{"id":3370,"date":"2019-12-30T18:30:00","date_gmt":"2019-12-30T10:30:00","guid":{"rendered":"https:\/\/transnovo.com\/news\/%e3%80%90%e8%b5%84%e8%ae%af%e3%80%91%e6%95%b0%e8%af%b4%e4%b8%ad%e5%9b%bd%e5%99%a8%e5%ae%98%e7%a7%bb%e6%a4%8d%e4%ba%8b%e4%b8%9a5%e5%b9%b4%e5%8f%91%e5%b1%95%ef%bc%9a%e6%88%91%e4%bb%ac%e7%bb%98%e5%88%b6\/"},"modified":"2023-06-02T16:52:24","modified_gmt":"2023-06-02T08:52:24","slug":"%e3%80%90%e8%b5%84%e8%ae%af%e3%80%91%e6%95%b0%e8%af%b4%e4%b8%ad%e5%9b%bd%e5%99%a8%e5%ae%98%e7%a7%bb%e6%a4%8d%e4%ba%8b%e4%b8%9a5%e5%b9%b4%e5%8f%91%e5%b1%95%ef%bc%9a%e6%88%91%e4%bb%ac%e7%bb%98%e5%88%b6","status":"publish","type":"post","link":"https:\/\/transnovo.com\/en\/news\/%e3%80%90%e8%b5%84%e8%ae%af%e3%80%91%e6%95%b0%e8%af%b4%e4%b8%ad%e5%9b%bd%e5%99%a8%e5%ae%98%e7%a7%bb%e6%a4%8d%e4%ba%8b%e4%b8%9a5%e5%b9%b4%e5%8f%91%e5%b1%95%ef%bc%9a%e6%88%91%e4%bb%ac%e7%bb%98%e5%88%b6\/","title":{"rendered":"\u3010Information\u3011 Counting the development of China's organ transplantation business in 5 years: We drew the \"Nuwa mending map\""},"content":{"rendered":"
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On October 4, 2019, in the heart transplant surgery room of the PLA General Hospital, looking at the normal beating numbers on the monitor, all the medical staff took a long breath of relief.<\/span><\/p>\n
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On September 11, a boy, Aung Aung, who suffered a severe traumatic brain injury, was rushed to the PLA General Hospital for resuscitation. Unfortunately, due to the severity of the traumatic brain injury, Aung Aung's spontaneous respiration had disappeared and he was subsequently ruled brain dead by the hospital.<\/span><\/p>\n

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On October 2, a message that a two-year-old girl in Henan Province was in urgent need of a heart transplant reached the PLA General Hospital, and Aung Aung's mother decided to donate her son's heart.<\/span><\/p>\n

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A day later, under the knife of the PLA General Hospital's heart transplant team, as if by the magic of Nuwa Wa, Ang Ang's heart successfully beat vigorously in the body of the two-year-old girl - the hospital's first heart transplant surgery donated by a young child (guardian's will) was declared a success!<\/span><\/p>\n

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Since 2015, when China stopped using organs from death row inmates, citizen organ donation has become the only legal source of organs in China. After five years, where does China's organ transplantation business stand in the world's organ transplantation landscape? What dilemmas does it face and how will it break through?<\/strong><\/p>\n<\/section>\n


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I. Steady growth in the number of donations and too low a per capita donation ratio<\/strong><\/p>\n

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Compared with Europe and the United States, China's organ transplantation business started late and has a weak foundation, but is developing rapidly.<\/span><\/p>\n

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Trends in total organ donation volume and annual donation rate per million population (PMP) in selected countries of the world, 2013-2017<\/p>\n

Data from the Global Organ Donation and Transplantation Observatory (www.transplant-observatory.org) show that from 2016 to 2018, the increase in organ donation after the death of Chinese citizens has always remained above 20%, much higher than the increase in world organ donation during the same period.In 2018, China surpassed the United States in the number of organ donations, jumping to the world's second place.<\/span><\/p>\n

