A pilot project of organ donation in Nanjing had only one donor in the first year since its launch in February 2009, Yangtse Evening Post reported Friday.

But that is somewhat an improvement from what the city's struggling organ donation campaign received in the last 20 years - three volunteer donors.

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Based on data released by the Ministry of Health, among China's 1.5 million people who need organ transplants every year, only 10,000 are lucky to receive one. The 150:1 ratio casts a cloud over China, as the ratio in the US is 5:1.

The stagnation and backwardness are due to multiple factors. But the most troublesome one lies in Chinese people's traditional thinking about organ donations. Only a small group of people accept the concept of organ donation. Others believe the deceased should keep his body intact.

In the US, people are usually asked before applying for a driver's license whether they would like to donate their organs if they die in a car accident. The system allows a doctor to remove the dead donor's organ without family consent. While in China, the same question would undoubtedly be considered offensive.

Immature laws and regulations on organ donation also make the issue thorny. Family members of the dead can withdraw the commitment to organ donation. And hospitals have no right to use a dead person's organs if he or she has no family.

Even if a donation commitment is reached, it is possible for things to go awry. Organs such as the heart, liver and kidney should be collected after the brain is dead and while other organs are still viable. Some hospitals will not deal with a brain death, where the heart is still beating and breathing is assisted by machine, for fear of getting involved in medical disputes.

And another issue is, only a small percentage of hospitals have the capability of organ salvaging, preservation and transplants. And in many cases, donors' unfit health conditions, such as hepatitis B, would obstruct the process.

But the prospects for China's organ donation system is promising. According to the health ministry, an amendment to China's organ transplant regulations is being prepared and may be out in March after some revisions.

"It will give legal footing to the Red Cross Society of China to set up and run China's organ donation system." said Huang Jiefu, vice health minister, in an interview with China Daily in January.

The Red Cross Society's responsibilities will include encouraging voluntary posthumous organ donations, establishing a list of would-be donors and drawing up registries of people waiting for a suitable donated organ, he added.