Medical experts called for measures to facilitate cross-boundary organ donations to save Hong Kong patients waiting for a transplant, though legal and institutional hurdles make that hard to achieve in the short term.

He Xiaoshun, a mainland expert in organ transplants and vice-president of Sun Yat-sen University’s First Affiliated Hospital in Guangdong province, said  fewer than 90 percent of the more than7,000 hearts donated on the mainland found their way to recipients last year.

He blamed the bulk of the wastage on a shortage of doctors who can perform heart-and-lung transplant operations. The mainland, he said, entered the field relatively late.

According to Lo, most organs need to be transplanted within 24 hours of being removed from donors. The survival window for hearts and lungs is only about six hours. He warned that if clearance procedures held up delivery, the donor organs may be rendered useless.

Hong Kong has carried out more than 100 heart transplant operations and at least 75 lung transplants so far.

But both organs are in short supply. Last year, there were only eight heart donations for the 54 Hong Kong patients who required heart transplants. Twenty-four people were in the queue for lung transplants, but just seven organs were available.

Some organs were lost before suitable recipients could be found. This is pronounced among donors with rare blood types, such as AB and RH.

He believes cross-boundary collaboration can increase the possibility of matching donated organs with suitable recipients.

He said his hospital had attempted several times to donate organs to Hong Kong patients. But, each attempt failed because of the ban on exporting organs, a situation he described as “regrettable”.

“Regulations should serve people’s needs. If the regulations contradict the needs, they should be improved,” He said.

Hong Kong liver transplant expert Lo Chung-mau, who heads the University of Hong Kong-Shenzhen Hospital in Guangdong, agrees on the need for a cross-boundary organ-donation mechanism, especially for Hong Kong patients not be able to travel to the mainland for the surgery.

Lo helped deliver three-quarters of a donor’s liver from Taiwan’s Chang Gung Memorial Hospital to Hong Kong in 1997. The successful transplant, which Lo said was Asia’s first cross-boundary organ donation case, allowed the critically ill Hong Kong patient to survive.

Since then, Hong Kong has donated two livers to Taiwan in 2010 and 2016.

Lo stressed that even if the ban is lifted, clearance procedures will remain a problem.

In addition to having to pass regular checks by officers from Hong Kong’s Customs and Excise Department, organs brought into Hong Kong require approval from the Human Organ Transplant Board -- the city’s designated body for organ transplants.

According to Lo, most organs need to be transplanted within 24 hours of being removed from donors. The survival window for hearts and lungs is only about six hours. He warned that if clearance procedures held up delivery, the donor organs may be rendered useless.

He hopes that under the Guangdong-Hong Kong-Macao Greater Bay Area development plan, simplified clearance procedures for transplant organs could save more lives.

Chak Wai-leung, a senior kidney specialist in Hong Kong and former president of the Hong Kong Society of Transplantation, foresees cross-boundary organ donations becoming a long-term solution to alleviate Hong Kong’s worsening organ shortage.

But, he notes that before there can be an effective mechanism, both sides have to agree on a set of unified standards covering the key points of organ donation and transplants, such as the sources of donated organs and the criteria for organ distribution.

Hong Kong hospitals currently only receive organs donated by brain-dead patients, while most of the mainland’s donated organs come from people who have died of cardiac arrest. Most organ donations internationally occur after a patient has been declared brain dead. But in some countries, both are acceptable.

Chak said that a cross-boundary organ donation mechanism is possible only after sufficient preparations are completed.

lingbingcun@chinadailyhk.com