Organ transplantation in Japan

Organ transplantation in Japan is regulated by the 1997 Organ Transplant Law which legalized organ procurement from "brain dead" donors.^[1] After an early involvement in organ transplantation that was on a par with developments in the rest of the world, attitudes in Japan altered after a transplant by Dr. Wada in 1968 failed, and a subsequent ban on cadaveric organ donation lasted thirty years. The first transplant after the Organ Transplant Law had defined "brain death" took place in February 1999.^[2]

Due to cultural reasons and a relative distrust of western medicine, the rate of organ donation in Japan is significantly lower than in Western countries.^[3]

History

The first organ transplant in Japan took place at Niigata University in 1956 when a kidney was temporarily transplanted to a patient with acute renal failure.^[4] In 1964 a permanent and full-scale kidney transplant was successfully undertaken at the University of Tokyo, and by 1992 nearly 9,000 kidney transplants had taken place.^[5] In the same year, a liver transplant was performed at Chiba University by Professor Komei Nakayama.^[6] The first heart transplant in Japan was conducted at Sapporo Medical University in 1968 by Dr Wada.^[7] This operation attracted concerns that Dr Wada's evaluation of brain death was inappropriate, and even though an investigation of possible criminal liability was dismissed, a distrust of organ transplanting developed, particularly of transplants from brain dead donors. This brought subsequent developments in transplanting to a halt.^[6][8]

Cultural attitudes

The Japanese people's views regarding life, death, ethics and religion have influenced their negative attitude toward organ transplanting. The Wada heart transplant in 1968 increased a sense of apprehension, especially regarding the evaluation of brain death.^[1] The Shinto religion regards death as impure, and has tainted connotations which have carried through into Japanese culture. Burakumin are a Japanese minority whose occupations dealt with death.

References

1. ^ ^{a b} "Japan Organ Transplant Network ­ Organ Transplanting in Japan". www.jotnw.or.jp. http://www.jotnw.or.jp/english/00.html. Retrieved 2010-07-05. 
2. ^ "BBC News". news.bbc.co.uk. 1999-02-28. http://news.bbc.co.uk/1/hi/health/287880.stm. Retrieved 2010-07-05. 
3. ^ "Brain Death and Transplantation: The Japanese". Medscape. 2000-04-25. http://www.medscape.com/viewarticle/408769. Retrieved 2010-02-17. 
4. ^ "SpringerLink - Journal Article". www.springerlink.com. http://www.springerlink.com/content/1w12311638357105/. Retrieved 2010-07-05. 
5. ^ "Case studies on human rights in Japan - Google Books". books.google.co.uk. http://books.google.co.uk/books?id=73sE6NkXPbAC&pg=PA185&dq=kidney+transplant+1964+tokyo&hl=en&ei=OiAyTNuUG8jKjAeWk5XDBQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CDgQ6AEwAQ#v=onepage&q=kidney%20transplant%201964%20tokyo&f=false. Retrieved 2010-07-05. 
6. ^ ^{a b} "Liver Transplantation for Hepatocellular Carcinoma in Asia -- de Villa and Lo 12 (11): 1321 -- The Oncologist". theoncologist.alphamedpress.org. http://theoncologist.alphamedpress.org/cgi/content/full/12/11/1321. Retrieved 2010-07-05. 
7. ^ "Organ Transplantation and Brain-Death in Japan.". www.bioethics.jp. http://www.bioethics.jp/licht_transplant98.html. Retrieved 2010-07-05. 
8. ^ "Japan Organ Transplant Network ­ The History of Transplanting". www.jotnw.or.jp. http://www.jotnw.or.jp/english/01.html. Retrieved 2010-07-05.