or are based locally. Do you know this information?

Doctor: Yes, we do.

Investigator: Ah, you know it. In general, they are local, right?

Doctor: This follows a regional allocation principle.

Investigator: Are you doing a lot of liver transplants?

Doctor: Yes, a lot. Why not?

Investigator: How many have you done this year?

Doctor: I can’t tell you that.

Investigator: I see, can you tell me how many you did last year then?

Doctor: I can’t tell you that, either.

Investigator: Oh, so the Red Cross has nothing to do with you…It’s mainly the state…

Doctor: The Red Cross helps play a coordinating role.

Investigator: Oh, coordinating. But it doesn’t play a leading role.

Doctor: No.

Investigator: The Red Cross doesn’t find donors for you?

Doctor: I don’t really know whether it finds donors or not. It is not up to us to decide.

Investigator: So…

Doctor: Ok, I guess that is it for today.

Addendum 75

A ward doctor for kidney transplant operations at the First Hospital of Kunming

Phone number: +86+ 871_67390509

Date: 07/22/2016

Key points:

1. When the investigator called, the director and his team were not in the office, as they were doing a kidney transplant operation.
2. The hospital has done around 200 transplants in the past six months.
3. The patients’ donor organ wait time is approximately one month.
4. “Our hospital is the only one in the entire Yunnan Province doing this kind of [kidney transplant] operations.”

Phone Investigation Recording:

……

Investigator: Hi, hello, is this the First Hospital of Kunming? Is Director Hu Wei available?

Doctor: Oh, Director Hu Wei, right?

Investigator: Uh, is he available?

Doctor: He’s not, at this moment.

Investigator: I want to reach out to him about kidney transplants. Is your hospital still doing kidney transplantation?

Doctor: They should still be doing it.

Investigator: Aren’t you in this department?

Doctor: Oh, they are not in the department right now. They’re doing it right now.

Investigator: Oh, so they are doing a kidney transplant, right? They are at the operating table?

Doctor: Ah, yes, yes, yes.

Investigator: I want to ask you, is the wait time long for a patient, if he comes here right now?

Doctor: It is possible. Anyway, once an operation is finished, it’s the turn for the next patient in line. But the wait time might be a little long.

Investigator: So, that means you have done a lot of transplants in the past six months?

Doctor: Yes, we have done quite a lot.

Investigator: That sounds like a lot of them. Have you done about 100 to 200 [cases] in the past six months?

Doctor: Ok, please wait for a second. [He went to ask someone else.] Yes, we have, they told me we have.

Investigator: So you have done about 200 cases of them?

Doctor: Yes, that is correct.

Investigator: It sounds like that you have done quite a lot of them. So it means, after I come over, it’s possible that the patient might not wait for long? Do you think that the patient can have his surgery after waiting for a month?

Doctor: It should be fine, it should be.

Investigator: It should be, right? If your hospital were able to do 200 transplants in half a year, like you said, I don’t think that there will be a problem. I just want to reach out to Director Hu, to see if he can do the transplant as soon as possible. This is what I intend.

[Switched to a female doctor.]

Doctor: This is not his decision to make. It mainly depends on the [tissue] typing and the kidney source’s availability.

Investigator: So, your hospital has done a lot of cases, in comparison with other local hospitals here. Do you say that…

Doctor: Right now, our hospital is the only one in the entire Yunnan Province doing this kind of operations.

Investigator: So that means, you have done almost 200 cases within the past six months. You’ve done 200 cases, right?

Doctor: That is about right.

Investigator: So, may I ask about the pricing?

Doctor: Um, I am not very sure about that.

Investigator: That is ok, but thank you. Okay, goodbye.

Doctor: You are welcome.

Addendum 76

A nurse on duty in the Liver Transplant Ward A at the First Hospital of Kunming

Phone number: +86 87167390554

Date: 11/25/2016

Key points:

1. “We have done a lot [of liver transplants]! We haven’t stopped doing them since last August.”
2. “We should have done more than 100 [cases this year, so far].”
3. The nurse is not sure about the organ sources.
4. “We were able to do three operations in one day, when we had liver sources in the past.”
5. The hospital has more than 20 doctors, who can do liver transplants.

Phone Investigation Recording:

……

Nurse: Hi.

Nurse: What can I help you with?

Investigator: Ah, I would like to talk with Doctor Chen.

Nurse: There are several doctors surnamed Chen. Which one are you looking for?

Investigator: I want to ask you if the Doctor Chen on duty today is Chen Ming, who does liver transplants.

Nurse: All the doctors in our department do liver transplants.

Investigator: I know they all do. But isn’t he the one in charge of finding donors? People told me to find him. So I want to ask him and get some detailed information. So, have you always been doing liver transplants? You are still doing them?

Nurse: Yes, we have always been doing them.

Investigator: Have you done a lot of liver transplants this year?

Nurse: We have done a lot of these! What about this? You can come here on Monday and check it out yourself.

Investigator: So have you done a lot of liver transplants this year? Till now?

Nurse: We have done a lot! We haven’t stopped doing them since last August.

Investigator: Oh, so have you done a couple of hundreds this year?

Nurse: Not a couple of hundreds, but we should have done more than 100 [cases].

Investigator: So that means you have done quite a lot this year. Where are the organs from? Are you sure about this? Are the organs healthy?

Nurse: I am not very sure about this. We were able to do three operations in one day, when we had liver sources in the past.

Investigator: So that means you have more liver sources in comparison with the other hospitals.

Nurse: In the entire Yunnan Province, we are one of the hospitals, which are doing liver transplants relatively well. [Investigator: A lot.] Ah, yes, a lot of patients would choose our hospital for transplants.

Investigator: For instance, there is another hospital doing this in Kunming, that is, the People’s Hospital, so I am wondering…

Nurse: Where?

Investigator: The First Affiliated Hospital [of Kunming Medical University].

Nurse: This is not very easy to say. There have been a lot of people, who transferred from their hospital to ours.

Investigator: Really? I’ve heard that some patients got transferred to your hospital, because they weren’t able to do it there.

Nurse: That is right, a lot of them did get transferred here.

Investigator: Is Zheng Shengning still the department director?

Nurse: Yes, he is.

Investigator: Oh, I see. Good, I have time. How about this? I will go to talk to Director Zhang, because I know that he is doing [the transplants]. He is the main operator, right?

Nurse: Yes, they all need to be there, when major operations are in session. The president has to be there, [too].

Investigator: How many doctors do liver transplants in your hospital? The ones capable of doing liver transplants?

Nurse: Alas, all of the doctors in our department do liver transplants.

Investigator:  How many doctors do you have? More than a dozen?

Nurse: Very similar, more than 20 of them.

Investigator: More than 20. Not all of them would be there, when doing an operation, right? Are they divided into several teams?

Doctor: They are divided into several teams, of course. They have to. Otherwise, the operations would last for more than 10 hours…

Investigator: That is right. You just said that they once did three operations in one day. So there should be at least three teams.

Nurse: Yes, they are divided. They all have different duties. Otherwise, the liver transplant operations lasting for more than 10 hours…

Investigator: Right, right, yes, yes. Then thank you very much! Ok, ok, bye, bye.

Nurse: No problem. No problem. Come over next Monday.

Investigator: Ah, okay. Okay, okay, bye.

Addendum 77

Zhu Xinfeng, Doctor on duty in the Liver Transplant Department at the First Hospital of Kunming

Phone number: +86+ 15877991035

Date: 05/20/2017

Key points:

1. “Back in the days, I am not afraid of saying this out, let me tell you, [the organ donors] were all executed prisoners, etc. This is not allowed anymore.”
2. “Some people wouldn’t get [the organs] after waiting for a couple of weeks. Some might be able to obtain the donor livers, after getting registered just a few days ago. Some people would wait for one or two months. It is all possible.”
3. “We have done several dozen cases this year for sure. Altogether, we’ve done more than 800 cases [of liver transplants].”
4. There is a separate fee for liver procurement.

Phone Investigation Recording:

……

Investigator: …

Doctor: What is the illness? What is the illness?

Investigator: Oh, he has the Hepatitis B liver cirrhosis. He might need to change his liver, which is a liver transplant. Since Guizhou Medical University hardly does any of them, so [I’m calling] to check out your [hospital]…

Doctor: Oh, oh, ok, we do a lot of these, for sure.

Investigator: So basically, you do a lot [of liver transplants] in the entire Southwest China, right?

Doctor: Yes, yes, yes, correct.

Investigator: Oh, I’ve heard that it costs about 400,000 yuan [to do a liver transplant] here, right?

Doctor: It is definitely more than that. I would advise you to have 500,000 to 600,000 yuan prepared, because nowadays [you] cannot bargain the price for a liver transplant, this kind [of operations], right?

Investigator: So, do you have liver sources?

Doctor: You should prepare a little bit more [money], a little bit more [money].

Investigator: Oh, that is fine. Do you charge us for finding the liver source? Because some hospitals, like the ones in Guangzhou, charge a separate fee for finding liver sources. What about you?

Doctor: Possibly you’ll need to pay a separate fee for it, because the liver [procurement] all relies on the donations from braindead patients now. This type. The quality of the livers must be guaranteed to be good, so they can be used. This is the general situation.

Investigator: Right.

Doctor: Ah, yes, that’s for sure. So in due course, this fee will be used to subsidize this, this donor’s family. This will, ah, the money will certainly [be used this way]. So all the costs being added up together, you would have to prepare 500,000 to 600,000 yuan, right? Well, yes, yes.

Investigator: At your hospital, how long do I have to wait? If I need to do the transplant right now, how long will I have to wait?

Doctor: After the patient gets hospitalized, he’ll need to register first, because the entire nation shares the same network system for [organ procurement] registration. You have to register, in order to get on the waiting list. For some people with certain blood types… For example, if someone’s lucky, he may be able to get the liver he needs right away. Others would have to wait for a while. This also depends on the situation, depends on the severity of his illness. This can be properly operated. There are still such possibilities. Some people wouldn’t get [the organs] after waiting for a couple of weeks. Some might be able to obtain the donor livers, after getting registered just a few days ago. Some people would wait for one or two months. It is all possible, this kind of situation.

Investigator: Oh, oh, so most of time…

Doctor: Generally speaking, it won’t happen, unless he has a rare blood type… Because now the major blood types and this…

Investigator: Our friend is also a doctor. He told me that in fact, your hospital, you can still get [livers from] the judicial [system] in Kunming. Anyway, we have a friend working there, he said…

Doctor [laughs]: Uh, that judicial [system] stopped [providing organs to hospitals] a long time ago, because back in the days, I am not afraid of saying this out, let me tell you, [the organ donors] were all executed prisoners, etc. This is not allowed anymore.

Investigator: The director in Guiyang asks you, how many cases [of liver transplants] have you done this year? He saw patients coming to your hospital, so he would like to refer his patients to you.

Doctor: We have done several dozen cases. We have done a lot [of liver transplants], a lot. I didn’t specifically count the numbers myself, as we do have someone that does the statistics. We have done several dozen cases this year for sure, yes. Altogether, we’ve done more than 800 cases [of liver transplants]. Please rest assured.

Investigator: Ah, you’ve done a total of 800 or 900 cases, right? Oh.

Doctor: Uh, we’ve done more than 800 cases, do you know? This year, we have done several dozen cases.

Investigator: I see that you are very busy. I am sorry to bother you during your business hours, so that’s why I actually pick a Sunday to call you today.

Doctor: It is fine, it is fine. I will be able to pick up your phone calls, even if I am next to the operating table, ok? Text me before you call, or just call me, it is fine, either way, ok?

Investigator: Ok, I will text you, or whatever works, as long as I am not too busy. I will call you by then.

Doctor: Ok, sure.

Addendum 78

A nurse on duty in the Liver Transplant Ward at the First Hospital of Jilin University

Phone number: +86 43 181875162

Date: 07/14/2016

Key points:

 “We did do three [operations] on the night before last. Why would I say so, if we didn’t actually do three of them?”

Phone Investigation Recording:

Investigator: Hi, miss, hello!

Nurse: Hi.

Investigator: Here is the thing. A doctor from your hospital’s internal medicine department told me that your hospital did three liver transplants the day before yesterday. Is that correct?

Nurse: Oh, yes, do you have a problem with that? We did do three [operations] on the night before last. Didn’t you call us last night though?

Investigator: Oh, I wanted to know if your hospital has this capability for sure, and I want to see how the patients are doing.

Investigator: So you think that I would fool you? Why would I say so, if we didn’t actually do three of them?

……

Addendum 79

Zhang Wenlan, MD, in the Kidney Transplant Department at the First Hospital of Jilin University

Phone number: +86 13756868617

Date: 04/15/2017

Key points:

1. “Right now in our country, cardiac death donations are currently permitted. There is no clear diagnosis to determine brain death yet, so the answer is no.”
2. “Among us northeastern Chinese people, there aren’t a lot of donations. Around 50 or 60 [a year].”
3. “[We can do] about 200 cases at most in one year. One third would come from the patients’ relatives’ donations.”

