Falsifying Transplant Data

We found that underreporting of transplant volume is a common phenomenon among the 165 approved transplant hospitals. A series of representative case studies are presented below.

Oriental Organ Transplant Center

The Tianjin First Central Hospital Transplant Surgery Division was established in 1998. It later became the Oriental Organ Transplant Center in 2003. It is the largest such center in Asia and has ranked first in China for the cumulative number of transplants performed since 1998.¹ Liver and kidney transplants became routine surgeries at the center in 1999.²

The center’s archived web pages show that it broke ground on its new building in 2002.³ The Tianjin municipal government funded construction of the new building with plans for 500 transplant beds.⁴ The center aimed to perform 500 liver transplants and 300 kidney transplants per year.⁵ This implies that each transplant bed would accommodate fewer than two patients per year. We can thus see that the center began to deflate its transplant volume from an early stage.

On December 28, 2003, Xinhua Net reported that the Oriental Organ Transplant Center was officially approved for 500 beds. While its main focus was to be on the development of liver and kidney transplants, it would also develop pancreas, bone, skin, hair, stem cell, heart, lung, cornea, and larynx transplantation.⁶ An archived webpage from Jan 4, 2006 showed this center had the facilities to simultaneously carry out nine liver transplants and eight kidney transplants.⁷

In September 2006, Tianjin Daily News reported that the center’s new building officially entered operation with 500 beds.⁸

According to a special interview with Shen Zhongyang in February 2006 conducted by the Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care, the newly completed Oriental Transplant Center building had actually opened with 700 beds.⁹ This was 200 more than the bed count announced in September 2006.¹⁰ Its bed utilization rate reached 90%¹¹ in October 2009 and 131% in 2013 before it added still more beds.¹²

Even if we conservatively count the center as having 500 beds, when it achieved a 100% bed utilization rate (which would have been around 2010 given its growth trend), with an average liver transplant hospitalization time of 3 to 4 weeks,¹³ its transplant volume may have reached 6,000 to 8,000 per year. With its 131% bed utilization rate in 2013, the corresponding annual volume may have been as high as 7,800 to 10,400.

Yet, the center’s current website shows only 271 total beds, with 120 transplant surgery beds and seven liver and kidney transplant teams. This bed count is even fewer than when the center was established in 2003, let alone after its new building was put into use in 2006. In 2010, the hospital publicly claimed 330 liver transplants but reported only 7 to the official liver transplant registry.¹⁴

The center claims that it has completed 10,000 organ transplants in total.¹⁵ However, this number would have been easily surpassed by just a few of its doctors:

• The center’s director Shen Zhongyang himself had reportedly completed close to 10,000 liver transplants by 2014.¹⁶ His colleagues and the majority of the doctors he trained had each independently completed over 1,000 transplants.¹⁷
• By 2011, Vice President Zhu Zhijun had completed 1,400 liver transplants with 100 liver transplants from relative donors.¹⁸
• Deputy Director Cai Jinzhen completed 1,500 liver transplants.¹⁹
• By July 2006, Associate Chief Surgeon Pan Cheng had independently completed over 1,000 liver transplants and participated in over 1,600 liver graft procurements.²⁰
• Chief Surgeon Song Wenli from the Renal Transplant Department completed over 2,000 kidney transplants and over 100 combined transplants.²¹
• Associate Chief Surgeon Mo Chunbo completed over 1,500 kidney transplants.²²
• Chief Surgeon Gao Wei completed over 800 liver transplants with 100 from relative donors.²³

In 2006, the center had 310 medical professionals.²⁴ The total number of transplants performed by this center has been huge.

First People’s Hospital of Yunnan Province

The First People’s Hospital of Yunnan Province has deleted the online introduction to its organ transplantation department. Based on a version saved on transplantation.org.cn, on January 9, 2014, the hospital claimed to have conducted 18 liver transplants between April 2005 and February 2014, and 21 liver transplants to date.²⁵

However, we found a liver transplant study published by one of its doctors, for which the patient sample size was six times the number of transplants the hospital had claimed. These samples were only a small portion of the large number of transplants that met the study’s criteria. Therefore, the hospital’s actual number of liver transplants is most likely well above six times the official number.

For example, Mo Yiwo, current director of hepatobiliary surgery, published a study that he conducted on eight piggyback orthotopic liver transplants over the 23 months between August 2000 and July 2002.²⁶ Another doctor from the hospital published a paper about lung infections in 55 orthotopic liver transplant patients between April 2005 and May 2007.²⁷ Zeng Zhong, deputy director of the transplantation center, published a paper about biliary reconstruction of 55 orthotopic liver transplant patients between April 2005 and March 2007.²⁸ Another paper randomly selected 12 orthotopic liver transplant patients who underwent the surgery at the hospital between 2007 and 2009.²⁹

The online profile of the hospital’s transplantation department states that it has conducted 41 kidney transplants since 1983, including 17 with living relative donors.³⁰

However, doctors at the hospital published a study in 2008 based on 50 “living relative-donor kidney transplants” between February 2002 and May 2008.³¹ Based on this number, in the six-year period between 2002 and 2008, the number of “living relative-donor kidney transplants” is three times the hospital’s total claim for the 33-year period. Another study was based on a sample of 18 out of 84 kidney transplants.³² From these contradictory fragments, one can see that the public transplant volume has been severely deflated.

