Report on the Development of Organ Donation and Transplantation in China (2023) comprehensively documents the advancement of China's organ donation and transplantation sector into a new era of legal governance, systematic operation, and high-quality development. The report systematically details recent progress in policymaking, regulatory frameworks, institutional mechanisms, and international collaboration—notably underscored by the formal enactment of the "Regulations on Human Organ Donation and Transplantation" in December 2023. This milestone signifies an elevated phase in China's donation and transplantation system, highlighting the balanced emphasis placed on both donation and transplantation.

The report reflects China's consistent commitment to "placing people's health at the forefront of national development", detailing ongoing efforts to refine the organ donation and transplantation system and ensure its transparent and well-regulated functioning. Through open data disclosure, participation in global monitoring networks, and interdepartmental coordination mechanisms, the report illustrates China's accountability and institutional innovation in advancing the Healthy China initiative.

Beyond serving as a factual record of China's organ donation and transplantation reforms, this report also stands as a forward-looking contribution that shares China's insights in this field. It reinforces China's voice in global transplantation discourse and offers practical examples and institutional references for fostering a shared vision of global health.

HUANG Jiefu, former President of Sun Yat-sen University of Medical Sciences, former Vice Minister of Health, former Deputy Director of the Central Healthcare Committee (ministerial level). He currently serves as Chairman of the National Organ Donation and Transplantation Committee, Chairman of the China Organ Transplantation Development Foundation, Dean of the Institute for Hospital Management at Tsinghua University, and Professor of Surgery at Peking Union Medical College and Tsinghua University. He has edited 16 surgical monographs, published 607 academic papers, chaired over 80 academic conferences, and received eight national and ministerial-level scientific and technological awards. He has been honored with the National May Day Labor Medal, the National Outstanding Returnee Award, the Bethune Medal from the Ministry of Health. In 2008, he received the Significant Contribution Award from The Transplantation Society (TTS), followed by the WHO World No Tobacco Day Award in 2013. That same year, he was awarded honorary doctoral degrees by the University of Hong Kong and Hong Kong Metropolitan University. In 2015, he received the GUSI International Peace Prize and the Special Contribution Award of the Wu Jieping Medical Award, the most prestigious medical accolade in China. In 2019, he was granted the Major Contribution Award by the Red Cross Society of China. He is a Fellow of the Royal College of Surgeons of Edinburgh, a Fellow of the Hong Kong Academy of Medicine, a Chinese member of The Transplantation Society, and a Chinese council member of the Asian-Pacific Hepato-Pancreato-Biliary Association. Additionally, he holds visiting or honorary professorships at numerous renowned universities worldwide, including Peking University, Tsinghua University, Sun Yat-sen University, the Chinese University of Hong Kong, Harvard University, Massachusetts Institute of Technology, and the University of Sydney.

Chapter 1 Human Organ Donation in China ……………… 101

1.1 Organizations and team building ……………………………… 102

1.2 Registration of human organ donation volunteers ……………… 105

1.3 Organ donation in China ……………………………………… 107

1.4 Progress of related work ……………………………………… 109

1.5 Future outlook ………………………………………………… 113

Chapter 2 Donated Organ Procurement in China ………… 115

2.1 Development and construction of human donated organ

procurement system …………………………………………… 116

2.2 Distribution and construction of OPOs ………………………… 118

2.3 Organ donation in China ……………………………………… 119

2.4 Procurement and utilization of organs ………………………… 121

2.5 Quality of donor organs ………………………………………… 123

2.6 Features and future outlook …………………………………… 125

Chapter 3 Human Organ Allocation and Sharing in China 129

3.1 Distribution of transplant hospitals in China …………………… 132

3.2 Overview of human organ donation …………………………… 133

3.3 Patients waiting for organ transplantation ……………………… 135

3.4 Policy implementation effi cacy in organ allocation and sharing 140

3.5 Feature and future outlook ……………………………………… 142

Chapter 4 Liver Transplantation in China ………………… 145

4.1 Distribution of medical institutions qualifi ed for liver

transplantation ………………………………………………… 146

4.2 Demographic characteristics of liver transplant recipients …… 149

4.3 Quality and safety analysis of liver transplantation …………… 150 4.4 Feature and future outlook ……………………………………… 153

Chapter 5 Kidney Transplantation in China ……………… 156

5.1 Distribution of medical institutions qualifi ed for kidney

transplantation ………………………………………………… 157

5.2 Demographic characteristics of kidney transplant recipients … 165

5.3 Quality and safety analysis of kidney transplantation ………… 166

5.4 Feature and future outlook ……………………………………… 169

Chapter 6 Heart Transplantation in China ………………… 172

6.1 Distribution of medical institutions qualifi ed for heart

transplantation ………………………………………………… 173

6.2 Demographic characteristics of heart transplant recipients …… 175

6.3 Quality and safety analysis of heart transplantation …………… 177

6.4 Feature and future outlook ……………………………………… 179

Chapter 7 Lung Transplantation in China ………………… 183

7.1 Distribution of medical institutions qualifi ed for lung

transplantation ………………………………………………… 184

7.2 Demographic characteristics of lung transplant recipients …… 187

7.3 Quality and safety analysis of lung transplantation …………… 190

7.4 Feature and future outlook ……………………………………… 195

Chapter 8 The Development of Technologies and Innovations

for Organ Transplantation in China …………… 199

8.1 Establishment and promotion of key technical system for split liver

transplantation ………………………………………………… 199

8.2 The AGH score is a predictor of disease-free survival and targeted

therapy effi cacy after liver transplantation in patients with

hepatocellular carcinoma ……………………………………… 202

8.3 A novel stratifi cation integrating dual biomarkers in liver

transplantation for hepatocellular carcinoma …………………… 206

8.4 Establishment and application of core technology system for the

treatment of multiple organ failure with natural polymer biological

liver materials …………………………………………………… 208

8.5 Genotype-guided model used for precise anti-rejection therapy afterliver transplantation …………………………………………… 211

8.6 Application of Da Vinci robot-assisted laparoscopy in kidney

transplantation ………………………………………………… 213

8.7 The utilization of an artifi cial protective external vascular sheath in renal

transplantation represents a novel technological advancement aimed at

preventing graft artery kinking ………………………………… 217

8.8 Six-genes edited porcine-rhesus kidney xenotran-splantation … 219

8.9 The fi rst group of 37 cases of kidney transplantation for infants and

young children in China ………………………………………… 221

8.10 Ischemia-free heart transplantation …………………………… 224

8.11 A novel myocardial biopsy technique after heart

transplantation ………………………………………………… 225

8.12 A machine learning based prognostic model for lung

transplant patients ……………………………………………… 228

8.13 Robot-assisted lung transplantation …………………………… 230

8.14 Application of donor-derived cell-free DNA in diagnosing

rejection after lung transplantation …………………………… 232