Phone Investigation Recording:

……

Investigator: Hi, hello, hello, is this Dr. Zhang Wenlan? Hello?

Zhang Wenlan: Who is calling?

Investigator: My last name is Liu. I am calling you out of admiration, because I’ve heard from other people that you are very famous…

Zhang Wenlan: How can I help you?

Investigator: One of my family members is in need of a kidney transplant, so I am wondering if the wait time is long.

Zhang Wenlan: In the cases, where the patients have to wait for a very long time, there are two types of donors. One is the donors, who are the patients’ relatives; the other one is voluntary cardiac dead donors. Then you would get the kidney sources.

Investigator: Oh, here is the problem. No one in my family can donate a kidney to him, so we hope that a braindead donor would be available at this point…

Zhang Wenlan: Right now in our country, cardiac death donations are currently permitted. There is no clear diagnosis to determine brain death yet, so the answer is no.

Investigator: So, approximately how long will we have to wait [for the operation], after we come?

Zhang Wenlan: Oh, that is hard to say, it varies…

Investigator: So, donation by relatives would be fast…

Zhang Wenlan: Among us northeastern Chinese people, there aren’t a lot of donations though…

Investigator: That is, having an organ from one’s relative would result in a fast transplant? How many people can do the operations, if the organs come from donations in one year?

Zhang Wenlan: Around 50 or 60 [a year].

Investigator: So, how many transplants do you do in a year? This kind you just mentioned…

Zhang Wenlan: About 200 cases at most in one year.

Investigator: You are talking about allografts?

Zhang Wenlan: In these 200 cases, one third would come from relatives’ donations.

Investigator: Oh, so this is the case.

Zhang Wenlan: Yes, yes.

Investigator: Ok, ok, thank you very much, bye-bye.

Zhang Wenlan: You are welcome.

Addendum 80

Zhang Haiyu, Director of the Pediatric Surgical Department at the First Hospital of Jilin University

Phone number: +86-13756661622

Date: 06/14/2017

Key points:

Zhang Haiyu: The “Previous Children” assistance program of liver transplantation is definitely real. We are not lying. The surgery wait time will not be long, because we have a particularly large number of DCD [donations after cardiac death], and we do a lot of [organ transplant operations for] adults. So we carry out [this program] for children. The first ten [surgeries] are free of charge. We can do more than 200 cases [of liver transplantation] a year.

----------------------------------------------

Phone Investigation Recording:

Investigator: Hello, hi, is this Director Zhang?

Director Zhang: Hi.

Investigator: Hi. This is…?

Director Zhang: Ok, speaking.

Investigator: Is this Director Zhang? Director Zhang Haiyu? Hi, hello.

Director Zhang: Hi? Who is calling?

Investigator: Can you hear clearly what I am saying?

Director Zhang: What?

Investigator: Oh, I saw this public service ad of yours. It’s about that kids [assistance program] of liver transplantation, whose registration started in June. So, after registration, if my [child] is one of the 10, who get selected for liver transplants, will we be able to do the transplant in June?

Director Zhang: It does exist. [The “Previous Kid” assistance program] is definitely real.

Investigator: So, it’s real.

Director Zhang: Yes, indeed. The first 10 [surgeries] are free of charge. 

Investigator: Nowadays, some of the public service ads are not real, so I wanted to ask you about it.

Director Zhang: This is not a lie. Our hospital indeed carries this out. This is not fake. It is real.

Investigator: So, this is real, not fake then.

Director Zhang: Well, you should bring your child here to take a look.

Investigator: Oh, I see.

Director Zhang: Come to the pediatric surgery department. Ok.

Investigator: Let’s say that these 10 kids [will start their transplants], how long does it take for them to finish [the operations]? How long do they have to wait?

Director Zhang: The surgery wait time will not be long, because we have a particularly large number of DCD [donations after cardiac death].

Investigator: Oh, so do you usually do a lot of liver transplants, this kind?

Director Zhang: We do a lot of [organ transplant operations for] adults. So we carry out [this program] for children. The first 10 will be free of charge.

Investigator: Oh, Oh, Ok, I see. So that means your hospital has a lot of donor sources, am I right?

Director Zhang: Yes, Yes, Yes.

Investigator: So speaking of liver transplants, you usually do a lot of these for adults, is that why you are [carrying it out for children]…?

Director Zhang: Yes, a lot.

Investigator: So you still need to have this condition…

Director Zhang: Yes. We do more than 200 cases every year.

Investigator: Are you talking about liver transplants, or kidney…?

Director Zhang: We do more than 200 cases every year!

Director Zhang: Ok, then.

Investigator: Ok, Director Zhang. Thank you, bye.

Addendum 81

A Jilin Provincial Travel Radio staff member at the information desk for the “Previous Children” assistance program for free liver transplantation of the First Hospital of Jilin University

Phone number: +86 43185815665

Date: 06/14/2017

Key points:

“We don’t really have any specific requirements regarding the registration process, nothing very specific. As long as [your child] is qualified in terms of age and illness, you can go ahead and register. Let’s just say that if you come to the hospital now with 2 million yuan, you still won’t know your [donor] liver source, because this is confidential.”

Phone Investigation Recording:

Investigator: Hi, hello, hello. It’s so difficult to get through on this phone! Regarding our Jilin University’s “Previous Children” [assistance program], what are the registration requirements?

Radio Station: We don’t really have any specific requirements regarding the registration process, nothing very specific. As long as [your child] is qualified in terms of age and illness, you can go ahead and register.

Investigator: So, the liver sources at Jilin University are relatively abundant?

Radio Station: Jilin University is…How should I put it, regarding the liver sources, let’s just say that if you come to the hospital now with 2 million yuan, you still won’t know your [donor] liver source. Because this is confidential.

Investigator: Ok, I am sorry that I asked a little too much! So, that will be all, sorry that I wasted your time! I am sorry!

Radio Station: Ah, it is ok.

Addendum 82

Doctor Du Wenxiao at the anesthesiology department of Lingyuan Prison Hospital, Liaoning Province

Phone number: 013050922179

Date: 04/12/2017

Key points:

1. Du Wenxiao said that the liver transplants were not allowed to be performed.
2. “Deaths need to be verified. Nowadays the laws are very strict.”
3. “Go ask a police station [about organs]! You are better off with them!”
4. [Investigator: I can even pay you a visit in person! I will come over to do [the transplant…] Du Wenxiao: Then how much money are you preparing to pay our Director Ai?”
5. “Liver transplantation is Director Ai’s specialty! I will ask him to talk to you.”
6. The phone was handed to Ai, but he suddenly hang up, once the investigator  mentioned that she wanted their help with getting organ donors from prisons.

——————————————

Phone Investigation Recording:

Investigator: Hello?

Du Wenxiao: What do you need?

Investigator: Hello, Dr. Du, I think that you are a very straightforward person. So how about helping me with finding organ donors in Lingyuan Prison? And can the transplant take place at the hospital? Can I come and find you?

Du Wenxiao: You can’t find me!

Investigator: Why? Aren’t you at the hospital? How come I can’t find you?

Du Wenxiao: You want to know why? I… I… I am very busy now. You can’t find me.

Investigator: Ok, you are very busy, you are very busy~

Du Wenxiao: I don’t know you, either. Who is this? Why are you calling me? There is really no point.

Investigator: I am one…Someone I know gave me your phone number, but I am not going to tell you who it was, who gave it to me. He/She didn’t allow me to tell you.

Du Wenxiao: Then just don’t, don’t call me.

Investigator: So?

Du Wenxiao: I have nothing to do with you!

Investigator: So can I come and find you … Hey! Dr. Du, can I come to your hospital and do it?

Du Wenxiao: What do you want to do! Do what! Go find someone else.

Investigator: A liver transplant, a liver transplant. I take that your hospital can do liver transplants?

Du Wenxiao: We don’t do those. We are not capable of doing them, we can’t do liver transplants.

Investigator: So what do you do then? So you can’t do liver [transplants], and you told me to go talk to someone else. Where should I go and which doctor I should talk to?

Du Wenxiao: Um, we are currently not permitted to have bodies…

Investigator: Oh, don’t you have…

Du Wenxiao: I do know what you mean, I know what you mean, but~

Investigator: What?

Du Wenxiao: But, the issue of death, you need to verify…you need to be sure. Nowadays the laws are very strict.

Investigator: Oh.

Du Wenxiao: We don’t , we…we won’t do that. Instead of searching for a prison to do this, you are better off… Let me give you a suggestion!

Investigator: Ah? Please go ahead.

Du Wenxiao: Go ask a police station! You are better off with them!

Investigator: How can I be better off with a police station? You are in charge of the prison, and the police stations are really far away from you.

Du Wenxiao: Prisons are Prisons.

Investigator: So prisons… Your hospital…isn’t it easier for you, when it comes to [finding organ donors]! They told me that the prison’s hospital is more… you know, compared to others…

Du Wenxiao: So you want me to cut off someone’s head for you to replace yours, right?

Investigator: Then can you, can you provide me with a…

Du Wenxiao: You mean that I can give you a head, so you can go to connect it with a body, right? This is what you mean?

Investigator: You…you are so far away from the prison… The inmates are in the prison after all. It would be easier for you to find such people, in comparison with other hospitals. You…

Du Wenxiao: Alas! You are wrong. You should go read up on either laws on the prisoners’ rights or human rights! You are wrong, very wrong, I am not going to chat with you anymore. Ok?

Investigator: I am calling you, because I know you are very straight with things, so~

Du Wenxiao: Yes, you are right, I am indeed straight with things. My teacher is still here. His head is still attached to his body!

Investigator: I see, I like that you are straight with things. So our… Um, if the prison’s hospital can get things done, it is fine for me to come over, too! I can even pay you a visit in person! I will come over to do it…

Du Wenxiao: Then how much money are you preparing to pay our Director Ai? Would you like it, if I go get Director Ai to talk to you, okay?

Investigator: Whom can I speak to?

Du Wenxiao: Excuse me?

Investigator: Whom can I talk to?

Du Wenxiao: What? This is what Director Ai does, liver transplantation is his specialty!

Investigator: Are you talking about your wife?

Du Wenxiao: No, our Director Ai!

Investigator: Ok! Director Ai, that sounds good. Director Ai

Du Wenxiao: Ok, I will ask him to talk to you, I will ask him to talk to you. Ok, ok.

Investigator: Ok, then.

Du Wenxiao: Come on, come on.

[Director Ai joined the conversation]

Director Ai: I don’t want to talk. I don’t want to talk. I know that you want to talk about organ transplants, don’t make it sound so… I won’t talk. Oh, I don’t know how to do it!

Du Wenxiao: You two go ahead and talk.

Investigator: Hi! Director Ai… Hi there! Director Ai!

Director Ai: Oh.

Investigator: Hello!

Director: Hi.

Investigator: So, someone recommended me [to talk to you]. He told me, “Go to Lingyuan Prison Hospital, and ask them whether they can get that type of healthy livers from the prison.” So I’m calling you about it. So, can I find a comparably healthy donor through you, such as… [He hung up all of a sudden].

Addendum 83

Gao Guangjie, Anesthesiologist at the PLA’s No. 463 Hospital in Shenyang

Phone number: +86 13352456947

Date: 04/12/2017

Key points:

1. “There are many kidney transplants. There are many, many.”
2. “Tomorrow morning, call the operator to find the number of the Department of Urologic Surgery, OK? Today they are performing surgeries. They must be doing operations, kidney transplants.”

Phone Investigation Recording:

Gao Guangjie: Hello?

Investigator: Hi, hello!

Gao Guangjie: Please go ahead.

Investigator: Is that Doctor Gao speaking?

Gao Guangjie: Who is calling?

Investigator: I am from Xinbin. One family member of mine wants to receive a kidney transplant. Can your No. 463 Hospital still do that?

Gao Guangjie: Do what?

Investigator: Kidney transplantation.

Gao Guangjie: Yes, we can.

Investigator: So, you mean you can still do it, right? So …

Gao Guangjie: You should contact the Department of Urologic Surgery. Even if you ask me, I am still not very clear about the details such as matching. I do not work for the Department of Urologic Surgery.

Investigator: Oh, oh. You are from the Department of Anesthesiology. OK, then I know whom to call and I will call them. You do a lot? I mean your hospital?

Gao Guangjie: Hmm?

Investigator: Does the hospital do a lot of…this kind of kidney transplants?

Gao Guangjie: There are many kidney transplants.

Investigator: Ah?

Gao Guangjie: There are many, many.

Investigator: OK, can you give me their telephone number?

Gao Guangjie: I am now at home, at home! Can you check the directory tomorrow morning? Currently the Department of Urologic Surgery is able to perform kidney transplants.