PLA No. 458 Hospital

In 2016, a Lifeweek report titled “Medical Stories Behind the Lens” featured a segment regarding liver transplants at the PLA Hospital No. 458:³³ On September 28, 2006, Dr. Sun Ningdong of the PLA 458 Hospital’s Hepatobiliary Surgery Department hosted his first photography exhibition. Sun was most proud of one photo that had won many photography awards, “It’s Again the Dead of Night” depicting a scene of the hospital’s first liver transplant: “At that time, the surgery had already lasted 6 hours at night. Some people were dozing off, and some were moving. If you magnify it, you can see the eyes of the lead surgeon–they are really bright.” The 458 Hospital has now performed over 140 liver transplants…

This report shows that in the two years after its first liver transplant in 2004, this hospital carried out more than 140 liver transplants. Nine years later, however, its total number of liver transplants has not grown on paper.³⁴

If this were really the case, the hospital could not have maintained its certification by the Ministry of Health. The hospital also self-reported doing 20 liver transplants each year (the minimum requirement to maintain its Ministry approval). Based on this number, by 2013, it should have performed over 300 liver transplants. Using a conservative figure of 70 cases per year from the media report, it would have accumulated nearly 800 liver transplants to date.

The patient rooms of the PLA Hospital No. 458 liver disease center are well equipped with amenities, including five “presidential suites” with high-speed Internet access. The center has 108 beds and can simultaneously carry out two liver transplants and one regular surgery.³⁵ If we assume that each operating room is used only once per day (otherwise, only one operating room for liver transplants would suffice), it would have performed 700 per year, or 10,000 to date. We estimate that the hospital’s public numbers represent about 1/70th of its actual liver transplant volume.

West China Hospital of Sichuan University

An introduction to the West China Hospital of Sichuan University’s liver transplant center published on September 2, 2004 mentioned that its five full sets of imported liver transplant equipment allowed five liver transplant operations to be performed simultaneously and that the center had 72 beds.³⁶ In July 2005, Prof. Yan Lvnan said at a symposium, “My department can do 3-5 liver transplants on the same day. The most we did was seven liver transplants in one day.”³⁷

The webpage claimed that the center had conducted nearly 800 liver transplants, including more than 260 from relative donors. Based on its bed count and an average hospital stay of 30 days, the center would be able to perform more than 800 transplants in a single year.

The liver transplant center no longer appears on the hospital’s website. The most recent search result states that the center “now routinely performs DCD (donation after cardiac death) liver transplantation, adult and pediatric living-donor liver transplantation, split form liver transplantation, constituting approximately 100 cases per year.”³⁸

West China Hospital has Asia’s largest ultra-clean surgery department. According to a purification engineering plan for the department, the hospital has 67 operating rooms, including at least 9 for the Urologic Surgery Department (3 originals and 6 newly constructed), at least 8 for the General Surgery department, and 6 for the Cardiothoracic Surgery Department.³⁹

The hospital’s web page, with a posting date of February 22, 2005 shows, “Since its first kidney transplant carried out in September 1978, the center has performed more than 4,000 kidney transplants.”⁴⁰

By September 2014, the number of transplants listed had shrunk: “the center has performed more than 2,500 kidney transplants.⁴¹ From 2011 onwards, more than 200 kidney transplants have been completed annually.”⁴² This volume would require no more than one operating room.

Xinqiao Hospital of the Third Military Medical University

Xinqiao Hospital claims to be the largest organ transplant center in southwestern China. It was one of the first hospitals to carry out kidney, cornea, pancreas-kidney, and other types of transplants. Its published report, “Urology Surgery History of PLA Nephrology Center,” states, “As of 2002, 2,590 renal transplants [have been] performed…The center once performed 24 kidney transplants in one day.”⁴³

However, its current webpage states, “Since our first kidney transplant performed in January 1978, our department has performed more than 2,100 surgeries to date, becoming the third site to exceed 2,000 surgeries in the country.”⁴⁴ Compared to its number from 2002 (2590 cases), the current figure after 13 years is 490 cases short, which suggests that the current figure has been deflated.

Navy General Hospital

As of 2012, its official web page titled “Introduction to hepatobiliary surgery” claimed, “Several thousand patients with end-stage liver cancer have gained a second life through liver transplantation at the Hepatobiliary Surgery Department of Navy General Hospital.”⁴⁵

Yet, the same webpage in 2015 stated, “Since 1999, 300 liver transplants have been successfully carried out.”

General Hospital of Jinan Military Command

The Jinan Military Command General Hospital’s website states that its Urologic Surgery Department has completed 1,500 kidney transplants since 1978, ranks among the top ten in China and among the top five in the military.⁴⁶ These two figures imply that the hospital has performed fewer than 200 kidney transplants per year since 2003.

However, according to the Qilu Evening News in 2008, the department once performed 16 kidney transplants in 24 hours. In addition, transplantation.org.cn reported in 2012 that the department’s director, Zhang Aimin, claimed that the hospital had performed more than 2,500 kidney transplants between 1978 and 2012.⁴⁷ The total on the hospital’s website in 2016 is 1,000 fewer than Zhang Aimin’s figure from 2012.

Third Affiliated Hospital of Sun Yat-sen University

The News Center of the website of the transplant center at Third Affiliated Hospital of Sun Yat-sen University stated in 2006, “Director Chen Guihua has served as lead surgeon for more than 1,000 liver transplants in recent years.”⁴⁸After the exposure of organ harvesting crimes, Chen’s personal webpage showed that he undertook only over 100 liver transplants.⁴⁹ On the night of February 10, 2004, Chen oversaw 4 liver transplant operations simultaneously. He conducted 246 liver transplants in 2005, according to the hospital’s news website.⁵⁰

References