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 surgeon Juro 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]
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 Juro Wada. [7] This operation attracted concerns that 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]
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.
Organ donation is the process when a person authorizes an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive, through a legal authorization for deceased donation made prior to death, or for deceased donations through the authorization by the legal next of kin.
Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.
Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians. Favorable outcomes require careful screening for eligible recipients, as well as a well-calibrated live or deceased donor match.
Prior to the introduction of brain death into law in the mid to late 1970s, all organ transplants from cadaveric donors came from non-heart-beating donors (NHBDs).
The Toronto General Hospital (TGH) is a major teaching hospital in Toronto, Ontario, Canada and the flagship campus of University Health Network (UHN). It is located in the Discovery District of Downtown Toronto along University Avenue's Hospital Row; it is directly north of The Hospital for Sick Children, across Gerrard Street West, and east of Princess Margaret Cancer Centre and Mount Sinai Hospital. The hospital serves as a teaching hospital for the University of Toronto Faculty of Medicine. In 2019, the hospital was ranked first for research in Canada by Research Infosource for the ninth consecutive year.
Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end-stage kidney disease (ESRD). Kidney transplant is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ. Living-donor kidney transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient. The first successful kidney transplant was performed in 1954 by a team including Joseph Murray, the recipient's surgeon, and Hartwell Harrison, surgeon for the donor. Murray was awarded a Nobel Prize in Physiology or Medicine in 1990 for this and other work. In 2018, an estimated 95,479 kidney transplants were performed worldwide, 36% of which came from living donors.
Organ procurement is a surgical procedure that removes organs or tissues for reuse, typically for organ transplantation.
Certain fundamental Jewish law questions arise in issues of organ donation. Donation of an organ from a living person to save another's life, where the donor's health will not appreciably suffer, is permitted and encouraged in Jewish law. Donation of an organ from a dead person is equally permitted for the same purpose: to save a life. This simple statement of the issue belies, however, the complexity of defining death in Jewish law. Thus, although there are side issues regarding mutilation of the body etc., the primary issue that prevents organ donation from the dead amongst Jews, in many cases, is the definition of death, simply because to take a life-sustaining organ from a person who was still alive would be murder.
Organ trade is the trading of human organs, tissues, or other body products, usually for transplantation. According to the World Health Organization (WHO), organ trade is a commercial transplantation where there is a profit, or transplantations that occur outside of national medical systems. There is a global need or demand for healthy body parts for transplantation, which exceeds the numbers available.
Organ transplantation in Israel has historically been low compared to other Western countries due to a common belief that organ donation is prohibited under Jewish law. This changed with the passage of new organ donation laws in 2008. If two patients have the same medical need, priority will now go to the patient who has signed an organ donor card, or whose family members have donated an organ. This policy was nicknamed don't give, don't get. The law also defines "brain death" as an indication of death for all legal purposes, including organ donation. Additionally the law provides financial reimbursement to living donors for medical expenses due to donation and lost time at work. Organ trafficking is explicitly banned. Health insurance plans can no longer reimburse patients who go abroad to receive transplants.
Many different major religious groups and denominations have varying views on organ donation of a deceased and live bodies, depending on their ideologies. Differing opinions can arise depending on if the death is categorized as brain death or cease of the heartbeat. It is important for doctors and health care providers to be knowledgeable about differentiating theological and cultural views on death and organ donations as nations are becoming more multicultural.
A beating heart cadaver is a body that is pronounced dead in all medical and legal definitions, connected to a medical ventilator, and retains cardio-pulmonary functions. This keeps the organs of the body, including the heart, functioning and alive. As a result, the period of time in which the organs may be used for transplantation is extended. The heart contains pacemaker cells that will cause it to continue beating even when a patient is brain-dead. Other organs in the body do not have this capability and need the brain to be functioning to send signals to the organs to carry out their functions. A beating heart cadaver requires a ventilator to provide oxygen to its blood, but the heart will continue to beat on its own even in the absence of brain activity. This allows organs to be preserved for a longer period of time in the case of a transplant or donation. A small number of cases in recent years indicate that it can also be implemented for a brain-dead pregnant woman to reach the full term of her pregnancy. There is an advantage to beating heart cadaver organ donation because doctors are able to see the vitals of the organs and tell if they are stable and functioning before transplanting to an ailing patient.
Francis L. Delmonico, MD, FACS is an American surgeon, clinical professor and health expert in the field of transplantation. He serves on numerous committees and is affiliated with various leading organizations and institutions. He is the chief medical officer of the New England Organ Bank (NEOB) and Professor of Surgery, Part-Time at Harvard Medical School in Boston, Massachusetts, where he is emeritus director of renal transplantation. He served as president of The Transplantation Society (TTS) from 2012 to 2014, an international non-profit organization based in Montreal, Canada that works with international transplantation physicians and researchers. He also served as the president of the United Network of Organ Sharing (UNOS) in 2005, which overseas the practice of organ donation and transplantation in the United States. He was appointed and still serves as an advisor to the World Health Organization in matters of organ donation and transplantation. He was appointed by Pope Francis to the Pontifical Academy of Science in 2016. In 2020, he became the recipient of the Medawar Prize of The Transplantation Society.
A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed. As of 2018, the most common procedure is to take a functioning heart, with or without both lungs, from a recently deceased organ donor and implant it into the patient. The patient's own heart is either removed and replaced with the donor heart or, much less commonly, the recipient's diseased heart is left in place to support the donor heart.
The practice of selling one's kidney for profit in Iran is legal and regulated by the government. In any given year, it is estimated that 1400 Iranians sell one of their kidneys to a recipient who was previously unknown to them. Iran currently is the only country in the world that allows the sale of one's kidney for compensation ; consequently, the country does not have either a waiting list or a shortage of available organs.
MOHAN Foundation is a not-for-profit, registered non-government charity organisation in India that works in the field of deceased organ donation and transplantation. MOHAN is an acronym for Multi Organ Harvesting Aid Network.
Organ donation is when a person gives their organs after they die to someone in need of new organs. Transplantation is the process of transplanting the organs donated into another person. This process extends the life expectancy of a person suffering from organ failure. The number of patients requiring organ transplants outweighs the number of donor organs available.
The current law in Ireland requires a potential donor to opt in to becoming an organ donor. However, it is ultimately up to their family to make the decision whether or not the person can donate their organs after they die.
Organ transplantation in the Indian state of Tamil Nadu is regulated by India's Transplantation of Human Organs Act, 1994 and is facilitated by the Transplant Authority of Tamil Nadu (TRANSTAN) of the Government of Tamil Nadu and several NGOs. Tamil Nadu ranks first in India in deceased organ donation rate at 1.8 per million population, which is seven times higher than the national average.
Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994. The law allows both deceased and living donors to donate their organs. It also identifies brain death as a form of death. The National Organ and Tissue Transplant Organisation (NOTTO) functions as the apex body for activities of relating to procurement, allotment and distribution of organs in the country.