The National Organ Allocation System of China, known as China Organ Transplant Response System (COTRS), stands as a testament to the country's commitment to an ethical and transparent approach in organ donation and transplantation.
As one of the five subsystems of the National Organ Donation and Transplantation System, COTRS plays a crucial role in upholding the legal mandates set forth by the 2007 China State Council Regulation and its comprehensive update in 2023. COTRS's role extends beyond mere legal compliance, anchoring the national system in the bedrock principles of justice, fairness and transparency, thereby nurturing and safeguarding the foundational cornerstone of organ donation worldwide: public trust.
Originating from a decade-long research project at the University of Hong Kong's Department of Surgery (2004-2014), COTRS has been operational since April 6, 2011, marking over 13 years of continuous service. The core of COTRS algorithm is derived from the complex scientific policies for organ allocation, which are publicly accessible on the COTRS and National Health Commission (NHC) websites. These policies largely mirror its international counterparts in term of medical and scientific criteria, as well as the ethical considerations outlined in the WHO's guiding principles. The significant role of COTRS was further highlighted by the 2023 revision of the State Council Regulation.
As the official operational system in organ allocation, the data produced by COTRS form the basis for official organ traceability records, and have been published annually on the WHO website since 2015, in compliance with WHO requirements for its member states. In 2022, COTRS also played a central coordination role in facilitating the historic first organ sharing between Hong Kong SAR and Mainland China.
