Hong Kong a Special Administrative Region of China has a population of over seven million people for which 94% is ethnic Chinese. It ranks the third most important international financial center after London and New York and enjoys low taxation and free trade.
Transplantation of the kidney, liver, heart, and the lung were first performed in Hong Kong in 1969, 1991, 1992, and 1995 respectively. The organ procurement system is based on voluntary decisions of the donor or their families to donate organs. This emphasis on voluntarism is consistent with the value of respecting individual autonomy and the dignity of the body after death. Though highest among different regions of Asia, brain dead deceased donor organ donation rate remains low in Hong Kong and is at the range of only 4 to 6 per million population per year.
Compounded by a hepatitis B carrier rate of 10%, living donor liver transplantation has emerged as an alternative to overcome this shortage in supply of brain dead deceased donor liver grafts for transplantation. In May 1996, we performed the first adult living donor liver transplantation using the right liver, now a life-saving transplantation commonly adopted by many centers in the world. Our aging population also created need of other organs for transplantation. Given the inevitable risks and morbidities of living donor organ donations, the ultimate solution to organ shortages for transplantation is improvement of brain dead deceased donor organ donations from a concerted effort of the transplant community under an accountable and transparent system.