Investigator: OK…OK…

Gao Guangjie: So call again tomorrow during the day.

Investigator: OK, OK. So I should call the [hospital’s] operator to check the number [for the Department of Urologic Surgery], right?

Gao Guangjie: Tomorrow morning, call the operator to find the number of the Department of Urologic Surgery, OK? Today they are performing surgeries. They must be doing operations, kidney transplants.

Investigator: Thank you. Goodbye.

Gao Guangjie: OK.

Addendum 84

Nurse on duty in the Department of Renal Transplantation at Dalian (Municipal) Friendship Hospital

Phone number: +86 411-82718882-3508

Date: 06/01/2017

Key points:

1. “We can [still] do kidney transplants. It’s just around 20 cases. 10 or 20 cases, roughly.”
2. “There exists a specific national allocation system [of organs].” Hospitals procure organs from this system.
3. Both patients and medical workers are not permitted to access that network.
4. There are strict national rules regarding this system. Only certified individuals have access to the system.
5. “Only OPO [Organ Procurement Organizations] have access to it. We cannot access.”
6. “The donor’s age, birth place or name will not be revealed. This is not allowed by the state.”

Phone Investigation Recording:

……

[The phone exchange operator picked up the call]

Recorded voice: Hello, Dalian Municipal Friendship Hospital. Please dial the extension number. Dial 9 for the directory. Please wait. The telephone exchange will serve you.

Exchange operator: Hello. This is Friendship Hospital.

Investigator: Hello! Is that Friendship Hospital? I am a family member of a patient. So I want to know whether your hospital still performs kidney transplants.

Exchange operator: Yes, we do.

Investigator: So the answer is yes, right? If we go there, how long will we wait?

Exchange operator: I don’t know about that.

Investigator: Are there many people waiting in line, I mean at the moment?

Exchange operator: I am not sure about this. I can transfer you to the Department of Renal Transplantation. You can ask them.

Investigator: Oh, so which department are you? The operator?

Exchange operator: Right, the phone exchange operator.

Investigator: OK then. Today I, so, I did not mean to reach you. But the exchange already gave me the extension number of 3508. But I tried to dial that one, but it didn’t work. It seemed so. I thought I was dialing them.

Exchange: Hmm. Right, that’s [the number for] kidney transplantation. Let me do this, transfer your call to 3508. You can consult with their nurse, OK?

Investigator: Good, good. Thanks, thanks.

Nurse: Hello. Neurological 23… [interrupted]

Investigator: Hello, hello. Is that Dalian Friendship Hospital, Department of Renal Transplantation?

Nurse: That’s right. Who is that speaking?

Investigator: Ah, I want to, I have a family member, who hopes to receive a kidney transplant. Does your hospital still perform that?

Nurse: Yes. We can do kidney transplants.

Investigator: So nurse, I would like to ask that, so your hospital keeps doing [transplants]. How many kidney transplants can you do in one year? With this information, it will be clear to me regarding how long to wait, shorter or longer.

Nurse: Seven cases since [the beginning of] this year. Seven or eight cases.

Investigator: Oh, seven cases. So you have done seven transplants this year. That is to say, you are still doing [other ones] at the moment?

Nurse: Yes, that’s right.

Investigator: So how many did you do last year? Based on last year’s number, I will be able to know how long we have to wait in line this year. I mean approximately.

Nurse: It’s just around 20 cases. 10 or 20 cases, roughly.

Investigator: I see. So from where are kidneys sources allocated? Are this kind of kidneys healthy?

Nurse: There exists a specific national allocation system.

Investigator: Oh, so [you] get [organs] from that allocation system?

Nurse: Yes, that’s right.

Investigator: Just within Northeastern China or for the entire country?

Nurse: The entire country?

Investigator: So, can a person like me access that kind of system?

Nurse: No, you cannot.

Investigator: OK. So can you access it?

Nurse: I didn’t get what you just asked.

Investigator: I said, medical workers like you should be able to access that network.

Nurse: We cannot, either. It’s a professional system, and not everyone can access. One must hold state-issued professional certificates and particular titles to access.

Investigator: Oh, so that means at least at the director level.

Nurse: The program is very strict, very strict.

Investigator: So that is to say, even in your hospital, no more than a few people can access that network?

Nurse: Right.

Investigator: Oh, so only the directors or other key individuals can access?

Nurse: That’s true in our hospital. Possibly the directors, or in other words OPO [Organ Procurement Organization] members can access and we cannot.

Investigator: Then, will the patient be able to know anything about the donor source? How healthy is he?

Nurse: No.

Investigator: So patients will know, will be informed, right?

Nurse: Patients will be informed of some general information, like the status of [the donor’s’ kidney and creatinine level. That’s it. His age, birth place or name will not be revealed. This is not allowed by the state.

Investigator: Oh I see. OK then. I will discuss with my family about this, to decide when to visit your hospital. I will call your doctors later then.

Nurse: Yes, you can talk with the doctors to consult them.

Investigator: Who is in charge of this, regarding the transplantation? Can I directly give him a call?

Nurse: The last name of our director is Hu. You can call this number during the day and ask for Director Hu’s contact information. We … [interrupted]

Investigator: OK. Good, great. I got it. So thank you. I will contact him in the day. Good.

Nurse: Right.

Investigator: OK. Thanks, thanks. Goodbye. Bye, bye.

Nurse: You are welcome.

Addendum 85

A ward physician in the Department of Urology at Inner Mongolia Baotou Steel Hospital

Phone number: +86 472-5992751

Date: 04/13/2017

Key points:

1. “I think [we perform] at least 100 or 200 cases per year.”
2. [Investigator: Only counting allografts?] Ward Physician: I think so.

Phone Investigation Recording:

Nurse: Hello, Department of Urologic Surgery.

Investigator: Hello, is that Baotou Steel Hospital?

Nurse: That’s right.

Investigator: So, if your hospital performs kidney transplants, then I will bring the patient there. If you don’t do them, I will not go there.

Nurse: Yes, yes. We do them. Just hold on.

Investigator: Oh, OK.

Physician: Hello! [A physician took over the phone]

Investigator: Hi, how do you do? So you are a doctor. So, I have a patient here, planning to visit you for…kidney transplant. I mean I don’t know how long we will wait if we go there.

Physician: What kind of kidney transplant? [With an organ] from a family member?

Investigator: No, not from a family member.

Physician: OK, so not from family member. Then you have to queue up. If you want to learn more details, you need to come here and talk to Doctor Han. He is in charge of this area.

Investigator: So like your hospital, how many allograft [transplant surgeries] can you do every year?

Physician: You need to talk to Doctor Han. He is not here right now, because he knows the number. I think at least 100 or 200 cases?

Investigator: So, if counting [the transplants with organs] from the patients’ relatives as well, you can do several hundred transplants every year. Like that.

Physician: Almost…Hmm, I don’t know about the details.

Investigator: Just roughly?

Physician: Roughly over 100, or 200 [cases].

Investigator: Only counting allografts?

Physician: I think so.

Investigator: OK. Then I will give him a call. So I can find Doctor Han by dialing this number, right?

Physician: Right, right.

Investigator: He is on a regular work schedule? He offers consulting service [to potential patients] and also does surgeries?

Physician: Of course.

Investigator: Oh, oh. I see! Good, good! Thank you then. I will find another time to call Doctor Han.

Physician: Sounds good.

Investigator: Thank you. Goodbye.

Physician: You are welcome.

Addendum 86

A nurse on duty physician in the Urology Ward at Inner Mongolia Baotou Steel Hospital

Phone number: +86 472-5992751

Date: 04/14/2017

Key points: 

1. “I never count the number [of kidney transplants we do]. Anyway, there was a sharp increase last year.”
2. “There are currently people specialized in procuring kidney sources. So they procured a lot last year, donated kidneys. So we did relatively more [kidney transplants] last year. The number will definitely increase because the [relevant] law just changed last year.”

Phone Investigation Recording:

Nurse: Hello!

Investigator: Hello. Is that Department of Urologic Surgery of Baotou Steel Hospital?

Nurse: Yes.

Investigator: Is Doctor Han available? Doctor Han Lisheng.

Nurse: He is on a business trip at the moment.

Investigator: Oh, on a business trip. I guess that’s why the line was always busy when I called him. When will he come back?

Nurse: I think next Monday at the earliest. He will not be back in a few days for sure.

Investigator: OK. Isn’t he the person in charge of registration for transplants, kidney transplants? Because one of my family member needs to do that, so we can still do it now, right?

Nurse: Yes, we’ve always been doing them.

Investigator: It seems that you have been doing pretty well. So we can no longer use that kind of organs as previously, right?

Nurse: Right. It has been some time that [organs from] executed prisoners are not allowed. Since last year.

Investigator: I’m calling from a faraway place, so I want to take the opportunity to ask him that how many [kidney transplant] cases you have done this year? Just approximately.

Nurse: I never counted it. Recently… [interrupted]

Investigator: So yesterday, a doctor told me to call Doctor Han. I asked him for the number and he said it’s about 100 to 200 cases. Is that the case?

Nurse: How many?

Investigator: 100 to 200 cases.

Nurse: I never count the number. Anyway, there was a sharp increase last year.

Investigator: So there were more last year than the year before, right?

Nurse: There are currently people specialized in procuring kidney sources. So they procured a lot last year, donated kidneys. So we did relatively more [kidney transplants] last year. The number will definitely increase because the law just changed last year … on body donation. They are slowly developing this.

Investigator: So after stopping using [organs from] executed prisoners, this [kind of organ sources] becomes more and more, gradually.

Nurse: Because body donations were very rare previously. Now specialists are assigned to that job, so there will be more and more.

Investigator: Regarding surgery, is it always the chief surgeon that performs surgeries?

Nurse: The chief surgeon?

Investigator: Does the chief surgeon perform surgeries?

Nurse: Not only the chief.

Investigator: Oh, so generally ordinary surgeons also perform [transplantation surgeries].

Nurse: Right.

Nurse: Since this kind of transplant surgeries with donated organs are always done in pairs, it is impossible for one doctor to complete them. There are several surgeons required for each surgery. So every time we do it, all surgeons of our department have to attend.

Investigator: Ah, I see. So that is to say…

Nurse: Right, separately.

Investigator: You just said two surgeries are performed at the same time. Do you mean one surgery [to excise] the donor[’s] kidneys, and another [to transplant the kidneys] for the recipient?

Nurse: I mean one person has two kidneys. If one person donates his organs, then it will be used by two people.

Investigator: Oh, then donated organs are not excised at your hospital? Or from other places?

Nurse: It depends. So they are running business such that every hospital advocates body donations. Then when a hospital gets a kidney source, someone will go to take it. Then we do the transplants here.

Investigator: After excising [a pair of kidneys], you bring them from elsewhere and do [the transplants] here. So the organs are not excised here?

Nurse: Right.

Investigator: Oh. So if two kidneys are harvested, then two patients will receive transplants at the same time. I got it.

Nurse: Right. That is the case for body donations. You can ask Doctor Han later for more details. I am really, really busy at the moment. There is no choice, since I am the only one here.

Investigator: Ah, I am sorry. Sorry. I won’t bother any more. Good, good. Thank you. Goodbye.

Nurse: OK, bye, bye. 

Addendum 87

Li Wengang, Surgeon in the Department of Hepatobiliary Surgery at the PLA No. 174 Hospital in Xiamen

Phone number: +86 18906055326

Date: 04/30/2017

Key points:

1. “We do [liver transplantation].”
2. “Our boss [Peng Zhihai] comes here from Shanghai to perform liver transplantation surgeries.”
3. Peng Zhihai from the liver transplantation center of Shanghai Jiao Tong University is prepared to perform surgeries at Xiamen University. Peng has performed over 5,000 transplants throughout his career.
4. “That person is really amazing!” He will be transferred to the Second Affiliated Hospital of Xiamen University.
5. “The surgery itself is not complicated. The key is [how to get] the donor source.”
6. [Investigator: Oh, so are our donor sources generally procured locally now?] Li Wengang: That has none of your business.
7. “My boss did about 400 [cases] annually several years ago in Shanghai. Nowadays maybe each year, he did less now, maybe 100 [cases] each year.”
8. [Investigator: Then after that person comes, you will have donor sources?] Li Wengang: He has access to a lot of donor sources all over the country!
9. [Investigator: Oh, so you rely on him to get donor sources, right?] Li Wengang: Yes, yes. It’s OK for now.
10. “Prof. Peng will found a liver transplantation center for Xiamen University, a very big one.”

Phone Investigation Recording:

Investigator: Hello?

Li Wengang: Hello?

Investigator: Hello, Doctor Li. I would like to ask that, whether your No.174 Hospital still does liver transplantation or not?

Li Wengang: We do. Where are you from?

Investigator: I am from our city, but now I live in Hong Kong. I am calling you from Hong Kong. I would like to inquire about this. If I do it, then I will go back home to do it.

