After nearly half a century of development, the Chinese organ transplant technology has reached the international advanced level. However, the biggest bottleneck for transplant is the shortage of organs. To convert the situation of over-dependent on condemned prisoners for organs, China started a pilot project of voluntary organ donation in 2010, and now spreading it to the whole nation. Based on the long time fieldwork, the paper suggests that the construction of Chinese organ donation system couldn’t copy the international mature experiences, for every step of the donation process from registration, confirmation, acquisition, allocation, disposal to compensation has some local sociocultural significances, which involve the relations between individual and family, body part and whole, biological death and cultural death, giving and feedback, distribution and fairness. Reflection the culture embedded the organ donation system will be helpful to us to carry out the system deliberately, and construct a donation system according to Chinese culture context.