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On December 4, 2014, former Vice Minister of Health Huang Jiefu announced that from January 1, 2015, the use of organs from death row inmates as a source of transplant donors would be completely stopped. Since then, citizen self-donation has become the only legal source of organ donation, and this change has driven the construction of China's organ donation system to be gradually standardized and the donation process to be more transparent. As citizens' trust in the above system grows year by year, the number of organ donations in China has begun to see a significant increase, and the simultaneous opening of a number of new registration channels has also greatly stimulated the enthusiasm of all sectors of the community to donate organs.In March 2014, China's first organ donation volunteer registration network was opened, providing citizens with a more convenient online channel in addition to offline registration.In December 2016, the \"National App\" was launched, providing citizens with a more convenient online channel to register. Alipay, the \"national app\", launched the organ donation registration function. This function greatly simplifies the registration process, and it only takes ten seconds to complete the registration quickly. Since then, the number of registrations has doubled in just one year.<\/span><\/p>\n

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However, human organs are always in short supply due to insufficient donors, high prices and technical difficulties. By the end of 2016, the ratio of organ supply to demand in the United States was about 1:4, while in mainland China, the ratio was close to 1:30. about 300,000 patients in China urgently need organ transplants every year due to end-stage organ failure. By the end of 2018, 169 medical institutions with organ transplant qualification have completed more than 18,000 cases of organ donation after the death of citizens, and the number of donations and transplants ranked the second in the world and the first in Asia, but compared with the number of patients in urgent need of transplantation, it is still a \"drop in the bucket\". Although the overall number of organ donations in China ranks in the forefront, the number of donations per capita is only about half of the world average, far below the level of the vast majority of European and American countries. 2017, as the world's number of organ transplants per capita ranked first in Spain, about 113 people per million people to receive organ transplants, and in the same year, the per capita value of 60 people in Europe, the world's average per capita value of 25 people, and the average per capita value of our country is only 11 people. In the same year, the per capita value was 60 in Europe and 25 in the world, while the per capita value in China was only 11. The low per capita rate of organ donation in China has led to a very prominent contradiction between the supply of and demand for organ transplants, which is similar to the situation in which \"Nuwa wants to mend the sky, but suffers from a lack of colorful stones\".\u00a0<\/span><\/section>\n

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Second, the law is incomplete and standards are inconsistent, and the willingness to donate hovers in the doldrums.<\/strong><\/p>\n

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As of October 2019, more than 90 countries and regions have recognized the criterion of \"brain death\", but the determination of \"brain death\" in China has not yet been written into legal provisions. At present, only some of China's human organ donation pilots have adopted the model of \"heart death\" and \"brain death\" at the same time, and citizens can voluntarily choose the standard of death, but the legal level is still based on \"heart death\" as the uniform donation standard. However, at the legal level, \"heart death\" is still used as the uniform standard for donation.<\/span><\/p>\n

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Many countries used to take \"cardiac arrest\", \"loss of breathing\" and \"zero blood pressure\" as the criteria for death, but with the development of medicine, even if the brain has died, the patient's heartbeat, However, with the development of medicine, even if the brain has died, the patient's vital signs such as heartbeat, respiration and blood pressure can still be maintained normally for a long period of time by means of medication and advanced equipment.\u00a0<\/span>
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Experts say that for organ donation, every second after cardiac arrest is critical. The time allowed for thermal ischemia is 3-4 minutes for the heart, 5-8 minutes for the liver, and 30 minutes for the kidneys. In other words, after \"cardiac death\", the organs will quickly enter a state of hypoxia and ischemia, and the quality of the organs will be drastically reduced compared to brain death. This will certainly have an adverse effect on organ transplantation. Therefore, the \"brain death criterion\" can better explain the significance of organ donation.<\/span><\/p>\n

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It is undeniable that while the number of registered organ donation volunteers is growing at a high rate, a considerable number of citizens are still skeptical about organ donation and hold a resistant or wait-and-see attitude. 2011 National Health and Family Planning Commission (Note: now renamed as National Health and Wellness Commission) organ donation research project \"Public Attitude Towards Organ Donation\" Survey According to the survey, the traditional concept of \"leaving a whole body after death\" is one of the main reasons why citizens are reluctant to donate organs; secondly, 30.1% of the respondents are worried that the organs they donate may be sold or bought; another 20.7% of the respondents chose not to make a decision if they did not have enough knowledge about the relevant issues; and \"Respondents who were worried about the complexity of registering for organ donation, \"discussing with family members whether to donate organs\" and \"there is no need to help others\" accounted for about 15% of the total number of respondents.<\/span><\/p>\n

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Whether in terms of the quantity or quality of organ donation, under the rapid growth in recent years, China's organ donation cause is still confined by a series of structural problems such as imperfections in regulations and standards, as well as negative behaviors triggered by citizens' biased understanding of organ donation.<\/span><\/section>\n

