Japan NPO Director Sent to Prosecutors Over Overseas Transplant

The Yomiuri Shimbun

16:49 JST, February 9, 2023

The director of a Tokyo-based nonprofit organization was arrested Tuesday on suspicion of facilitating an organ transplant without official permission, sources close to the investigation told The Yomiuri Shimbun.

The director, Hiromichi Kikuchi,62, was sent to prosecutors Thursday on charges of violating the Organ Transplant Law, which prohibits organ trafficking and unauthorized mediation in arranging organ transplants.

The Metropolitan Police Department also sent the NPO to the Tokyo District Public Prosecutors Office on the same charge.

Shadowy organ transplants in developing and other overseas nations have become a serious problem, but the arrest of Kikuchi, of Tsuzuki Ward, Yokohama, marks the first time such actions have resulted in a criminal case in Japan.

The case comes amid growing suspicions that the Intractable Disease Patient Support Association facilitated overseas transplants without permission.

The MPD apparently focused on the matter because the condition of several patients had deteriorated after undergoing operations, sparking mounting criticism of transplants conducted abroad through unclear arrangements.

According to the sources, Kikuchi did not have the required permission from the health, labor and welfare minister to operate as an intermediary for organ transplants. However, in October and November 2021, Kikuchi recommended a man in his 40s who suffered from cirrhosis receive a liver transplant and wrote a letter of reference to a hospital. The man paid about ¥33 million to the NPO’s bank account to cover the transplant and other expenses. Kikuchi is suspected of arranging for the man to travel to Belarus in January 2022, and the patient received a liver transplant at a hospital in Minsk the following month.

The transplanted liver was not from a living donor; it came from a person who had died in Belarus.

While Kikuchi reportedly admitted to investigators that he had recommended the patient receive a transplant, he denied doing anything wrong. “I shouldn’t need **permission from the Japanese government** for operations conducted overseas,” Kikuchi reportedly said.

Penalties for violating the Organ Transplant Law include imprisonment of one year or less, and a fine up to ¥1 million. The MPD decided Kikuchi’s actions, including persuading the patient to get a transplant and writing a referral letter, amounted to working as a go-between.

According to sources at the NPO, the male patient fell ill while returning from Belarus and had to be admitted to hospital in Finland, which was a transit point on the journey back to Japan. After returning to Japan, the man was admitted to a Tokyo hospital and received a living-donor liver transplant from a family member. However, his health did not improve, and he died in November.

Under the law, organ mediation covers only transplants from dead people, including those who are brain-dead, and not live-donor transplants. It is difficult to determine whether an organ used in a transplant conducted overseas came from a living or dead donor, but the MPD built a criminal case after collecting evidence that verified the liver used in the Belarus operation had come from a cadaver.

Several intermediaries arrange organ transplants overseas, but problems — including the death of Japanese patients — have previously emerged. Suspicions that organs are trafficked for these operations also have arisen.

Police had investigated prior cases that appeared to violate the transplant law, but a criminal case was never filed. “The transplants take place overseas, so it’s difficult to confirm the details of the operations and whether any monetary payments were made in exchange for organs,” a police source said.