Li Wengang: Let me tell you this, you should come back. Come back. Our boss comes here from Shanghai to perform liver transplantation surgeries. You can come then, get some discount on fees.

Investigator: Oh, so how long is the wait time, if I come back?

Li Wengang: You just come back first, I will give you … What is your blood type?

Investigator: Type B. Type B.

Li Wengang: OK, Type B. The person from a liver transplantation center in Shanghai is surnamed Peng, Peng Zhihai. [Investigator: Oh, he comes to our city …] Just come and then … Xiamen University is preparing for a surgery, you … You know that? Peng Zhihai has performed over 5,000 cases [of liver transplantation]. When you arrive, you can come to see me. I can help you get in touch with him. OK?

Investigator: Oh, regarding the doctor you talked about, is he coming here to help your hospital perform liver transplants?

Li Wengang: No, no. He has, he will be transferred to Xiamen.

Investigator: Oh, I see, I see. That is to say, your hospital is still doing a lot? Sounds pretty good?

Li Wengang: No, it is THAT person, who is really amazing!

Investigator: Oh? Will he be transferred to your hospital?

Li Wengang: No. He is transferred to Xiamen University, the Second Affiliated Hospital of Xiamen University. He will be the leader of a very big hospital to be founded.

Investigator: Oh, not transferred to your No. 174 Hospital.

Li Wengang: No. He might work with me at the No.174 Hospital at some early stage. So he works here at an early stage. But the key is that, the surgery itself is not complicated. The key is [how to get] the donor source.

Investigator: Oh, so are our donor sources generally procured locally now?

Li Wengang: That has none of your business. Just come and I will contact him for you.

Investigator: Can you, can you tell me approximately when? When shall I return, can you tell me?

Li Wengang: How about this? You add me as a friend on WeChat. You can find my WeChat account with my cellphone number. The same one you dialed just now. Then let’s talk on WeChat.

Investigator: So roughly speaking, I should return in less than one or two months?

Li Wengang: That’s OK. It works. So let’s talk on WeChat later, okay?

Investigator: Ah, so you just said, you can do transplantation there. So a hospital like yours can do several hundreds of liver transplants every year?

Li Wengang: My boss did about 400 [cases] annually several years ago in Shanghai. Nowadays maybe each year, he did less now, maybe 100 [cases] each year.

Investigator: Oh, so how about your hospital? The No.174 Hospital?

Li Wengang: Our No. 174 Hospital did this kind of surgeries before. This surgery is, we are planning to develop this kind of surgeries.

Investigator: Ah, so your hospital never did it before, right?

Li Wengang: We did it previously. We did it.

Investigator: Then why you said you never did it before? Did you do it last year?

Li Wengang: In the past several years, many hospitals stopped doing it because of the lack of donor sources.

Investigator: Then after that person comes, you will have donor sources?

Li Wengang: He has access to a lot of donor sources all over the country!

Investigator: Oh, so you rely on him to get donor sources, right?

Li Wengang: Yes, yes. It’s OK for now. Tomorrow send me your information via a text message.

Investigator: I will. Thank you. So your hospital had stopped doing that for a few years. Then you will restart it after that surgeon comes, right?

Li Wengang: No, Prof. Peng will found a liver transplantation center for Xiamen University, a very big one.

Investigator: Oh, so your hospital will become part of it?

Li Wengang: We will all join it. The key is, it is he that will do [the surgeries].

Investigator: Oh, so your hospital did not do it in the past two years. You did not.

Li Wengang: We did it before. No longer now.

Investigator: Oh, you stopped. That is to say, after this professor comes, then we will restart the program to do it, right?

Li Wengang: Yes, exactly.

Investigator: Oh, so that person must have very good skills. Can we say that?

Li Wengang: Of course, He is the No. 1 in the country.

Investigator: Which hospital is he from?

Li Wengang: The Shanghai General Hospital, affiliated to Shanghai Jiao Tong University.

Investigator: That’s a very famous hospital. It’s very famous. I see. Thank you, Doctor Li, I will…

Li Wengang: You send your materials first, and I will contact him for you.

Investigator: Great. Thank you, Doctor Li Wengang. Bye, thank you. Bye, bye.

Addendum 88

He Fangping, Hepatic Transplantation Surgeon at the First Affiliated Hospital of Xinjiang Medical University

Phone number: +86 13999801966

Date: 06/04/2017

Key points:

1. “Regarding doing the surgery, we will do it within three days, once a [matching] liver becomes available.”
2. “The donors are from the entire Xinjiang region, brain-dead ones.”
3. “We have done over 60 cases of AOLT [Auxiliary Orthotopic Liver Transplantation]. As for DCD liver transplantation, we did approximately over 30 cases. We have over a dozen years of experiences in this area. So along with LDLT [Living Donor Liver Transplantation] and other various types, we have performed over 200 [liver] transplants.”
4. “The technical level of [DCD transplantation] is not high at all. We do cadaveric liver transplantation here, over 30 cases each year. The cadaveric liver transplantation is much, much, much more difficult than DCD [transplantation].”

Phone Investigation Recording:

Investigator: Hello, hello. Are you …? Hello? Can you hear me? Is that Doctor He speaking? Doctor He Fangping? Hello, can you hear me?

Doctor He: Speaking, how do you do?

Investigator: I want to ask about …

Doctor He: Sure.

Investigator: So is the First Affiliated Hospital of Xinjiang Medical University still doing liver transplantation? Do you? I have a family member, who wants to do it.

Doctor He: Where are you from?

Investigator: I am from Xinjiang. But right now, I live abroad. I am calling from abroad. I just want to inquire about it. I want to go back to do it, because that’s closer to my home. After all, it is definitely cheaper to do it home than abroad.

Doctor He: OK. So you just said, you are currently abroad, right?

Investigator: Right, right. So one of my family members has end-stage cirrhosis. He has to wait for a long time abroad for a liver transplant. So I come to inquire the hospitals in our hometown. If you can do it, because our First Affiliated Hospital of Xinjiang Medical University is a relatively big hospital, and a teaching hospital, so I want to know, if you can do it…

Doctor He: Oh, OK, OK. I got it. So he is…if he comes back, and [you want to] do it, he should receive DCD [Donations after Cardiac Death] liver transplant. He can wait for [how long]… so he has end-stage cirrhosis now, right?

Investigator: Yes, yes. That’s right. He was infected with Hepatitis B before. He got Hepatitis B before.

Doctor He: OK, that’s OK. OK. Now we use livers from brain-dead [donors], donated organs.

Investigator: So for you hospital, if I come back, how long is the wait time? What I care most about is the wait time, whether you can do it very soon or not.

Doctor He: Regarding doing the surgery, we will do it within three days, once a [matching] liver becomes available.

Investigator: Oh. So now the donors are all locally provided? Or from other places? Where to get them?

Doctor He: They are from the entire Xinjiang region, brain-dead ones.

Investigator: At your hospital, are there many people waiting in line at the hospital?

Doctor He: Not quite.

Investigator: So everyone can have it. So how many liver [transplants] can your hospital perform in one year? Like you said.

Doctor He: That’s a different thing. We have done over 60 cases of AOLT [Auxiliary Orthotopic Liver Transplantation]. As for DCD liver transplantation, we did approximately over 30 cases. We have over a dozen years of experiences in this area. So along with LDLT [Living Donor Liver Transplantation] and other various types, we have performed over 200 [liver] transplants.

Investigator: So you were saying you had performed over 200 [liver] transplants during the past year?

Doctor He: Not that many, not that many. We, we, the DCD [transplantation] depends on…you can learn about DCD and then you will know. Its technical level is not high at all. We do cadaveric liver transplantation here, over 30 cases each year. The cadaveric liver transplantation is much, much, much more difficult than DCD [transplantation].

Investigator: Oh, it seems that I did inquire the right person. I thought, yours is a big hospital, so I’m calling you now.

Doctor He: Right. Xinjiang only has one qualified hospital [to do liver transplants]. All other hospitals do not have the qualification.

Investigator: OK, I know about the situation now. Thank you, Doctor He.

Doctor He: Good, good.

Investigator: Good bye.

Doctor He: OK.

Addendum 89

Nurse, Renal Transplantation and Dialysis Center, Shanxi No.2 People’s Hospital

Phone number: +86 14797169153

Date: 05/06/2017

Key points:

1. “We do at least more than 100 [kidney] transplants every year.”
2. “We have performed nearly 100 [kidney] transplants [since the beginning of] this year.

Phone Investigation Recording:

……

Investigator: Hello. Is this the right number to reach Chief Liu? Chief Liu Xin.

Nurse: Chief Liu Xin?

Investigator: Yes.

Nurse: Sorry, but here is the Center, the Kidney [Transplantation] Center. I don’t have his number, either.

Investigator: Uh, I thought Chief Liu is working in your ward?

Nurse: You mean Liu Xin? I can ask someone else about his information. What’s the matter?

Investigator: Here is the story. There is a patient from Anhui, who wants to visit your hospital for a kidney transplantation.

Nurse: That’s OK. You can come over to talk to Chief Zhou, Zhou Hua. He does kidney transplantation. However, Chief Liu, he no longer works in our hospital. I don’t know where he has gone. I forgot.

Investigator: Ah, I see. Oh, so [he is] no longer in your hospital. I see.

Nurse: If you plan to come to Shanxi for kidney transplantation, you can just talk to Chief Zhou. But in Shanxi Province, we are the only hospital that is capable of doing this [kidney transplantation]. So after you arrive, just call this number.

Investigator: I’ve heard that your hospital did more than 100 kidney transplants last year. Is that correct?

Nurse: We do at least more than 100 transplants every year.

Investigator: Oh, so it’s the same for this year, right?

Nurse: Right. We do more this year than last year.

Investigator: How many have you done since [the beginning of] this year? Several dozen?

Nurse: Yes, almost 100.

Investigator: Nearly 100 so far?

Nurse: Yes, not exceeding 100 yet.

Investigator: Then about 70 or 80?

Nurse: That’s correct.

Investigator: So is there another physician named Yang Jun working in your hospital?

Nurse: A physician named Yang Jun, maybe he has gone to the rural places recently. We cannot reach him. It’s also OK that you just talk to Chief Huang.

Investigator: Chief Huang?

Nurse: Yes. Chief Huang is in charge of dialysis, then performing kidney transplant and contacting Chief Zhou. Yes, for this kind of thing.

Investigator: I never heard of a Chief Zhou, sorry about that. He introduced several chiefs to me but I did not listen carefully. Maybe you have had personnel changes recently? So I will … [interrupted].

Nurse: Wait, have you heard of Wu Xiaotong, Chief Wu?

Investigator: Yes, I know this person. He is the one doing surgery in the final step, right?

Nurse: Right, right. So how about you directly contact Chief Wu?

Investigator: OK, I got it. Bye, bye.

Addendum 90

A Ward Nurse in the Department of Urology and Renal Transplantation at the First Affiliated Hospital of Medical School, Xi'an Jiaotong University.

Phone number: +86 29-85323955

Date: 06/08/2017

Key points:

1. “We have done quite a lot [of kidney transplants.] More than 50 cases, I guess.”
2. “We definitely do more than Xijing [Hospital].”

Phone Investigation Recording:

Nurse: Hello.

Investigator: Hello. Is that the Department of Kidney Transplantation?

Nurse: Ah, yes.

Investigator: I have a family member, who wants to receive a kidney transplant. Can you do it now?

Nurse: We do. We do. You need to tell him to come to our outpatient clinic first.

Investigator: But I am not able to visit your clinic right away. I have to first learn more about the situation. Are there many people waiting in line? At the moment.

Nurse: Quite a lot.

Investigator: So many are waiting. So, so are you doing a lot [of transplants] this year? How many have you done?

Nurse: Quite a lot [of renal transplants].

Investigator: Quite a lot. You mean every week? Or every day?

Nurse: Every week. If you want to do it, you need to tell him to come here for evaluation. You have to do evaluation first. Once that is done, you have to queue up here. Do you understand?

Investigator: I think your hospital…because I have consulted with Xijing Hospital… [interrupted]

Nurse: We’ve done quite a lot. We definitely do more than Xijing [Hospital]. How about you come here. We did quite a lot. We are pretty good.

Investigator: Nurse, can you tell me approximately how many you have done this year?

Nurse: I don’t know the precise [number], more than 50 cases, I guess.

Investigator: OK, that is a bit more than Xijing [Hospital has done].

Nurse: Let’s not go further. Come to our clinic if you want to do it here, OK? I am busy now.

Investigator: OK, no problem. Thank you. Goodbye.

Addendum 91

A Staff Member on Duty at Bright Eye Hospital in Nanchang

Phone number: 0791-86259791

Date: 07/06/2016

Key points:

1. “In general, once the patients come in here, once the corneas arrive, we would do the operations for them right away.”
2. “Since our hospital has an advantage, that is, we have our own corneal bank and corneal sources, so we can start doing operations sooner than other hospitals do.”
3. The donor corneas are all fresh.
4. The donor corneas are not obtained locally.

