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 30 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 modern 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.

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References
  1. "Japan Organ Transplant Network Organ Transplanting in Japan". jotnw.or.jp. Japan Organ Transplant Network. Retrieved 2010-07-05.
  2. Hindell, Juliet (1999-02-28). "Transplant first in Japan". news.bbc.co.uk. Tokyo: BBC News. Retrieved 2018-03-17.
  3. Newsome Wicks, Mona (2000-04-25). "Brain Death and Transplantation: The Japanese". Medscape. Retrieved 2010-02-17.
  4. Ota, K. (August 1989). "Organ transplantation in Japan — present status and problems". Transplant International. 2 (2): 61–67. doi:10.1007/BF02459321. PMID 2675896.
  5. Goodman, Roger; Neary, Ian, eds. (1996). Case studies on human rights in Japan. Psychology Press. ISBN 9781873410356. Retrieved 2018-03-17 – via Google Books.
  6. de Villa, Vanessa; Lo, Chung Mao (November 2007). "Liver Transplantation for Hepatocellular Carcinoma in Asia". The Oncologist. 12 (11): 1321–1331. doi:10.1634/theoncologist.12-11-1321. PMID 18055852.
  7. Kimura, Rihito (1998). "Organ Transplantation and Brain-Death in Japan". Annals of Transplantation. 3 (3): 55–58. Retrieved 2018-03-05 – via bioethics.jp.
  8. "The History of Transplanting". jotnw.or.jp. Japan Organ Transplant Network. Retrieved 2010-07-05.
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