Executive Summary

A Decade-Long Investigation

It first came to light in 2006 that prisoners of conscience were being killed on demand for organ transplants in detention facilities and hospitals throughout China.¹

Since then, international researchers have continued to investigate these alleged practices. Among them, two Canadians—former Secretary of State for Asia-Pacific David Kilgour and human rights lawyer David Matas—came to “the regrettable conclusion that the allegations are true.”² Meanwhile, London-based investigative journalist Ethan Gutmann independently researched the topic over the course of seven years and reached similar conclusions.³

Unfortunately, organ harvesting has not ended. Rather, the industry has continued to grow at a rapid pace over the past decade.

Investigators joined forces and researched hundreds of transplant hospitals around China. Based on this research, Kilgour, Matas, and Gutmann published Bloody Harvest/The Slaughter: An Update⁴ in June 2016. Spanning 680 pages and nearly 2,400 references, the report uncovers the true nature and scale of these abuses.

Our study unearths and analyzes hospital data and policy directives concerning the growth of organ transplantation in China. We found that China came to perform the most transplants in the world in just a few years despite the lack of an effective organ donation system. Furthermore, the industry continued to grow after live organ harvesting gained international attention in 2006. Through examining statements and policies regarding China’s officially recognized organ sources, and summarizing the industry’s history and relevant government regulations, we have pieced together evidence showing that state, military, and civilian institutions that have been mobilized to carry out this medical genocide.

On-Demand Transplants

Investigators discovered the existence of an industry in which organ transplants were conducted as needed, on-demand.

The China Liver Transplant Registry reported a large proportion of emergency liver transplants for which organ sources were found within days or even hours. In elective cases, waiting times for kidney and liver transplants were commonly listed in weeks.⁵

One hospital advertised “donors seeking matched recipients” and promised, “in case of failure, [to] continue to perform transplants until one is successful.”⁶

Doctors could procure multiple organs for the same patient in quick succession, in case of rejection or to have as spares.⁷ It is not uncommon in China for a patient to receive multiple transplants of the same organ.⁸ Furthermore, the vast array of transplantable organ types and their prices openly listed on hospital websites give the impression that any body part can be replaced as needed.⁹

Researchers continue to see numerous individual and institutional feats reflected in hospital profiles, media interviews, and other sources:

• Surgical teams performing transplants around the clock¹⁰
• Hospitals carrying out multiple transplants concurrently
• Over ten, twenty, or even more kidney transplants being conducted in a single day¹¹
• Bed utilization rates exceeding capacity
• Expansion of transplant wards and construction of new buildings¹²

Official Numbers Debunked

The number of transplants in China is falsified level by level due to unexplainable organ procurement sources and financial incentives for hospitals and doctors¹³ As a result, the true, absolute number may forever remain unknown.

In recent years, Chinese officials have often claimed a total of 10,000 transplants per year.¹⁴ However, we analyzed data concerning individual hospitals and doctors and found that this official figure is surpassed by just a few hospitals; China in fact performs the most transplants of any country in the world.^{15 16} As a point of reference, all transplant centers in the United States have performed an average of 6,000 liver transplants annually since 2000;¹⁷ this figure can be matched by just a few hospitals in China.

Based on government-imposed minimum capacity requirements for transplant centers, the 169 transplant hospitals approved by the Ministry of Health could have conducted between 60,000 and 100,000 transplants per year. This is equivalent to a capacity of more than one million total transplants since 2000.¹⁸

However, even this is far from the full picture. The investigators found that the vast majority of these hospitals well exceed the minimum requirements. In addition, more than 1,000 hospitals applied for permits in 2007 to continue performing transplants,^{19 20} which suggests that they also met the Ministry’s minimum capacity requirements. Many of them continued to perform transplants despite not having received approval.²¹

Organ Sources

Since 2005, Chinese government spokesmen have claimed that the vast majority of organs have come from death-row prisoners, and later, from voluntary donations. However, these two sources combined can only account for a small fraction of all transplants performed in China.

