National Health Commission says more research needed on procedure that has been performed in nearly 400 hospitals across the country

Beijing has banned a surgical treatment for Alzheimer’s disease that has been carried out in almost 400 hospitals across China, but has left open the possibility that it could be re-evaluated after rigorous clinical trials.

The procedure, known as lymphatic-venous anastomosis (LVA), involves connecting the patient’s lymph vessels to veins near the neck to speed up the flow and drainage of lymph fluid. The aim is to boost the removal of harmful brain proteins and slow the disease’s progression.

The surgery has grown in popularity, particularly over the past year, since it was first performed in 2021 by a microsurgery expert from a private hospital in Hangzhou, in the eastern province of Zhejiang.

Based on publicly available information, an estimated 382 hospitals across almost all Chinese provinces had performed the procedure by the end of June.

However, in a notice on Tuesday, the National Health Commission said the therapy was still in the exploratory stage of clinical research, with indications and contraindications yet to be clearly defined.

“There is a lack of high-quality medical evidence supporting its safety and efficacy,” the notice said. The procedure has been prohibited for the treatment of Alzheimer’s disease, pending further clinical studies.

The authority did not rule out the surgery completely. Once sufficient preclinical evidence was available, it would guide qualified medical institutions to conduct clinical studies in a scientific and standardized manner, it said.

“Based on the results, we will organize another review of the clinical application of this procedure at an appropriate time.”

Hospitals that have been conducting the surgery for research purposes have largely suspended their operations.

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A doctor at the Affiliated Hospital of Guangdong Medical University said that its clinical trial – which started recruiting patients on May 30 – was suspended at the beginning of July, with “no idea when it can reopen”.

Another doctor from the Second Hospital of Jilin University said they were asked to stop research on June 28 for the clinical trial launched in November. “We were just about to start the research and were asked to stop it, without any prior notice,” he said.

Alzheimer’s disease – the leading cause of dementia – is a brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks.

Since it was first described in 1906, scientists and doctors have been striving to find an effective treatment without success. In China, around 10 million people are living with Alzheimer’s.

When the surgery first came to public attention, some Chinese doctors promoted it enthusiastically on social media, claiming it was “effective for 60 to 80 per cent of patients”.

In December, the South China Morning Post visited Xiangya Hospital of Central South University in Changsha, where Dr Tang Juyu, head of the hospital’s microsurgery unit, and his team had already performed the procedure on more than 70 patients.

According to Tang, improvements were observed in around 80 per cent of those patients, though he stressed that this was based on a preliminary, qualitative observation.

The surgery has also been met with scepticism, with some medical experts questioning its fundamental mechanism and long-term effectiveness.

Dr Fan Dongsheng, a professor with the neurology department at Peking University Third Hospital, warned that the scientific mechanism behind the treatment had not been well studied and was at present not convincing.

He also noted that reported improvements in patient symptoms were qualitative and not based on the accepted evaluation system.

Fan welcomed the government’s decision to halt the treatment, calling it “apparently problematic” that many hospitals, even small ones, performed the surgery extensively without solid evidence and had charged patients for it.

On Chinese social media platforms, many commenters expressed their anxiety that diagnosed family members would no longer be able to receive the treatment.

“If the patient’s family agrees, I think it’s worth trying, because some patients are in a really serious condition and their families are exhausted and desperate,” a person from northeastern Liaoning wrote.

One man said that his father, who was treated in March, had recovered well and could now recognize people and look after himself. If surgery had the potential to improve patients’ conditions, “most families would choose to give it a try”, he told the Post.

Cheng Chongjie, one of the first doctors to share details of the procedure with the public in December, said in a video posted to social media on Thursday that he “firmly supports” the ban.

“I think this surgery should have been stopped a long time ago because there is no standard way in which it is currently performed,” he said.

Cheng, from the First Affiliated Hospital of Chongqing Medical University in southwestern China, said there were huge discrepancies in results, with some medical institutions having an effectiveness rate of less than 30 per cent.

“By taking this opportunity, I hope that the regulator will determine a standardized way of performing the surgery and collaborate with major medical institutions to conduct a multicenter, high-level clinical study,” he added.