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To the Editor—Transplantation is advancing rapidly to such an extent that in the foreseeable future we may witness the first head transplantation.1 Low donation rates will be one of the main global barriers undermining transplantation. I read with interest the article by Cheung et al2 and I would like to highlight a few issues concerning this research. Although the article analysed the willingness of potential donors under three systems (opt-out, opt-in, and opt-in with allocation priority), it did not consider an opt-out system with allocation priority. Previous research showed that an opt-out system with allocation priority may result in a higher willingness to donate than other systems.3,4 Cheung et al2 found that the difference in willingness between the opt-in and opt-out systems was not significant; therefore, it is highly possible that an opt-out system with allocation priority would result in a similar, or perhaps better, willingness to an opt-in system with allocation priority. Moreover, the opinion of health care professionals on donation legislative systems is critical in this context, as they play a vital role in facilitating the process of donation and transplantation.5 Although the findings of Cheung et al2 are imperative, more accurate policy recommendations in this context require further studies to investigate willingness to donate under an opt-out system with allocation priority as well as health care professionals’ opinion of donation legislative systems in Hong Kong.

In search of the best organ donation legislative system for Hong Kong: further research is needed