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For the first time in China, doctors have successfully transplanted the heart of a brain-dead patient, despite a taboo on taking organs from people whom Chinese traditionally do not consider dead.

The successful operation shows China has the necessary technology including long-distance transport, storage of the donor's heart and revival of the transplanted organ to perform heart transplants.

The 36-year-old donor, a construction worker identified as Yang from east China's Zhejiang Province, was the first brain-dead patient in the province and the 18th nationwide to have his organs transplanted.

A 38-year-old man with a heart condition, Wu, was the recipient, undergoing transplant surgery on July 1 in Jinan, the capital of east China's Shandong Province.

The recipient remained in a critical condition yesterday. In China, heart transplants have been known to add a further 12 years to a patient's life.

Chen Zhonghua, a specialist in charge of a national programme studying brain death and organ transplants initiated by health and education authorities, was notified early last week that the brain-dead man's family wanted to donate his organs and corneas.

After careful medical examination Chen and other doctors confirmed the man's brain had stopped functioning the stage at which much of the developed world consider a person to be dead. The man had fallen from scaffolding while working.

Professionals attached to the programme helped match the donor to the recipient by blood type and age.

His heart was removed after family members signed a formal consent letter and was transported by plane to Jinan. After a 6-hour operation, doctors announced the transplant a success.

The donor's other organs, including liver, kidneys and corneas, went to another five recipients across China.

"As the first transplant with a heart extracted from a brain-dead patient, the surgery is of great medical and ethical significance," Chen, director of the Institute of Organ Transplantation of Tongji Hospital under Huazhong University of Science and Technology in central China's Hubei Province, said yesterday.

In China, a country that has long believed that death comes only after the heart stops beating and the body turns cold, at least 2 million patients need organ transplants each year, but only 20,000 such operations can be carried out because of the shortage of donated organs.

To date, 69 organs have been removed from 18 brain-dead patients nationwide and have been transplanted to 59 patients on waiting lists.

"With organs from brain-dead contributors as a new source, China's heart transplant technology will take a big step forward in terms of organ quantity and quality," Chen said.

The surgery also coincided with the enforcement of a regulation mandating all organ transplant operations in China be discussed with and approved by a medical science and ethics committee.

The first attempt by China's health authorities to regulate organ transplants, the rule is designed to ban the sale of organs and put a stop to practices that violate the ethics and medical standards of transplant surgery.

"The surgery is a milestone event that signifies Chinese organ transplant medicine is becoming standardized, legal, open and internationalized," Chen said. "Unnecessary misunderstandings, stereotypes, criminal and civil law issues could be avoided as long as we are cautious and abiding by the international standards and practices, even though a law in this regard is still absent."

(China Daily July 5, 2006)