Phone Investigation Recording:

Staff on Duty: Hello, how do you do? This is Bright Eye Hospital in Nanchang.

Investigator: Hello, how do you do? I just called a moment ago, but the signal was not clear.

Staff on Duty: Hello! how do you do?

Investigator: Hello! Hello! It’s me again. I just want to ask if your hospital is still doing corneal transplantation now.

Staff on Duty: Ah, yes.

Investigator: Do you mean that you are doing a lot now? How many cases you can do in half a year? Do you do a lot?

Staff on Duty: Ah, in general, once the patients come in here, once the corneas arrive, we would do the operations for them right away. Since our hospital has an advantage, that is, we have our own corneal bank and corneal sources, so we can start doing operations sooner than other hospitals do. At other hospitals, people may have to wait for a longer time to find corneas. We are generally faster.

Investigator: I see, once a patient arrives you can start...

Staff on Duty: In addition, we have the doctors, who started [doing] corneal transplants the earliest and did the largest number of such surgeries.

Investigator: Oh, is that Director Zhou Wentian, [who operates]?

Staff on Duty: Yeah, that’s right.

Investigator: Oh, I also heard that he’s been doing well. In that case, have you done about 100 cases in the first half of the year?

Staff on Duty: Ah, because for corneas, in general, once they’re available, [the surgeries] can always be performed. Every month there will be a set of monthly data.

Investigator: Oh, oh, that is to say, those corneas are freshly collected? Not the artificial ones?

Staff on Duty: They are all fresh, ~ [inaudible]

Investigator: Are they freshly excised from the eyes and ready to be transplanted?

Staff on Duty: Yeah.

Investigator: Are those corneas local, or from other places?

Staff on Duty: Ah, not local, we get them from the entire ~ [nation].

Investigator: Excuse me, if we come to your hospital, will Director Zhou Wentian do it in person for us?

Staff on Duty: That’s right, Professor Zhou Wentian does it in person.

Investigator: How much is the cost for one operation?

Staff on Duty: One corneal transplant costs 25,000 yuan.

Investigator: Ah, 25,000 yuan. Oh, that’s fine. Usually (the corneas) are fresh, alive, aren’t they?

Staff on Duty: Yeah.

Investigator: Ah, that’s it. I will tell him to contact you at any time. After I talk to him about the situation, I’ll let him contact you directly? Okay, goodbye.

Staff on Duty: Okay, that’s good.

Addendum 92

Person on Duty at the Organ Donation Management Center of the Zhejiang Red Cross Society

Phone number: +86+ 571-85043999

Date: 12/15/2016

Key points:

1. The Zhejiang Red Cross Society generally goes to various hospitals to promote organ donation.
2. “There are different circumstances. For example, someone is willing [to donate] by himself; someone is suggested by his family members [to donate]; then some people are mobilized by our doctors, or by some other people.”
3. “It is certain that most people would refuse to donate; otherwise, it wouldn’t be such a small number of donations!”
4. “We certify the donations from Zhejiang Province [only]. Donations from other provinces are certified by their own provinces. If [the hospitals in Zhejiang] receive organs assigned from other provinces, it has nothing to do with us.”
5. [Investigator: In general, you have a little more than 170 (donated organs), however, Zhejiang hospitals did many more than that.] Person on Duty: That’s because they have organs assigned from other provinces.
6. “The transplantation process is never managed by our Red Cross.”

Phone Investigation Recording:

……

Person on Duty: Hello, how do you do?

Investigator: Hello, how do you do? Is this the Zhejiang Red Cross Society’s Organ Donation Department?

Person on Duty: Uh, yeah.

Investigator: I am [calling] from Beijing. I am also a volunteer for the Red Cross. I am a recently retired doctor, and I started [volunteering] not long ago. I found out about you on the Internet. Your province has been doing a good job, so I want to learn from you.

Person on Duty: Beijing does better than we do now.

Investigator: What?

Person on Duty: Beijing is doing better than we are now.

Investigator: Do you generally go to various hospitals or into different communities?

Person on Duty: Hospitals.

Investigator: Mostly hospitals. When you start talking to someone [about donating his organs], would he be generally willing to donate? Would he easily agree to do so?

Person on Duty: There are different circumstances. For example, someone is willing [to donate] by himself; someone is suggested by his family members [to donate]; then some people are mobilized by our doctors, or by some other people. It is certain that most people would refuse to donate; otherwise, it wouldn’t be such a small number of donations!

Investigator: Exactly, that’s I’ve also been thinking. Most people would refuse. And in general, when you talk to him [about donating his organs], it is very difficult, very difficult for him to accept. They would just do you a favor…How about the hospitals, such as Zhejiang University’s affiliated hospitals and those international hospitals? They do transplant surgeries, so in general they need donors for liver transplantation and kidney transplantation. Would all of these organs have to go through your certification process?

Person on Duty: Yes, [we provide] organ donation certificates.

Investigator: We have this problem in Beijing. That is, some hospitals did a lot of transplants, many more than the number of donations from our Red Cross. In your case, for example, this year you have 179 donations, but several hospitals in Zhejiang did a lot of transplant surgeries. What about those extra organs? Do those hospitals get certified from you? Do they have to go through the Red Cross?

Person on Duty: ~ No.

Investigator: Do they have to get your certification? Do they have to go through from you?  ~

Person on Duty: We certify the donations from Zhejiang Province [only]. Donations from other provinces are certified by their own provinces. If they receive organs assigned from other provinces, it has nothing to do with us. This is related to the organ distribution.

Investigator: Oh ... you mean that you only certify donations from your own province. If a hospital obtains donor organs from other provinces or other places, then...

Person on Duty: You cannot say so, it’s not called “obtain”, you can only say it’s allocated through the distribution system. Our province’s [Red Cross] doesn’t receive organs assigned to Zhejiang Province.

Investigator: It does not go through your Red Cross...

Person on Duty: Donation process, our Red Cross is only responsible for the organs donated here, until they are taken away.

Investigator: That means…

Person on Duty: It is just about the organ procurement. Once the operation is done, then it is all set.

Investigator: For example, Zhejiang University’s affiliated hospitals, since I have a friend telling me that they did a lot of transplants, but here you have only more than 170 donations. I think, I think, Beijing also has this problem, that is, hospitals did a lot of transplants, but not many went through our Red Cross, I mean ...

Person on Duty: We certify them all.

Investigator: If you certify them all, then the number you have certified and the number of operations in hospital are not consistent.

Person on Duty: [They] should be the same, how could they be inconsistent?

Investigator: In general, you have a little more than 170 [donated organs], however, Zhejiang hospitals did many more than that. I would like to ask ...

Person on Duty: That’s because they have organs assigned from other provinces.

Investigator: Those organs are not from you ...

Person on Duty: We do not certify those.

Investigator: Oh, you mean ...

Person on Duty: That is to say, the transplantation process is never managed by our Red Cross.

Investigator: Oh, regarding how many [transplants] they have actually done, you do not have to get involved?

Person on Duty: That’s right. The transplants are regulated by the Department of Health, not certified by our Red Cross.

Investigator: But they can only do [the transplants] after you [receive] donated [organs], if you do not have donated [organs]...

Person on Duty: That’s right. However, not all the organs [used in transplants] were donated in our Zhejiang Province!

Investigator: Oh, that means they would find organs [from elsewhere] themselves, for example ...

Person on Duty: There is a national organ distribution system. [Investigator: Because I just ...] It has a lot of organs, which are distributed through the system.

Investigator: Oh, that means each province, other provinces ...

Person on Duty: That means, after the system allocates [the organs], the hospitals get assigned organs.

Investigator: Uh.

Person on Duty: The certification of the donations is done by the provinces where the donors are from.

Investigator: Oh.

Person on Duty: So certification and transplant are two different processes.

Investigator: You mean that donor organs assigned from other provinces will not go through your certification process?

Person on Duty: Because that is not related to donations.

Investigator: In that case, so ...

Person on Duty: This is related to the organ distribution system and transplantation.

Investigator: Assignment for transplants, so the transplant would not go through your Red Cross, so it’s not your business ...

Person on Duty: The [organ] assignment is not our business.

Investigator: Organs from other provinces do not need you to certify them.

Person on Duty: If a donation takes place in Beijing, why do we have to certify the donations in Beijing?

Investigator: Oh, that’s why a donor [organ] from one province can be transferred to another province to do [the transplant].

Person on Duty: This is allocated through the system.

Investigator: This is allocated by the system, I see, the system does the allocation. This lady, I am sorry to bother you. I just want to learn how you do this work, that’s it, thank you, goodbye.

Person on Duty: goodbye.

Addendum 93

Person on Duty in the Organ Donation Office at the Red Cross Society of China Jiangsu Branch

Phone number: +86 25 8331 8652

Date: 04/24/2017

Key points:

1. “[The number organ donations here is] so so, not particularly a lot, just so so.”

2. “We received about 80 cases last year.”

3. “[We’ve received] about 30 or 40 cases so far this year.

4. [Investigator: 30 or 40 cases? But not all of these organs can be used (for transplants), right? You have to take (the donors’) ages and health conditions into consideration, right?] Staff: Yes, yes.

5. “Our organ donation [project] launched its national pilot in March 2010, when the organ donations first started.”

Phone Investigation Recording:

……

Staff: Hello, hello

Investigator: Hello, is this Red Cross Society of China Jiangsu Branch, the provincial Red Cross?

Staff: Yes, yes.

Investigator: Is this the organ donation office?

Staff: Hey, right, right.

Investigator: I want to know whether your [donated] organs are only for your local hospitals, or can they be distributed to other places?

Staff: This is not under our control. There is a distribution system belonging the Ministry of Health. The [organs] would be compared. After that, they would be assigned [to different hospitals] by computers. So I couldn’t say whether they are used locally or at other places, because it’s not managed by us.

Investigator: Then what role do you play? Isn’t the Red Cross in charge of the distribution of organs?

Staff: Donations, donations, and the coordination of donations.

Investigator: Oh?

Staff: From donations to procurement. After the organs are procured, the distribution is done by the Ministry of Health, which runs the management system.

Investigator: Does it just cover your local area or something else?

Staff: The local area is given the priority, definitely it is given the priority.

Investigator: Oh, how many organ donations do you receive here?

Staff: Ah, [the number is] so so, not particularly a lot, just so so.

Investigator: As I know, our Chinese people are relatively particular about their organs. We have very few [donated organs] here. Then how many donations did you receive last year? Or were there any donations?

Staff: We received about 80 cases last year.

Investigator: Oh, are these 80 cases registrations or successful donations?

Staff: Successful donations. Successful donations.

Investigator: Oh, more than 80 cases, that’s it. Since we hadn’t heard too much about donations in the past…can you still find that type of [organs from] [Falun] Gong practitioners through the judicial system?

Staff: I do not know about this. I really don’t know about this. That’s not under our management.

Investigator: Oh, you are just responsible for registration. How many donated organs have you got this year, the successful donations?

Staff: Ah, about 30 or 40 cases.

Investigator: 30 or 40 cases? But not all of these organs can be used [for transplants], right? You have to take [the donors’] ages and health conditions into consideration, right?

Staff: Yes, yes.

Investigator: Is it that what gets registered is that number [of successful donations], but the application rate of these organs in transplants is not 100% after the registration?

Staff: Ah, about this, we haven’t done the statistics regarding the utilization ratio of registered donated organs. There is no way for us to do statistics, ah.

Investigator: Oh, in the past, you did not participate in organ donations, right?

Staff: We did not participate in those. Our organ donation [project] launched its national pilot in March 2010, when the organ donations first started.

Investigator: Oh, oh, the Red Cross started [the donations by that time].

Staff: Ah, we do not know about the previous work.

Investigator: Oh, oh yes, so this is the case, uh

Staff: In this area, well.

............

Addendum 94

Person on Duty in the Organ Donation Office at the Red Cross Society of Changzhou City, Jiangsu Province

Phone number: +86 51988155335

Date: 04/26/2017

Key points:

1. “The organ distribution is done by the provincial health department.”

2. “[We have around] five to ten [cases of successful donations] a year. We have received four cases [of donated organs] this year.”

3. The Red Cross has received 29 cases of donated organs from 2011 to the present.

4. “Generally speaking, Shanghai would have a little more [organs]. Then you can contact other channels by yourself. Our Red Cross does not [have organs]...”

Phone Investigation Recording:

Investigator: Hello, is this the Red Cross of Changzhou City?

Staff: Hey, yes.

Investigator: I want to ask about the situation of organ donations, of which you are in charge. Are the organ donations mainly for your local hospitals, or they also be used to support other places?

Staff: This…this depends on the situation.

Investigator: Oh, what you mean?

