Compliance with ethical standards in the reporting of donor sources and ethics review in peer-reviewed publications involving organ transplantation in China: a scoping review

Abstract

ObjectivesThe objective of this study is to investigate whether papers reporting research on Chinese transplant recipients comply with international professional standards aimed at excluding publication of research that: (1) involves any biological material from executed prisoners; (2) lacks Institutional Review Board (IRB) approval and (3) lacks consent of donors.DesignScoping review based on Arksey and O’Mallee’s methodological framework.Data sourcesMedline, Scopus and Embase were searched from January 2000 to April 2017.Eligibility criteriaWe included research papers published in peer-reviewed English-language journals reporting on outcomes of research involving recipients of transplanted hearts, livers or lungs in mainland China.Data extraction and synthesisData were extracted by individual authors working independently following training and benchmarking. Descriptive statistics were compiled using Excel.Results445 included studies reported on outcomes of 85 477 transplants. 412 (92.5%) failed to report whether or not organs were sourced from executed prisoners; and 439 (99%) failed to report that organ sources gave consent for transplantation. In contrast, 324 (73%) reported approval from an IRB. Of the papers claiming that no prisoners’ organs were involved in the transplants, 19 of them involved 2688 transplants that took place prior to 2010, when there was no volunteer donor programme in China.DiscussionThe transplant research community has failed to implement ethical standards banning publication of research using material from executed prisoners. As a result, a large body of unethical research now exists, raising issues of complicity and moral hazard to the extent that the transplant community uses and benefits from the results of this research. We call for retraction of this literature pending investigation of individual papers.

Evidence to contradict “substantial” forced organ harvesting from prisoners in China is lacking, tribunal hears

“…In February 2019 Wendy Rogers, professor of clinical ethics at Macquarie University in Australia and ETAC’s advisory committee chair, and others, called for the retraction of 400 research papers that may document transplantation using organs from executed prisoners 78…”

Ethics of publication, between forgery, retraction and protecting freedom: an ENJOY score for authors and editors

“…These last years have seen several waves of retractions, the most recent and important one regarding papers from China on transplanted organs, when it appeared that the organs had come from prisoners whose death sentence had been timed to coincide with demand; Iranian teams are also frequently cited in retraction affairs [4,7]. In both cases, the political authorities were involved: military hospitals and prisons in the China affair, and on a lesser, but still disturbing scale, the fact that political authorities were included as authors of the Iranian papers.…”

“…The issue is not new, but the recent alert came from a scoping review published earlier this year, which succeeded in its aim of obliging all the major nephrology journals to take a position, at least with respect to previously published papers [7,8]. The conclusions of the study are clear: reviewers, editors and publishers were guilty of lack of attention.…”

“…Researchers and clinicians who cite and use this research implicitly accept organ procurement from executed prisoners. Immediate retraction is therefore demanded [7]. The review succeeded where the media had not; in fact you will probably be surprised, as I was, by the quantity of information available on the web, including a BBC podcast, long and detailed documentaries and official reports.…”

KI Editors’ expression of concern about organ source in transplantation papers

“…The British Medical Journal Open (BMJ Open) recently published an article highlighting many papers in which there is concern that transplanted organs were harvested from executed prisoners in China. 4 Although no papers from KI were identified in the BMJ Open article, the Editors surveyed transplant articles published in KI since the Declaration of Istanbul in 2008 and found 2 articles with suspect data. The first and senior authors of these articles were contacted to clarify the source of the transplanted kidneys, but in neither case could the authors confirm that no kidneys from executed prisoners were used.…”