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Third, medical institutions are few and uneven, and transplantation in the province is not yet complete<\/strong><\/p>\n

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As of October 2019, the National Health Commission has identified a total of 173 medical institutions as organ transplant medical institutions. The number of cities with organ transplant medical institutions is only 60, accounting for more than one-fifth of the total number of 293 prefecture-level cities in the country. Geographically, the number of organ transplant medical institutions in the western region is significantly lower.<\/span>
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The uneven distribution of organ transplant medical institutions is also reflected in the correspondence between the number of medical institutions and the population; the number of organ transplant medical institutions is not proportional to the population of the province. Beijing and Shanghai have 17 and 11 organ transplant medical institutions respectively, ranking second and fourth in the country, but both cities have a population of more than 20 million; while Sichuan Province, with a population four times as large as that in the north, has only four organ transplant medical institutions; Anhui Province, with a population three times as large as that in the north, has only two organ transplant medical institutions. \"Anhui Province, which has a population three times that of the two cities, has only two organ transplant medical institutions. In addition, it is not difficult to find that in more than half of the provincial administrative regions, organ transplant medical institutions are concentrated in the administrative centers, and medical institutions in other cities in the region are rarely able to provide appropriate treatment for patients.<\/span>
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It is worth noting that most healthcare organizations only have 1-4 organ transplant techniques.<\/span>
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Only 16 cities (Beijing, Tianjin, Shanghai, Hangzhou, Shenyang, Hefei, Jinan, Zhengzhou, Wuhan, Changsha, Guangzhou, Chengdu, Kunming, Xi'an, Urumqi, and Nanning) have all six organ transplant technologies. While 13 provincial-level administrative regions (Heilongjiang, Jilin, Shanxi, Hebei, Gansu, Qinghai, Tibet, Guizhou, Hainan, Fujian, Jiangxi, Chongqing, Ningxia) are not fully equipped with all 6 organ transplant technologies. This means that in the 13 provinces and regions mentioned above, \"patients need organ transplants, but there is no corresponding transplantation technology in their own province (autonomous region)\" occurs from time to time.<\/span><\/p>\n

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Even with the full availability of the six organ transplantation technologies, the allocation mechanism of donor organs is still affected by a variety of factors, including: the waiting time of the patient, the medical urgency score, the blood type matching, the acceptance principle of the donor, and the geographical factors. China's current organ transplantation-related policies stipulate that donor organs from the province are allocated to patients in the province first, followed by consideration of neighboring provinces; the longer the patient's waiting time and the more urgent his\/her medical condition, the higher his\/her ranking on the waiting list ...... Organ allocation after comprehensively considering multiple factors helps to improve the efficiency of organ utilization and guarantee that organs can be matched to patients in urgent need in a timely and efficient manner.\u00a0<\/span><\/p>\n

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The time between the organ leaving the donor and entering the recipient is known as the cold ischemia time. The longer the cold ischemia time, the worse the quality of the organ and the prognosis for the recipient. In Gansu and Tibet, where there are no heart transplant medical institutions, six hours is too much for a transplant operation. The Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, for example, which has the largest number of heart transplants in China, relies heavily on off-site heart donors, with Guangzhou, Beijing and Hangzhou among the top three cities of origin. Among them, Guangzhou and Beijing are thousands of kilometers away from Wuhan, and even by plane, the air journey takes about two hours, while waiting for the plane and the transportation on the city roads also takes a lot of time, such harsh and almost extreme conditions bring great difficulties to organ transplantation, and also objectively form a stagnation to the development of organ transplantation.<\/span><\/p>\n<\/section>\n


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IV. The plight of \"poverty caused by migration\" persists, but policy support is gradually easing it<\/strong><\/p>\n

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For patients suffering from organ failure, organ transplantation is almost the only hope for them to extend their lives. According to the data released by the National Health Commission, in China, the three-year survival rate of kidney transplants with relatively mature technology is above 90%, the five-year survival rate of heart transplants is nearly 90%, and the five-year survival rate of liver transplants is as high as 71%, which is up to or even higher than the international level.<\/span><\/p>\n

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China has about 300,000 patients in need of organ transplants every year, but only 10% of them are actually waiting in medical institutions and can pay for organ transplants. this means that 90% of the patients are still unable to receive relatively effective treatment due to financial constraints.<\/span><\/p>\n