Staff: This is not our business, the organ distribution is done by the provincial health department. They are responsible for the organ distribution.

Investigator: Oh, which section of the health department?

Staff: The provincial health and family planning commission [Investigator: Oh.] of our Jiangsu Province Health Department.

Investigator: Oh, they are in charge of the distribution, right?

Staff: Yes.

Investigator: Oh, I would like to ask, are there many people donating organs in your area?

Staff: Ah ... not many.

Investigator: Oh, that means, the demand is beyond the supply. How many cases would you have for one year? I mean voluntarily ... and successful donations.

Staff: Five to ten a year.

Investigator: Five to ten ... how about the successful ... I mean the ones successfully excised...

Staff: Yes, five to ten cases of successful donations.

Investigator: Five to ten ... oh [Staff: Right.] So how many cases have you received this year?

Staff: This year ah ...? [Investigator: Yes.] We have received four cases this year.

Investigator: Are these four cases with successful [organ] excisions?

Staff: Yes.

Investigator: In Changzhou, which hospitals are good at performing organ transplant surgeries? And which types of transplantation surgeries are their specialties?

Staff: Only the First People’s Hospital of Changzhou is qualified to perform organ transplants.

Investigator: What kinds of transplantation does it do?

Staff: Kidney transplantation.

Investigator: How about the other transplants, such as heart or liver transplants. They cannot do them?

Staff: No, [these’re done] only in Nanjing and Shanghai.

Investigator: If we want to look for the [type of donors] through the judicial system, like in the previous years, there were a lot of...

Staff: It does not work now.

Investigator: Can that kind of [organs of] [Falun] Gong practitioners be found?

Staff: No.

Investigator: No, ah... Their [organs] are no longer allowed to be used or there are other reasons...

Staff: Cannot be used... You are right.

Investigator: Oh ... Why could they be used in previous years?

Staff: Hey, this is a legal issue. When you ask me ... I cannot explain it to you.

Investigator: Oh ... I see.

Staff: Yes.

Investigator: Oh, ok ... so you mean that you can only provide [organs] for local use or ...

Staff: Jiangsu, Jiangsu, yes.

Investigator: Jiangsu, only for use in Jiangsu?

Staff: Yes, uh.

Investigator: Oh, that’s it. [Staff: Yes.] When did you begin to implement organ donations?

Staff: Year 2011.

Investigator: Oh, in 2011. From 2011 up until now, how many donations you have received, like the successful donations in the past few years?

Staff: Uh ... 29 cases.

Investigator: I am thinking that I should find one place, where they have a lot of donations, so that I can contact them to...

Staff: Are you in need [of donors] or what else?

Investigator: Yes, we are. We need [donors].

Staff: Ah?

Investigator: We need [donors].

Staff: Generally speaking, Shanghai would have a little more. Yes, Shanghai.

Investigator: Well, then I can contact…you said that I can find [organs] in Shanghai, right?

Staff: Yes, then you can contact other channels by yourself, our Red Cross does not [have organs]... We just monitor the formal procedure in this aspect and spread propaganda. The rest of the work is not our business.

Investigator: Oh. [Staff: Well.] Oh, yeah, this is the case.

 [The phone rang…]

Investigator: Ok. Thank you! Thanks!

Staff: Uh. Goodbye.

Investigator: Uh, Bye-bye.

Addendum 95

Person on Duty in the Organ Donation Office at the Red Cross Society of China, Suzhou Branch, Jiangsu Province

Phone number: +86 +51265233433

Date: 04/26/2017

Key points:

1. The Red Cross in Suzhou received 6 or 7 cases of organ donations in 2016.

2. “There have been two cases of donations this year.”

3. From July 2011 to the time this phone call was made, this branch has received a total of 35 cases of donated organs.

4. “The organ transplant hospital in Suzhou only performs kidney transplants.”

5. “There is no more judicial pipeline now. That kind of [organs of] prisoners can no longer be used. That is illegal, only from the normal [channels]…which is to choose from the registered donors.”

6. “The Ministry of Health has a national distribution system of donated organs. It’s not up to the Red Cross to decide the distribution.”

7. “The Red Cross is only responsible for formally spreading the propaganda for the organ donations on behalf of the state.”

Phone Investigation Recording:

Staff: Hello!

Investigator: Hello! Is that the Red Cross in Suzhou?

Staff: Yes, yes.

Investigator: Can I ask whether the donated organs you received can be given to other provinces to support them?

Staff: Ah, organs, what are you talking about?

Investigator: Aren’t you in charge of the organ donations?

Staff: Ah.

Investigator: How about the organ donations? Are the organ donations only for the use of your local hospitals, or they can also be transferred to other places?

Staff: No, no. By the way, what are you doing now? Do you want to donate [your organs] or get registered?

Investigator: No. We are looking for extra organs, which can be given to us for support.

Staff: Ah.

Investigator: Do you have many donated organs? How many donors do you have in a year?

Staff: Uh, as for donations, it should be 8 to 10 cases in a year.

Investigator: Oh, yes.

Staff: Every year ...

Investigator: Are these cases successful organ donations?

Staff: Uh, right, right. We don’t have too many organ donations in Suzhou right now.

Investigator: Well.

Staff: In the entire province, Suzhou has 35 cases of donated [organs]. So, we have relatively more, as a prefecture-level city.

Investigator: Are these all for last year?

Staff: Oh no, we didn’t receive that many donations last year. Only seven or eight cases…[no] six or seven cases.

Investigator: How about this year? The first half of this year?

Staff: Two cases this year. There have been two cases of donations this year.

Investigator: When were the over 30 cases you mentioned donated?

Staff: Since 2010…alas, from July 2011 to the present.

Investigator: Oh, there are a total of more than 30 cases of organ donations?

Staff: Uh, right, right, in your situation, you should not call around and apply at the Red Cross Societies of different cities one by one, because it’s useless, do you understand?

Investigator: Uh, oh, that’s the case.

Staff: On one hand, you cannot wait for donors; on the other hand, the organ donors all have blood types, which may not be suitable to your ill family member, right? So the best way for you is registering at all the organ transplant hospitals.

Investigator: Can I ask what kind of organ transplants are the best and have the most surgeries done in Suzhou?

Staff: Only kidney transplants in Suzhou. The organ transplant hospital in Suzhou only performs kidney transplants.

Investigator: Yes ...

Staff: But no liver transplants.

Investigator: Uh, yes ...

Staff: The First Affiliated Hospital of Soochow University.

Investigator: If they have many patients waiting for surgeries, and the organ donations from you are in short supply. How should we deal with this?

Staff: Uh, what donations?

Investigator: I mean that there are a lot of people waiting [for organs], but very few people are willing to donate theirs, how to deal with this?

Staff: Oh, there is no way to solve this situation. We can only wait, because we cannot break the law.

Investigator: Is there any other way to find [organs]?

Staff: There is no more judicial pipeline now. That kind of [organs of] prisoners can no longer be used. That is illegal, only from the normal [channels]…which is to choose from the registered donors.

Investigator: Weren’t there many [such organs] in the previous several years?

Staff: Alas, how could there be so many? The gap of organ donations was already large.

Investigator: Oh, no, in previous years, there were no organ donations. People all found the people in custody through the judicial pipeline, or that kind of Falun Gong practitioners, people who practice Falun Gong.

Staff: Oh, that was a violation of human rights and of the state laws. And it is not allowed to do that now.

Investigator: Why it did not ever break the law in the past?

Staff: In the past, that was…was…Well, this is not a topic I should communicate with you about, you know? We were not in charge of this, so we don’t know the details. And I cannot talk very comprehensively about this. This is not something that I should communicate with you about. Why there were so many donors before? In fact, the Ministry of Health gave the organs of executed prisoners [to hospitals] for transplants. That is, through the judicial pipeline, the organ transplant hospitals [used the organs to] conduct transplant operations. But it has stopped now, understand? They could take [the organs of the prisoners shot to death] before, but now it’s stopped. Anyone trying to get [those organs from the judicial system] is illegal, understand?

Investigator: Oh, the [organ] distribution is not managed by you, right?

Staff: Ah, the distribution belongs to the Ministry of Health, which has a national distribution system of donated organs. It’s not up to the Red Cross to decide the distribution.

Investigator: Oh?

Staff: Since you consult with us, I want to tell you that you can only go to the transplant hospitals and apply for matching and then wait. Do you understand?

Investigator: Yes, yes.

Staff: The Red Cross is only responsible for formally spreading the propaganda for the organ donations on behalf of the state. After someone makes a donation, we would coordinate and serve as a witness...[Investigator: I see.] Well, do you understand?

Investigator: Ok, ok, I see, so this is the case!

Staff: Good, good.

Investigator: So I may not be able to find [organs] through the Red Cross, but some [Red Cross Societies] with more [organs] can be ...

Staff: It’s useless to talk with our Red Cross. It’s useless to talk with our Red Cross. Only talking with the transplant hospitals can be useful.

Investigator: Talking with the hospitals? Oh, okay.

Staff: Yes, good.

Investigator: Hey, then...

Addendum 96

Person on Duty in the Organ Donation Office at the Red Cross Society of Taizhou, Jiangsu Province

Phone number: +86 +52386393269

Date: 04/27/2017

Key points:

1. “All the organs are allocated within the system. No, we do not know which [hospital] will receive the organs!”

2. “It’s useless to look for organ sources at the Red Cross. You should look for hospitals.”

3 “Some people donate [their organs], and we accept them. After that, how the organs will be used, it’s beyond our responsibility!”

4. “[We receive] very few [donated organs], one or two cases last year.”

5. “[This year], it seems that there’s nothing, I have not even heard of [any donation].”

6. “The doctor would tell the family members that this person would no longer be saved [Investigator: Hmm] due to a car accident. There’s certainly no way [to save him]. In this case, organ donation can be considered.”

7. “In the case, where the person is not dead but is brain-dead, then his organs can be used. So how many [useful] organs can there be?”

Phone Investigation Recording:

……

Staff: How do you do?

Investigator: Hello, is this Taizhou [Staff: Hello?] Is this the Red Cross of Taizhou?

Staff: Yes.

Investigator: Can I ask you, are you responsible for the organ donations?

Investigator: Are there many donations? For example, how many donations you receive in a year?

Staff: Very few.

Investigator: You...

Staff: Why? Because organs are different from human remains. Organs need the [donors] to be brain-dead.

Investigator: Oh?

Staff: That means a organ donated is useless if you are already dead. It’s very difficult to donate organs that way. In the case, where the person is not dead but is brain-dead, then his organs can be used.

Investigator: Oh, oh, this is the case.

Staff: Ok…

Investigator: Ok, ok, this is the case, oh…

Staff: This is the case. So how many [useful] organs can there be? Uh…

Investigator: Yes, for example, [would the deaths from] car accidents belong to this category?

Staff: Yes, [deaths from] car accidents can also be considered, yes.

Investigator: Oh...

Staff: Uh

Investigator: Then, before that...

Staff: That is, when a person can no longer be saved, at this moment, the person’s breathing and heartbeat haven’t stopped, so they can be maintained in this situation, and [his organs] can then be donated.

Investigator: Oh, that is... the heartbeat…

Staff: Can you guess how many [donations] would we have in a year?

Investigator: If the heartbeat completely stops, then…

Staff: Once the heartbeat stops, the organs would become useless after a while.

Investigator: Yes, even if he voluntarily donates his organs, it would still be unsuccessful.

Staff: The organs would be unfit for use!

Investigator: Right, that’s true.

Staff: That is, if a person dies, his organs cannot be used. It’s only when you die in the hospital, can your organs be excised at the scene.

Investigator: Oh…Then it becomes even more restricted, only in the hospital ...

Staff: But sometimes there wouldn’t be enough time. If someone indeed dies, when he arrives at the hospital, there are still some procedures to go through, and the deceased’s family members need to agree. It would be too late. So there is generally one situation: brain death. The doctor would tell the family members that this person would no longer be saved [Investigator: Hmm] due to a car accident. There’s certainly no way [to save him]. In this case, organ donation can be considered.

Investigator: Oh, it would still take some time, as his family members need to agree and there are some procedures to go through.

Staff: Yes, yes, so his breathing and heartbeat must be maintained.

Investigator: Oh, yes, yes, that’s the prerequisite…

Staff: Well, uh, uh, uh.

Investigator: For example, how many cases did you receive last year?

Staff: I do not know, I am not in charge of this work, but I have some rough idea. I’m not clearly about exact how many cases, either.

Investigator: That is, approximately...

Staff: Very few, one or two cases.

Investigator: Oh, how about this year? Half a year has already passed…

Staff: One case this year

Investigator: This year…

Staff: It seems that there’s nothing, I have not even heard of [any donation].

Investigator: Oh, then…

Staff: I haven’t heard!

Investigator: Then in Taizhou … are there any hospitals, which can conduct organ transplant surgeries, such as kidney transplants …?

