Reply: The boat, the sword, and the opacity of Chinese transplant data

We are grateful to Dong and colleagues1 for addressing several issues in our paper on the Chinese transplant system.2 We appreciate that many Chinese thoracic transplant surgeons want to make their system better, as we stated in our paper: “One of the most unfortunate consequences of the ongoing use of executed prisoner organs is the damage to the international reputations and standings of those transplant surgeons in China who are dedicated to high ethical standards in their practices and are making vigorous and honest efforts to establish a transparent and trustworthy system.” We have no reason to doubt that this statement describes the authors of the present letter but also understand the motivation for Chinese thoracic transplant surgeons to present their system in the best light, highlighting organ donations in their country as transparent, fair, and traceable, despite the direct and indirect evidence to the contrary from the several scholarly sources that we cited.