Devise mechanism to take advantage of people’s desire to donate

Twenty-five years have passed since the enforcement of the Organ Transplants Law, which recognizes brain death as a form of human death. There is still a serious shortage of organ donors. Measures to increase the number of donors must be promoted.

After the law went into effect in 1997, it became possible to take organs from people who had been declared brain dead and transplant the organs into other people. However, there were fewer than 100 such donors in total over the first 10 years.

This was partly because the conditions for organ donation from a brain-dead person were extremely strict, requiring a written declaration of the donor’s wishes. The requirements were eased in 2010 to allow such donations with just the consent of the family, and the annual number of donors has increased to nearly 100 at the highest.

More than a few people in Japan are willing to donate their organs after death, including brain death. According to a survey by the Cabinet Office, 40% of respondents said they would be willing to donate their organs. In addition, 90% were willing to respect the wishes of a family member who wanted to donate.

However, few people indicate their willingness to donate their organs on the back of their driver’s license or health insurance card, or tell their families about their feelings.

Measures to improve the situation should be considered, such as making sure to confirm a hospitalized person’s willingness to donate their organs. It is also important for the government and medical institutions to make efforts to disseminate detailed information about transplants.

About 900 people are currently waiting for a heart transplant in Japan and more than 13,000 for a kidney transplant, as well as several hundred for liver and lung transplants.

To make up for the shortage of brain-dead donors, living-donor transplants are widely carried out in Japan. A living relative donates one of their two kidneys, or part of a liver or lung. This medical treatment is based on the premise that a healthy body is damaged.

In other advanced countries, transplants from brain-dead donors are the standard method and living-donor transplants the exception. Japan’s reliance on living donors is not a desirable situation and needs to be rectified.

Suspicions of organ trafficking by a nonprofit organization have surfaced regarding an organ transplant overseas that a person earnestly seeking an organ received through the NPO’s mediation. The NPO denied involvement in organ trafficking at a hearing held by the Health, Labor and Welfare Ministry. The ministry has no authority to investigate further and is at a loss about what to do.

Such problems connected to overseas organ transplants have continued for many years. The current situation in which the Japanese government cannot extend its authority is problematic, and the prompt establishment of legislation to deal with the circumstances is urged.

Organ transplants involve individual opinions on life and death, and people’s perspectives are likely to differ. In the future, it will be necessary to focus on research to develop medical treatments that do not rely on organ transplants.

(From The Yomiuri Shimbun, Oct. 30, 2022)