【Column】Health Hall of Fame / Organ Donations Increase by Only 30 in 20 Years, Leaving the Ideal of “Great Love” Difficult to Fulfill

Recent media reports on illegal cross-border organ transplantation have exposed the dark side of organ trafficking and prompted reflection on the challenges facing transplantation medicine in Taiwan. The government should not simply tell patients to refrain from seeking illegal transplants overseas. It should also answer a more fundamental question: Why are Taiwanese patients willing to risk their lives by traveling to unfamiliar countries in search of organs of unknown origin? If the government fails to take meaningful action to improve Taiwan’s domestic transplantation environment, the country’s medical system may eventually face condemnation from international human rights organizations and the global transplantation community.

When we hear stories of successful transplants made possible through altruistic organ donation, we express gratitude and admiration for the donors and their families. Yet Taiwanese society has long maintained a certain distance from the issue of organ donation. People recognize its importance, but few truly take it to heart.

When healthy, few people are willing to initiate conversations with their families about death. Even fewer families sit down and seriously discuss the question: “If one day my life can no longer be saved, would I be willing to donate my organs to help others?” Organ donation has yet to become a shared social value and collective commitment toward life.

A review of corneal and organ donation data from 2005 to 2025, spanning 21 years, reveals two increasingly divergent trends—an issue that deserves serious attention from the government.

Corneal Donations Rise While Organ Donations Stagnate

In 2005, 74 people donated their corneas. By 2025, that number had increased to 281, reaching a peak of 380 in 2023. In contrast, the number of people who donated solid organs—some of whom also donated corneas—rose only from 84 in 2005 to 114 in 2025. Even more strikingly, the number of donors who donated organs but not corneas remained exactly the same: 37 in both 2005 and 2025.

Why have corneal donations increased significantly while solid-organ donations have remained stagnant for so long? The concept of “giving and gaining” (捨得) discussed below may offer a way to reshape how Taiwanese society thinks about altruistic organ donation.

In 2014, when I served as Chairman of the Taiwan Organ Sharing Registry and Patient Autonomy Promotion Center, I worked with colleagues in Taiwan’s transplantation community, with the support of Wang Tsung-hsi, then Director-General of the Department of Medical Affairs under the Ministry of Health and Welfare, to promote the concept of she-de (捨得)—literally, “to gain through giving”—in a way that resonates with Taiwanese cultural values.

Giving to Help Others Can Also Help Ourselves

Under this approach, the spouse and blood relatives within the third degree of kinship of a person who has previously donated organs or tissues may receive relative priority should they require an organ transplant in the future. To date, 54 patients have benefited from this priority mechanism, including 3 heart recipients, 7 liver recipients, 34 kidney recipients, 1 pancreas recipient, and 9 corneal recipients.

The true significance of this policy is that Taiwanese society remembers when a family, at one of the most difficult moments of its life, chose to help someone else. None of us knows whether illness, an accident, or organ failure might one day leave us in need of a transplant. By collectively supporting organ donation, we are effectively building a lifesaving safety net that any of us may someday need.

What altruistic organ donors leave behind for their families is therefore not merely a visible inheritance, but also an invaluable form of health protection. In this sense, “helping others is also helping ourselves” is more than just a slogan.

Missed Donation Opportunities Are the Real Indicator

In promoting organ donation, the government regularly publishes the number of people who have registered their willingness to donate organs. But the questions that truly need to be asked are: How many potential organ donors are there each year? How many are identified by hospitals? How many are reported to the relevant system? How many families receive professional counseling and explanations? How many families consent to donation? And how many organs are ultimately transplanted successfully?

The rate of missed potential organ donation opportunities is the true indicator of how well an organ donation system is functioning. Only by identifying where opportunities are being lost can we determine where reforms are needed—and understand how much of the public’s willingness to give has gone unrealized.

The shortage of organs should not be viewed merely as a problem for transplant physicians. It is a test of a nation’s capacity for governance. A mature organ transplantation system requires the government to ensure that not a single act of generosity that people are willing to offer is needlessly lost.

(The author, Lee Po-Chang, is a Chair Professor at the College of Public Health, Taipei Medical University, and former Director-General of Taiwan’s National Health Insurance Administration.)

Original source:https://udn.com/news/story/7266/9709526