OBJECTIVE. To review the factors involved in determining the availability of solid organs for transplantation in Hong Kong and to identify methods that have been used in other countries to increase organ donation rates.

DATA SOURCES. Medline and non-Medline search of the relevant English literature, local data, and personal experience.

STUDY SELECTION. Articles describing approaches to solid organ procurement for transplantation.

DATA EXTRACTION. Data were extracted and analysed by the author.

DATA SYNTHESIS. There is a severe shortage of solid organ donors in Hong Kong, which is compounded by an ever-increasing pool of potential recipients. Limited local data suggest public support for organ donation. The most common reason for objection to organ donation is a lack of knowledge of the wishes of the deceased. Despite the implementation of numerous legislative models worldwide, none has been shown to be superior as a facilitator of organ donation. Despite the lack of legislation in Hong Kong, the medical profession has adopted the expressed consent model. The use of non-heart-beating donors, elective ventilation of futile cases, and financial incentives pose significant ethical and legal barriers as well as resource implications for intensive care.

CONCLUSION. Greater effort should be directed through public education at the importance of telling one's family what one's wishes are concerning organ donation. More information is required in Hong Kong as to why families agree to organ donation and how best to approach families to request organ donation.

Key words: Brain death; Legislation, medical; Organ procurement; Organ transplantation; Public opinion

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