China is to extend a pilot program of organ donations after cardiac death to enable more life-saving transplant surgery.

Deputy Minister of Health, Huang Jiefu, a CPPCC member and an Australian-trained liver transplant surgeon, told China Daily that there had been 200 such donations in 16 regions during the two-year trial and the system would go nationwide within the year.

"Given that the concept of brain death remains controversial and unclear among the Chinese public, and even some medics, we can only invite the organ donation after cardiac death," he said. In China, death is declared when the heart stops beating and the person is no longer breathing.

"Donations after cardiac death fit better into the nation's practical situation and are recognized by international bodies, such as the World Health Organization, as an organ donation system with Chinese characteristics," Huang said.

More than 90 countries and regions recognize brain death as the diagnostic criterion for declaring death and patients classified as brain dead can have their organs removed for donation.

But in China, hospitals are generally reluctant to declare brain death, as it can cause misunderstanding among relatives who may believe medical treatment fell short, according to Ling Feng, also a CPPCC member and neurosurgery director of Xuanwu Hospital, Capital Medical University.

About 10,000 organ transplants are carried out each year on the Chinese mainland. It is estimated that around 1.5 million people are waiting for transplants. It was also a crucial part of an ethical and sustainable organ transplantation system that China was trying to establish, he added.

For a long time, when there was no public donation system in the country, executed prisoners formed the major source of organs for medical use, a practice denounced by the international community.

Shen Zhongyang, director of the Tianjin First Center Hospital's organ transplant unit said: "I sincerely welcome a public organ donation system featuring donation after cardiac death. It can help end dependence on donations from death-row inmates." He expected the system to be fully established within three to five years.

Huang said the system of donation after cardiac death would also help curb the trade in living organs. "At present, with the huge gap between demand and limited organ donations, the black market is almost impossible to eliminate."

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