Staff: No, no, no ~

Investigator: There’s no transplant?

Staff: No.

Investigator: They can’t do it?

Staff: They can’t.

Investigator: If they cannot do organ transplants, is it useless for people to donate [organs] to you?

Staff: They donate organs to us, and we can distribute them elsewhere through the unified allocation system. The hospitals in other places, like Shanghai and Nanjing, can do transplants.

Investigator: Oh, oh, so this is the case. The hospitals here cannot even do organ transplants. Are the hospitals too small? Maybe.

Staff: Uh, maybe there are too few patients doing operations.

Investigator: Oh, I see.

Staff: Yes.

Investigator: Oh, so this is the situation in your [Red Cross].

Staff: Okay?

Investigator: Okay, okay, thanks! Thanks!

Staff: okay.

Addendum 97

Person on Duty in the Organ Donation Office at the Red Cross Society of Nantong City, Jiangsu Province

Phone number: +86 +51385053656

Date: 04/27/2017

Key points:

1. “We do very little here. In all these years, we’ve only handled a couple of cases. We have had few donations here.”
2. “For all these years, the total number [of donated organs that we’ve received] is only two.”

Phone Investigation Recording:

Red Cross Staff: Hello.

Investigator: Hi, Hello. [Red Cross: Hello.] Is this the Nantong City Red Cross?

Red Cross Staff: Yeah, who is calling?

Investigator: Oh, I also work for a hospital, a hospital in northern China. I’d like to find out some info about your donated organs. Do you use them only locally? Could you allocate your surplus organs to other hospitals?

Red Cross Staff: We don’t have any. We…to be specific, there is mainly an Organ Coordination Committee, which makes decisions. We do very little here. In all these years, we’ve only handled a couple of cases. We have had few donations here. Uh, ok? And all [donation cases] involved people from the provincial government.

Investigator: Oh, not so many donations, right? For example, for the whole year last year [Red Cross: Yeah, that’s right.], how many donations did you receive?

Red Cross Staff:  Not only last year, for all these years, the total number [of donated organs that we’ve received] is only two. There is few, very, very few [donation]. Hum, uh, ok? Bye!

Addendum 98

Person on Duty in the Organ Donation Office at the Red Cross Society of Guilin, Guangxi Province

Phone number: +86 +7732896981

Date: 09/12/2016

Key points:

1. [Investigator: So the 165 donations all took place this year?] Staff on duty: That’s impossible. That’s [the total number] of all [received organs] since we started organ donations here.
2. [Investigator: Since last year, you’ve received that many?] Staff on duty: No, no. I cannot disclose the figure to you, ok?

Phone Investigation Recording:

……

Staff on duty: Hello.

Investigator: Hello, hi, is this the Emergency Care Department of the Red Cross Society of Guilin?

Staff on duty: Yes.

Investigator: I read a report and learned that you’d had 165 cases of donation. Uh, so it’s really not a small number, so I’d like to ask how you operate to have such a good result.

Staff on duty: Uh, for this, you may need to ask our department head. Because the main thing, this, uh, I cannot tell you the specific details.

Investigator: So the 165 donations all took place this year? Your 165 cases?

Staff on duty: That’s impossible.

Investigator: Oh, impossible.

Staff on duty: That’s for sure. That’s since…no… That’s [the total number] of all [received organs] since we started organ donations here.

Investigator: Since…well, since last year, you’ve received that many?  Still not a small number.

Staff on duty: No, no. I cannot disclose the figure to you, ok?

Investigator: Oh, ok.

Staff on duty: Eh, I’m sorry, uh, ok…

Addendum 99

Person on Duty in the Organ Donation Office at the Red Cross Society of Guilin, Guangxi Province

Phone number: +86 +7732896981

Date: 11/24/2016

Key points:

1. “We just have a total of 5-6 people in the Guilin City Red Cross. This organ donation is only one of our jobs, not all of our jobs.”
2. [Investigator: So the organs of those 30 kidney transplants performed in July didn’t all come from you?] Staff on duty: These? No, no.
3. “[We’ve received] over 40 cases [of donated organs this year].”

Phone Investigation Recording:

……

Staff on duty: Hello.

Investigator: Oh, hi. Is this the Guilin City Red Cross?

Staff on duty: Yes, it is.

Investigator: Oh, I have a question, that is, you’ve been doing a good job in terms of receiving organ donations, and [your story] must have been featured in newspapers. So, I’d like to know how you did the promotion to achieve such a wonderful result.

Staff on duty: Uh..Where are you calling from?

Investigator: Uh, I’m calling from Chengdu.

Staff on duty: Chengdu, Uh, Chengdu…Where in Chengdu?

Investigation: Let me explain. I was a doctor, but I’m retired. Now I want to become a volunteer. Since a professor of the Third Military Medical University often comes to Guilin to perform surgeries, he told me that there are relatively more transplant operations here. He does transplant operations at the No. 181 Hospital. He has performed a lot in the No. 181 Hospital. He said that they got their donor organs from the Red Cross donations, so I become very interested..

Staff on duty: You can’t say that we…we just… we participated as a witness.

Investigator: Oh, I see, so you…

Staff on duty: That’s right. Speaking of our Red Cross, we only have several staff members. To be frank with you, we just have a total of 5-6 people in the Guilin City Red Cross, and we also need to…This organ donation is only one of our jobs, not all of our jobs.

Investigator: Uh, this professor said that they did a lot here. For example, in July, they performed over 30 kidney transplants. Then I thought, Oh, they really did a good job, so I’d like to find out. Because the professor told me, the organs might all come from Red Cross donations, so I think..

Staff on duty: These? No, no.

Investigator: Oh, so after I heard the professor’s words, I’d like to call you and find out more about your situation. Because he comes here quite often, as he travels to the No. 181 Hospital very often. He talks to me about the situation here. So the organs of those 30 kidney transplants performed in July didn’t all come from you?

Staff on duty: No, no, no. Not all from us.

Investigator: Oh, oh, then I understand, oh, now I understand.

Investigator: Uh, right, right, so you received several dozen more donated organs this year?

Attendance: Uh, Over 40 cases.

Investigator: Oh, now I see, I know now, thank you. Thanks for the explanation.

Staff on duty: Ok, all right.

Investigator: Goodbye.

Addendum 100

Person on Duty at the Red Cross of China, Yangzhou Branch, Jiangsu Province

Phone number: +86 +51487323121

Date: 04/27/2017

Key points:

1. “Our Red Cross here has only corpse donations and cornea donations, organ donations haven’t started in our Yangzhou City yet.”
2. “Some cities nationwide are currently experimenting with organ donation pilot projects. But our Yangzhou is not one of them.”
3. “Not [all the Red Cross Societies] in different cities can accept organ donations.”
4. [Investigator: Since he has already donated his corpse, aren’t all his organs included?] Red Cross: No, you can’t. They are different. Corpse donations are different from organ donations.”

Phone Investigation Recording:

……

Red Cross: Hello?

Investigator: Hi, is this the Yangzhou City Red Cross?

Red Cross: Hi, yes.

Investigator: Hi, I’d like to ask you a question. You coordinate organ donations, and I also work for a hospital. I wonder if you have extra organs to share. Do you only supply organs locally or you give them to other places as well?

Red Cross: Where are you calling from?

Investigator: Oh, I’m calling from Shaanxi.

Red Cross: Oh, oh, your call to us is not appropriate actually, because ours is a remote city, and our Red Cross here has only corpse donations and cornea donations, organ donations haven’t started in our Yangzhou City yet. This is because some cities nationwide are currently experimenting with organ donation pilot projects. But our Yangzhou is not one of them.

Investigator: Oh, so you don’t take care of [organ] donations, uh…

Red Cross: We accept corpse donations.

Investigator: It’s…

Red Cross: Organs, not all cities can accept organ donations.

Investigator: Oh, has anyone voluntarily donated [his/her organs] to you and registered with you?

Red Cross: No, there is none. Our registrations here are all corpse donations. Corpse donations are different from organ donations. The entire bodies are donated in corpse donations, while certain individual organs are donated in organ donations.

Investigator: Oh, not the same. So a corpse donation takes place, when a person dies, and his/her entire dead body…

Red Cross: Ah, that’s right. He donates his corpse to the Medical College of Yangzhou University. The Medical College accepts it. He doesn’t sell organs, you know. He doesn’t donate organs.

Investigator: He only donates his dead body.

Red Cross: Ah, that’s right, yeah.

Investigator: So it’s called a corpse donation. Since he has already donated his corpse, aren’t all his organs included? You can excise [the organs] arbitrarily…

Red Cross: No, you can’t, you can’t do that. They are different. We can’t do that here. We are not running a experiment site. Eh, ok, thank you. We don’t have that here.

Investigator: Oh, so you don’t have organ donations? Ok.

Red Cross: No, we don’t. You’ve called the wrong place.

Investigator: Oh, ok.

Red Cross: Uh, that’s all right, goodbye.

Addendum 101

Office Staff on Duty in the Red Cross Society of Yantai City, Shandong Province

Phone number: +86 0535_2123999

Date: 04/21/2017

Key points:

1. [Investigator: Last year Yuhuangding Hospital did 270 cases (of kidney transplantation). For those 270 kidney transplants, they couldn’t all come from you?] Staff on duty: Certainly not. How could we have that many?
2. [Investigator: They performed 270 transplants. Did your Red Cross know about those organ transplants?] Staff on duty: We did not know about this.

Phone Investigation Recording:

……

Staff on duty: Hello.

Investigator: Is this the Yantai City Red Cross?

Staff on duty: Yes.

Investigator: Last year alone, you completed 46 cases of donations, a year-over-year increase of 450%. It’s indeed quite amazing. So, how did you launch…promote it?

Staff on duty: What are you talking about? About the corpse donations?

Investigator: Yes, that’s right. I saw that last year your number of donations increased by 450% from the [year before last]. Your grand total is only 81, but last year alone is 46. Now we are promoting donations in China, but it’s rather difficult to do so. So I think you’ve done a great job.

Staff on duty: Nothing specific. The comrade in charge is out of town, eh, not at home currently.

Investigator: Your promotion started ahead of time, so to speak?

Staff on duty: Of course. If you go to the wards asking for donations, you would be too inhumane, right? If the patient doesn’t want to donate, you would definitely be berated.

Investigator: Hey, I know in Yantai, there is a hospital called Liuhuang, no, Yuhuangding hospital?

Staff on duty: Yuhuangding.

Investigator: So the name is Yuhuangding Hospital. They did a lot of transplants.

Staff on duty: That’s right.

Investigator: So their organs usually all go through your Red Cross, uh, this…

Staff on duty: Of course. In terms of procedure, they have to go through us, because we are the witness.

Investigator: Oh, but they did..I saw a report…I just read an article…they did 100-160 organ transplants every year. That many donors, did their organs all come from you?

Staff on duty: No, they… [cleared his throat] They could also get organs from other regions, because they belong to the organ procurement hospitals, so they do not just get local organs. If we have organs, which cannot be used here, we also transfer them to other areas.

Investigator: Oh, so you do not need to directly…For example, now you have an organ donor, you contact Yuhuangding directly and say if you come, we can give it to you...

Staff on duty: Oh, no, no, there is no need.

Investigator: You don’t need to do that?

Staff on duty: We’re just, the Red Cross is just a witness. We check whether or not the procedures are legal and meet the [specific] requirements. That's all.

Investigator: But you see, taking Yuhuangding as an example, they released their latest statistics this year. They usually said 100-160 cases annually, but last year they did 270 cases. For those 270 kidney transplants, uh, they couldn’t all come from you?

Staff on duty: Certainly not. How could we have that many?

Investigator: But, they said they performed 270 transplants. This, did your Red Cross know about those organ transplants?

Staff on duty: We did not know about this.

Investigator: Oh, oh, because when I read that they did over 200 cases this year, [I thought], if all these organs were from the Red Cross, then, you should have more organ donations here, not just 46 cases.

Staff on duty: Uh.

Investigator: So it’s impossible that all were from you.

Addendum 102

Ms. Huang in the Organ Donation Office at the Red Cross Society of China, Guangdong Branch

Phone number: +86 020-38824642

Date: 04/28/2017

Key points:

1. Only hospitals can access the organ distribution online system of the National Health and Family Planning Commission [NHFPC], the Red Cross Societies cannot.
2. If more organs are transplanted than donated, the excess ones aren’t managed by the Red Cross. These organs are allocated to different hospitals through a distribution system supervised by the NHFPC.

Phone Investigation Recording:

Ms. Huang: Hello, hi

Investigator: Hi, is this the Guangdong Province Red Cross?

Ms. Huang: Yes.

Investigator: Oh, hello, I'd like to ask you, you really did quite well in terms of donations, ranking first in the entire country. I’d like to ask how you achieved this?

Ms. Huang: Where are you calling from?