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According to China's Regulations on Human Organ Transplantation, which came into effect on May 1, 2007, the cost of organ transplantation consists of the following three parts: the surgical fee for the removal and implantation of the human organ, the cost of preserving and transporting the human organ, and the fee for the medication, testing, and medical consumables incurred in the removal and implantation of the human organ.<\/span><\/p>\n

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From coordination, assessment, confirmation, death determination, acquisition, to allocation, transportation and transplantation, organs need to go through a very complicated process from donor to recipient. The current average cost of organ procurement and transplantation in China ranges from 300,000 to 600,000 RMB. Although this is much lower than the average cost of an organ transplant in the United States, it is still a considerable burden for the average family, and even more astronomical for poor families.<\/span><\/p>\n

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In addition to the cost of surgery, it is common for organ transplant patients to take anti-rejection drugs for life after surgery in order for the transplanted organ to function properly in the recipient. These drugs are often expensive, costing thousands or even tens of thousands of dollars per month. According to the New Beijing News, Zhang Haichao, who suffers from pneumoconiosis, has to take 13 pills costing more than $200 a day to fight rejection after his lungs were replaced. Once he stops taking the pills, he will not be able to recover due to respiratory failure. In China, many organ transplant patients face a similar dilemma to Zhang Haichao. In order to save money, some patients choose to reduce or even stop taking their medication, which leads to an aggravation of their condition, ranging from the need for another organ transplant to death.<\/span><\/p>\n

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Fortunately, however, the continuous improvement of policies in recent years has eased this predicament. According to the Circular on the Opinions on the Management of Diagnostic and Treatment Programs, Scope of Medical Service Facilities and Payment Standards of Urban Workers' Basic Medical Insurance issued by the former Ministry of Labor and Social Security in conjunction with other relevant departments, kidneys are among the diagnostic and treatment programs that are partially paid for by the basic medical insurance. As transplantation technology matures, some regions of China are gradually incorporating the costs of liver, lung and heart transplantation into the scope of medical insurance.<\/span><\/p>\n

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In terms of anti-rejection treatment, postoperative anti-rejection drugs such as merti-macrolide and mescaline sodium have also been included in the medical insurance drug catalog in the National Basic Medical Insurance, Workers' Compensation Insurance and Maternity Insurance Drug Catalog issued by the National Health Insurance Bureau in 2019.<\/span><\/p>\n

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National Catalog of Medicines for Basic Medical Insurance, Work Injury Insurance and Maternity Insurance (2019) Source.<\/p>\n

Perhaps in the near future, the fear of transplantation will be a thing of the past, and organ transplants will become affordable to the general public.\u00a0<\/span><\/p>\n

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Huai Nan Zi - Tuan Hei Xun: \"In the ancient times, the four poles were abolished and the nine states were split. ...... refined five-colored stones to mend the sky.\" The story of \"Nuwa mending the heavens\" has actually been performed in organ transplants, but I hope that the sufficient number of \"five-colored stones\" can bless those patients who are waiting for their turn and create a beautiful myth, just like the successful transplant of the heart in the General Hospital of the People's Liberation Army (PLA). Innocent and Valuable Heart ......<\/span><\/p>\n

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Reference:<\/strong><\/p>\n

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First Successful Heart Transplant for Young Children at PLA General Hospital, October 2019, http:\/\/health.people.com.cn\/n1\/2019\/1012\/c14739-31396805.html , October 2019<\/span><\/p>\n

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Former Deputy Minister of Health: stopping the use of organ donations from death row inmates is a sign of respect for human beings, January 2015, http:\/\/news.youth.cn\/gn\/201501\/t20150111_6399900.htm , October 2019<\/span><\/p>\n

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About 300,000 people need transplants every year, only about 10,000 people can realize Go to change - a line of investigation: organ donation How to wish, December 2013, http:\/\/theory.people.com.cn\/n\/2013\/1219\/c372656-23887883.html , October 2019<\/span><\/p>\n

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China's organ donation supply to demand ratio of 1:30 Did you know you can register to donate with your cell phone? , June 2018, https:\/\/media.nju.edu.cn\/74\/cb\/c21821a423115\/page.htm , October 2019<\/span><\/p>\n

