Traditional Chinese medicine

1938 www.thelancet.com Vol 372 December 6, 2008 transplantations. At present, 87 institutions have full approval from the Ministry of Health; 77 others have provisional approval and 18 months to comply with all the regulations. This number is a reduction from the more than 600 institutions that did transplants 1 year ago. Regulations have been set up to ban transplant tourism. The penalty for participating in a transplant that involves payment for organs is substantial. Reforms have decreased the number of cadaveric organ transplants by more than two or three fold and increased the number of living-related organ transplants by more than 100% in China in 2007. The drop in transplantation over the past 3 years is a result of these changes acting in tandem. Currently, post-transplant registries are being developed. An organisational structure for transplantation must be established to oversee, implement, audit, and set up a balance of authority between the central and provincial governments. A registry of recipients that uses robust methods of data-collection should be started. Donation, use of organs, and selection of patients are currently hospital based, without centralised standards, and a transparent system for organ procurement, equitable organ allocation, and selection of patients is needed. China is planning regulations for the new phase of transplantation, which will largely conform to international standards. There are nuances within the system to accommodate cultural diff erences. For example, the laws for brain death will incorporate language that will respect the family’s wishes, especially when they are based on religious belief that requires the whole body be buried. Despite a sharp decrease, capital punishment still exists in China. The long-term goal for social development is to abolish the death penalty but, until then, regulations need to protect prisoners’ rights and desires and separate transplant programmes from the prison system.