Investigator: We are a Red Cross Society in Hebei. Our president told me, “Go to ask them. Our province did poorly. We just don’t know how to go about doing it.” So we’d like to ask, as the number one in the country, how did you carry out this work?

Ms. Huang: Mainly because we’ve been doing it for a long time. Our Provincial Health Department divided the areas.

Investigator: So you are divided into different areas, and based on the areas, you provide hospitals with organs for transplants. I heard that there is another platform, to handle your extra donors or extra organs. It’s a national platform. Can your Red Cross get onto this platform? Can you go to this ...

Ms. Huang: This distribution [system] is under the National Health and Family Planning Commission [NHFPC].

Investigator: If the NHFPC is in charge, are you also involved?

Ms. Huang: We do not participate in this.

Investigator: Oh, not involved, so you cannot access this network?

Ms. Huang: Correct. The distribution is done by the hospitals themselves. They fill out forms according to the requirements of the distribution network. We are not involved.

Investigator: Only the hospitals can access this online system?

Ms. Huang: Yes, yes.

Investigator: Ma’am, my surname is Liu, and may I know yours? I don’t know how to address you?

Ms. Huang: That’s all right, my last name is Huang.

Investigator: Miss Huang, say the hospital, for example, you gave them 100 donated organs, but they might have done 300 transplants, then, the [transplant number] would exceed [your donated] number, how do you Red Cross manage in this area? ...

Ms. Huang: We’re only responsible for the donations. If the organ is allocated to them from another province…

Investigator: Then it has nothing to do with the Red Cross?

Ms. Huang: Right, it’s through the distribution system, and the allocation is directly managed by the NHFPC.

Investigator: If managed by the NHFPC, then it has nothing to do with you. How about for the extra donors, there’s no need for the Red Cross to testify, no need for you to bear witness?

Ms. Huang: It is allocated from the network.

Investigator: Oh, I see. If that’s the case, then they did more transplants than the number of organs you actually provided them, so they can go to find the organs themselves?

Ms. Huang: No, because it is distributed from the network, but the allocation is done by the distribution system, which is supervised by the NHFPC.

Addendum 103

Mr. Chen in the Organ Donation Office at the Red Cross Society of China, Yunnan Branch

Phone number: +86 0871 67195073

Date: 12/01/2016

Key points:

1. An Organ Donation Office at the Provincial Red Cross Society should be able to oversee the sources of all organs donated in the entire province.

2. According to Mr. Chen’s statistics, two days before the phone investigation, the number of organs donated was nearly 70 for the entire year of 2016.

3. [Investigator: How come those hospitals that operate organ transplants make a great deal of profit?] Mr. Chen: As to what kind of agreement is reached between the hospitals and the organ recipients, or what secrets are between the hospitals, we cannot get to know, neither will they tell us.

4. [Investigator: So the First Hospital of Kunming has done so many transplants, do their sources have to go through you?] Mr. Chen: They don’t have to go through us. However, without our testimonies, if anything happens, they would certainly have a hard time explaining.

5. [Investigator: But there are such incidences, where they don’t go through you (to procure organs). They do this themselves, looking for donors and operating surgeries, there are such incidences.] Mr. Chen: As far as I know, now that the government has passed legislation banning it, and they are prohibited from doing so. It is equivalent to organ trafficking.

6. “Today our Red Cross obtains the results from our systematic statistics. For example, about one million organs are in demand each year, now only about 300,000 organs are available, possibly accounting for less than 1/3 of the required number.”

Phone Investigation Recording:

Mr. Chen: Hello, hello.

Investigator: Hello, is this Yunnan [Provincial] Red Cross Society?

Mr. Chen: Right, right, who is this?

Investigator: I am a volunteer at the Beijing Red Cross Society. I heard that you have done a good job in terms of organ donations. How did you do that? I called your main office just now, and they told me that you are in charge of this matter.

Mr. Chen: Are you from the Beijing Red Cross?

Investigator: Yes, yes.

Mr. Chen: About the organ donations, we only serve as a witness to organ donations. As far as specific procedures are concerned, can I give you a telephone number [for you to call]?

Investigator: Sure, sure. Do we have many donated donors this year?

Mr. Chen: Do you mean in Yunnan Province? [Investigator: Ah, right.] Overall, it depends on the propaganda. For this year, let me see, nearly 70 cases, according to the statistics that I did two days ago.

Investigator: Oh, 70, for the entire Yunnan Province?

Mr. Chen: Just here, basically only provincial Red Cross Societies have organ donation offices.

Investigator: Does Kunming [City’s Red Cross] have one too?

Mr. Chen: It goes like this. In a province, the Organ Donation Office of the Provincial Red Cross Society is in charge of organ donations. And then all levels of Red Cross Societies get involved. For incidence, Kunming Municipal Red Cross, counties’ Red Cross Societies. If an organ donor is available, his information will be collected through the system of our Red Cross, then summarized to us, the provincial Red Cross, and then we take control of this matter and take a unified approach to operate this.

Investigator: Oh, do you mean that if they get any [organ] donor, they’ll have to report to you, am I correct?

Mr. Chen: They don’t report. It is equivalent to…as for organ donations, our Red Cross has an unified and vertical control. The organization, which is really doing this, at the provincial level, is the Organ Donation Office of the Provincial Red Cross Society. i.e. this office should be able to oversee sources of all organs donated in the whole province.

Investigator: How come those hospitals that operate organ transplants make a great deal of profit?

Mr. Chen: As to what kind of agreement is reached between the hospitals and the organ recipients, or what secrets are between the hospitals, we cannot get to know, neither will they tell us.

Investigator: Quite a lot of organ transplants have been done by the First Hospital of Kunming. Is that a large number?

Mr. Chen: Right, right. The First Hospital of Kunming is quite prominent, in terms of what they do. Let’s put it this way, the Red Cross is the middleman. After the government passed the related legislation, we, as a humanitarian organization, participate in this process, and mainly serve as a witness.

Investigator: So they have done so many [transplants], do their sources have to go through you? Some of the doctors there operate several hundred organ transplants in one year.

Mr. Chen: They don’t have to go through us. However, without our testimonies, if anything happens, they would certainly have a hard time explaining.

Investigator: But there are such incidences, where they don’t go through you [to procure organs]. They do this themselves, looking for donors and operating surgeries, there are such incidences.

Mr. Chen: As far as I know, now that the government has passed legislation banning it, and they are prohibited from doing so. It is equivalent to organ trafficking.

Investigator: When did you start working on organ donations? From which year?

Mr. Chen: Oh, we have been working on this for only a few years, because not many years have passed since the government regulated this [organ donation/transplant] category. We began working on this approximately since 2012 or 2013.

Investigator: So in general, most of the donations are basically [obtained] through this way. You said that you have 70 organ donation cases this year [2016], so what’s the accumulative total of the donated cases in all these years?

Mr. Chen: Oh, let me take a look, our side seems, from 2013 to the present, from the time we started participating in this to the present, we should’ve had 100 or 200 cases. Usually, many people are restricted by their traditional way of thinking, so they don’t want to do this [i.e. organ donation].

Investigator: The First Hospital of Kunming, as well as the First Affiliated Hospital of Kunming Medical University, they have done quite large amounts of organ transplants. Regarding the sources of their donors, if they didn’t come from you, the Red Cross, where do they get those organs?

Mr. Chen: Last year [2015], didn’t the government already abolish the provision that allowed the removal of organs from executed prisoners? Now, I say one thing, that is, they can avoid a lot of unnecessary trouble if doing this through the Red Cross. They will be better off if a Red Cross gets involved.

Investigator: But the [organ transplant] amount they do is far more than what your Red Cross can provide?

Mr. Chen: Then it involves the relationships between hospitals, or the equipment in the hospitals, or medical technologies… Anyway, I don’t understand those things, because it also involves a lot of things in the technical aspects.

Investigator: Is it true that there are absolutely no organs removed from executive prisoners, or there still are? Should this have been stopped?

Mr. Chen: What are you talking about?

Investigator: Is the practice of removing organs from executed prisoners stopped? Is it still ongoing?

Mr. Chen: That, that should not happen, that should not happen. The government has legislation banning it, so it certainly should not happen. Because of this, the need for organs now is quite huge, and the organs are really in short supply. There is no way [to meet the demand]. Today our Red Cross obtains the results from our systematic statistics. For example, about one million organs are in demand each year, now only about 300,000 organs are available, possibly accounting for less than 1/3 of the required number.

Investigator: All right. That is all for today.

Mr. Chen: Ok, ok, goodbye.

Addendum 104

Mr. Wang, Organ Coordinator at the Red Cross Society of China, Nanchang Branch

Phone number: +86+791_86771992

Date: 12/08/2016

Key points:

1. “We as a provincial capital city, only have 50 to 60 people registered with us to donate their bodies during one year.”
2. “Approximately 20 organ donations are successful in Nanchang City [this year].”
3. “I cannot guarantee that all hospitals obey the law, right?”
4. “Mr. Wang: If they want to violate the law, [they can], as our Red Cross has no supervisory authority.”
5. “According to legal procedures, a legitimate process of corpse donation must be witnessed by the Red Cross system.”
6. “If the donation is taking place between two family members, we don’t have to witness this type of donations. However, if the donations are between unrelated people, who do not know each other, then we must witness it”
7. [Investigator: Those hospitals can use their contacts and process the donations. That is, they don’t have to go though you…] Mr. Wang: Yes, because of this, it might lead to black marketeering.
8. “What they do on their own black market is not our business!”

Phone Investigation Recording:

……

Mr. Wang: Hello! Who is this?

Investigator: Hello, hello, is this the Nanchang Municipal Red Cross Society?

Mr. Wang: Yes. Who is this?

Investigator: I am calling from Beijing. I want to ask you about the organ donation situation in your office?

Mr. Wang: You are in Beijing, and you ask me about organ donations?

Investigator: Oh, I’m calling you, because I have heard that you guys are doing a good job. Recently I read an article, saying that in the last few months, November or so, there was an organ donation in your city. So I want to know how you are doing this so well? Because I am a volunteer for the Beijing Red Cross, and I have just retired and am now helping them. I would like to ask, because...

Mr. Wang: Oh, you, you are a volunteer for the Beijing Red Cross, right?

Investigator: Yeah.

Mr. Wang: The problem is that regarding corpse donations, we haven’t done particularly well, either. As a result, we as a provincial capital city, only have 50 to 60 people registered to donate their bodies during one year.

Investigator: Oh, then about your real donations…I read somewhere that you have one donation this year. How many actual donations do you have this year?

Mr. Wang: How many are donated? Do you mean the successful donations?

Investigator: Yes.

Mr. Wang: Approximately 20 organ donations are successful in Nanchang City [this year].

Investigator: Oh, more than 20 donors in your entire city, that is?

Mr. Wang: Yes, the whole city.

Investigator: Do you have this kind of situation: some hospitals get organ donors without going through you?

Mr. Wang: Yes, how could it not? Every hospital in the country, I dare not, I cannot guarantee that all hospitals obey the law, right?

Investigator: Uh?

Mr. Wang: If they want to violate the law, [they can], as our Red Cross has no supervisory authority.

Investigator: Oh, no authority?

Mr. Wang: So it has to rely on their own health system to monitor [the procedures]. According to legal procedures, a legitimate process of corpse donation must be witnessed by the Red Cross system. Moreover, an individual cannot get through the procedures by himself. If the donation is taking place between two family members, such as from a father to his son, or from a husband to his wife, we don’t have to witness this type of donations. However, if the donations are between unrelated people, who do not know each other, then we must witness it, and this type of donations must go through the platform of the Red Cross to be carried out.

Investigator: do you say that, for all the donors they [use] to perform surgeries, you have to issue testimonies for all donors?

Mr. Wang: No, they don’t have to go through us.

Investigator: Oh, those hospitals can use their contacts and process the donations. That is, they don’t have to go though you guys…

Mr. Wang: Yes, yes.

Investigator: Oh, that is to say, you…

Mr. Wang: Yes…because of this, this might lead to black marketeering.

Investigator: Oh, are you saying that if the hospitals find donors themselves, if they don’t inform you, you won’t have any idea?

Mr. Wang: We don’t, what they do on their own black market is not our business!

Investigator: Oh.

Mr. Wang: But if someone reports, someone reports or takes any act in such nature, the hospital and the person, who provided the organs, will be entirely responsible for it. As regard to other illegal conducts, we surely cannot oversee these. After all, the government doesn’t grant us any authority regarding this. And we cannot complain about this for sure, right?

Investigator: Oh, is it so? Ok, thank you. May I know your last name, please?

Mr. Wang: my last name is Wang.

Investigator: Mr. Wang, thank you!

Mr. Wang: ok, ok, you are welcome.

=====================================================

参考信息：

[i] Another advertisement of free liver transplantation comes into sight in China! http://www.upholdjustice.org/node/387