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Circular on the Issuance of Basic Principles and Core Policies for the Distribution and Sharing of Human Organs in China, July 2018, http:\/\/www.nhc.gov.cn\/yzygj\/s3586\/201808\/d35d96f2db82403ebe2ba41f2c583896.shtml , October 2019<\/span><\/p>\n

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Transcript of NCHS July 31, 2018 Press Conference, July 2018, http:\/\/www.nhc.gov.cn\/wjw\/xwdt\/201807\/903cf262b2904e16b0206d32f188339b.shtml , October 2019<\/span><\/p>\n

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People's Republic of China State Council Decree (No. 491) - Regulations on Human Organ Transplantation, March 2007, http:\/\/www.nhc.gov.cn\/wjw\/flfg\/200804\/ d0e7200bc48a4b45b26a50a63325e029.shtml , October 2019<\/span><\/p>\n

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Zhang Haichao \"Open Chest\" after July 2018, http:\/\/www.bjnews.com.cn\/inside\/2018\/07\/24\/496452.html , October 2019<\/span><\/p>\n

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Circular on the Issuance of Opinions on the Management of Diagnosis and Treatment Programs, the Scope of Medical Service Facilities and Payment Standards of Basic Medical Insurance for Urban Workers and Employees (Ministry of Labor and Social Affairs [1999] No. 22, June 30, 1999), June 1999, http:\/\/www.mohrss.gov.cn\/gkml\/zlbmxgwj\/ylbx_3063\/201411\/ t20141117_144319.html , October 2019<\/span><\/p>\n

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Notice of the National Health Insurance Bureau of the Ministry of Human Resources and Social Security on the Issuance of the National Catalog of Medicines for Basic Medical Insurance, Workers' Compensation Insurance and Maternity Insurance, August 2019, http:\/\/www.nhsa.gov.cn\/art\/2019\/8\/20\/art_37_1666.html , October 2019<\/span><\/p>\n

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Data sources:<\/strong><\/p>\n

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1. Global Observatory><\/span><\/p>\n

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2. China Human Organ Donation Management Center http:\/\/www.rcsccod.cn\/<\/p>\n

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3. Giving Recipient Organ Donor Volunteer Registry https:\/\/www.savelife.org.cn\/<\/p>\n

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4. National Health and Health Commission of the People's Republic of China List of 173 Organ Transplant Medical Institutions http:\/\/www.nhc.gov.cn\/wjw\/qgyzjg\/201910\/1fd158b625b445a2a26e91bb40966594.shtml<\/p>\n

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5. EPS data http:\/\/www.epsnet.com.cn\/<\/p>\n

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6. National Statistical Office http:\/\/www.stats.gov.cn\/<\/p>\n

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7. U.S. Bureau of Economic Analysis (BEA) https:\/\/www.bea.gov\/<\/p>\n

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Author: Jin Yi, Huazhong University of Science and Technology, School of Journalism and Information Communication, Dongqi Zhang, Guiyan Wei, Xinying Feng<\/p>\n

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Instructor: Xu Di<\/span><\/p>\n

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Source: pengshui news - pengshui number - pengshui guest<\/span><\/span><\/p>\n

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On October 4, 2019, in the heart transplant surgery room of the PLA General Hospital, looking at the normal beating numbers on the monitor, all the medical staff took a long breath of [...]<\/p>","protected":false},"author":6,"featured_media":3372,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"acf":[],"yoast_head":"\n\u3010\u8d44\u8baf\u3011\u6570\u8bf4\u4e2d\u56fd\u5668\u5b98\u79fb\u690d\u4e8b\u4e1a5\u5e74\u53d1\u5c55\uff1a\u6211\u4eec\u7ed8\u5236\u4e86\u201c\u5973\u5a32\u8865\u5929\u56fe\u201d - tranSnovo<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/transnovo.com\/en\/news\/\u3010\u8d44\u8baf\u3011\u6570\u8bf4\u4e2d\u56fd\u5668\u5b98\u79fb\u690d\u4e8b\u4e1a5\u5e74\u53d1\u5c55\uff1a\u6211\u4eec\u7ed8\u5236\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u3010\u8d44\u8baf\u3011\u6570\u8bf4\u4e2d\u56fd\u5668\u5b98\u79fb\u690d\u4e8b\u4e1a5\u5e74\u53d1\u5c55\uff1a\u6211\u4eec\u7ed8\u5236\u4e86\u201c\u5973\u5a32\u8865\u5929\u56fe\u201d - 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