International organizations estimate the number of death-row prisoner executions in China in the thousands each year since 2000 and decreasing since then.^{22 23 24}

Chinese tradition requires that bodies remain whole after death. China did not start piloting organ donation systems until 2010, and a national system was not established until 2013.²⁵ Nevertheless, by 2015, it still had not produced donations on any meaningful scale.²⁶

The 2016 independent report by Kilgour, Matas, and Gutmann states,

“The ultimate conclusion is that the Chinese Communist Party has engaged the State in the mass killings of innocents, primarily practitioners of the spiritually-based set of exercises, Falun Gong, but also Uyghurs, Tibetans, and select House Christians, in order to obtain organs for transplants.”²⁷

A State Crime

The Chinese government prioritized organ transplantation in its national strategy starting in 2000 by investing heavily in research, development, industrialization, and transplant personnel training. Within a few years China was performing the most transplants of any country in the world.²⁸

This exponential rise in transplants coincided with the Chinese Communist Party’s campaign to wipe out Falun Gong with directives to “ruin their reputations, bankrupt them financially, and destroy them physically.”

The investigators found that both military and civilian institutions implemented the large-scale organ harvesting from Falun Gong practitioners. The central Party leadership established a unified chain of operations through various levels of the extralegal “610 Office” and the Political and Legal Affairs Committee to enable the procurement of organs on demand. The People’s Liberation Army General Logistics Department has served as the core operations unit with cooperation from other military units, armed police, the medical system, and organ brokers.

The 2016 report explains,

“The Communist Party’s demonization and brutalization of Falun Gong and the health system’s insatiable demand for organs have formed a symbiosis. Each feeding on the other, the combination became an unprecedented, and barely imaginable, human catastrophe.”²⁹

Bodies Exported Worldwide

Researchers also found evidence that the same victim groups were used not only as organ sources for transplant surgeries but also as sources for plastination specimens.³⁰

Millions in the West have seen plastinated bodies from China on display. Furthermore, plastinated body parts from China have been sold to medical schools and universities throughout the Western world.

Plastination exhibits give an immediate, widespread, publicly visible reality to these abuses that the killing of innocents for their organs cannot.

Sources and Methodology

To gauge the development and scale of China’s organ transplantation industry, we analyzed 169 individual hospitals approved by the government to conduct transplants. Specifically, we collected data regarding transplant types performed, qualifications, revenue, potential patient demographics, bed counts, surgical and support personnel, transplant capacity and volume, research projects, relationships with other hospitals and related entities, funding, patents, and awards.

To estimate the true volume of transplants performed independent of official government figures, we referred to policies and regulations published by the Ministry of Health and its successor, the National Health and Family Planning Commission, which sets minimum bed count requirements transplant centers must meet to maintain their qualifications. We then incorporated bed utilization rates and lengths of hospitalization from primary hospital sources and other published materials to provide the minimum system-wide capacity among the 169 approved transplant centers since 2000.

To determine the sources of organs used, we tracked the evolving policies surrounding China’s officially acknowledged sources of death-row prisoners and recently introduced voluntary donation programs, including from relatives, cadavers, and donations after cardiac death. We are unable to calculate precise transplant volumes due to state censorship and widespread falsification of public data. Therefore, we qualitatively compared the number of transplants possible from officially claimed sources against the total transplant volume estimated above to determine the gap representing unaccountable organs.

We then examined Party and state policies that have resulted in the extralegal killing of prisoners of conscience and how state, military, and civilian institutions have been mobilized to conduct organ harvesting from these unwilling “donors.”

All of our data has been sourced from Chinese medical journals, media reports, official statements, web archives, government policies, national strategic programs and fund allocations, and other public sources. Researchers also made phone calls to hospitals to verify the status of their organ transplant programs and other key information.

The following is a summary of our findings. The transplant hospital database is available separately.

References