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- Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

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Page 1: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

www.chinatribunal.com

Page 2: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs
Page 3: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs
Page 4: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

MJE

Page 5: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

Organ Transplantation

the apotheosis of

human generosity

Page 6: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

Anti-rejectiontherapy

Page 7: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs
Page 8: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

Consent• Of the donor• Of the donor’s family• Of the recipient

Page 9: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

Opt In

The donor has voluntarily signed up

to a donor register whilst able to do so

Opt Out

Everyone is assumed to have given consent, unless they opt out by stating so in advance

The family can still override that consent (after death) by declining to donate the organs after death

Page 10: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

Donation after Brain Death

Donation after Circulatory Death

Donation from a Live Donor

Page 11: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

What is meant by brain death?

ComaApnoea

Lack of brain-stem reflexesNo sedative drugs

the irreversible loss of all functions of the brain, including the brainstem

A patient determined to be brain dead is legally and clinically dead

Page 12: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

trade in organs

Page 13: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

self non-self

Page 14: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

Human Leucocyte Antigen (HLA)

Page 15: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

Blood Tests Organ Assessment

Page 16: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

infrastructure

• Database (donor:recipient)• Prioritisation• Logistics• Expertise• Teamwork• Separation of donor from recipient

teams

www.odt.nhs.uk/transplantation/tools-policies-and- guidance/policies-and-guidance

Page 17: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

Organ Extraction

Page 18: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

WarmIschaemic

Time

ColdIschaemic

Time

Page 19: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

Removing organs under

ordersfrom live

(‘executed’) prisoners

Enver Tohti

Page 20: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs
Page 21: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

audit trail

Page 22: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

• 1978 - 1st Transplant (donor = executed prisoner)

• 1984 - Legislation to allow organ donation from

executed prisoners

• Transplant and execution statistics ‘state secret’

• 2010 - pilot voluntary organ donation system

• 2014 – becomes National policy

Page 23: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

0300060009000

1200015000

2002 2004 2006 2008 2010 2012

https://duihua.org.wp/?page_id=9270Number of people executed in China per year (Dui Hua Foundation data)

120,000 transplants 1997 – 2009*

* Alison et al BMC Ethics 2015;16:85

130 voluntary

Page 24: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

2000

Massive expansion of transplant infrastructureHospitalsStaff

2006

Interim regulationsBanning saleSetting standards

2011

Declared illegalOrgan trafficking

Page 25: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs
Page 26: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

hospitals/transplant units

surgeons publications2016

60-90,000transplants per year

4080registered

donors

7224 kidney Tx3257 liver Tx

Page 27: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

2016 (official) 10,000 transplants2016 (derived) >60,000 transplants

Page 28: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

Waiting Times

Page 29: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

GN

Page 30: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

I think very few countries have any leverage at all when it comes to what happens

inside China and the Chinese Government is absolutely clear that this is not a

matter for outside countries’.

‘When we look at what happens to the Uighurs this is

obviously completely against our values we raise

these issues with the Chinese government when we

see them and we also understand that if we talk too

loudly and publicly about our Human Rights concerns

we will lose access to senior people in the Chinese

government and then we won’t be able to do any

good at all. …………………………

Page 31: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

www.chinatribunal.comThe summary judgment of the China Tribunal and all evidence, written and oral, can be

watched and read on this website.We encourage you to do so.

Those who provided evidence often did so at their own risk

Page 32: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs
Page 33: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs
Page 34: - Amazon S3 · Brain Death. Donation after Circulatory Death. Donation from . a Live Donor. What is meant by brain death? Coma. Apnoea. Lack of brain-stem reflexes. No sedative drugs

first transplant (executed prisoner, CCP official recipient)

evidence of use of organs from political prisoners

1st experiments

legislation to use corpses of executed prisoners

1960

1978

1984

1995

TRANSPLANTATION IN CHINA

1999oppression/incarceration of Falun Gong (millions)

2000transplantation expansion part of national strategy

2017>80 million people on security database