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With the support and encouragement of the Chinese government, there has been a notable amount of development of donation after citizen death (DCD) work in China in the past several years. Hospitals play a crucial role in organ donation and procurement during DCD work. Transplant hospitals and organ procurement organization (OPO) have made great contribution to this cause in recent years.There are currently four main patterns of OPO in China: (1) mature and reinforced hospitals with an independent OPO; (2) experienced hospital lead several inexperienced hospitals and share an OPO; (3) Several small hospitals share one OPO; (4) Administrative intervention: health authorities combine various transplant hospitals to form OPOs. All forms of OPOs should be facilitated by their own hospitals, which should also be supervised and administered by local Red Cross association and Health and Family Planning Commission.All four patterns of hospital-OPO relationship above are considered proper in the current circumstances Transplant hospitals with sufficient economic and manpower support did better than those with inadequate support. Administrative intervention plays an important role in DCD work. Accompanying the vigorous development of national DCD work, several disadvantages of this hospital-OPO relationship have emerged.A more transparent, open and better-organized pattern of hospital-OPO relationship that fits the current conditions of Chinese DCD work is of great importance.The study was funded by Wu Jieping Medical Foundation (320.6750.15070) and Natural Science Foundation of Hunan Province (2016JJ4105).