Refusal of Organ Transplants: Ensure Patients Do Not Miss Out Due to Circumstances at Hospitals

Editorial

16:54 JST, June 26, 2024

There has been a spate of cases in which operations to transplant organs from people who were declared brain dead to other patients could not be performed due to inadequacies in the hospital system. It is necessary to rectify the current situation in which some patients miss out due to the circumstances of a hospital.

According to a survey conducted by the Japan Society for Transplantation, there were more than 60 cases in which transplant surgeries were declined during the past year between the University of Tokyo Hospital, Kyoto University Hospital and Tohoku University Hospital — the three university hospitals that had conducted the highest number of transplant surgeries. These cases were due to shortages of intensive-care unit beds and personnel.

Japan has significantly fewer brain-dead donors than other countries. For that reason, there is a constant flow of patients seeking transplants abroad, and there has been a case of a person being arrested over allegedly acting as an intermediary for organ transplants overseas.

On the other hand, the arrest triggered increased public interest in organ transplants, and the number of organ donations from brain-dead people climbed to a record high of 132 last year. However, the increase in turn revealed the inability of hospitals that perform organ transplants to keep up with the increasing demand for operations.

On top of the three university hospitals, there may be others with similar circumstances. The central government must hurry to grasp the reality of the situation. If the systems of hospitals in charge of transplantation is inadequate, the government should consider expanding their capacity.

The Japan Organ Transplant Network determines the order of patients waiting to receive donated organs based on the severity of their condition and other factors. If the hospital that is notified by the network is not able to perform the transplant operation immediately, a patient at another hospital who is next in line for a transplant will be prioritized.

If transplant surgeries cannot be performed because of the patient’s disease condition, that is unavoidable. However, if transplants are not performed on patients in more serious conditions due to a lack of hospital beds or personnel, patients may not be able to fully accept the situation.

It is also vital to have a system in place to ensure that patients do not miss out on opportunities.

Shouldn’t it be possible to allow patients to select multiple hospitals where they undergo transplants in advance, in case they are unable to receive organ donation due to an individual hospital’s circumstances?

Another idea would be to have multiple hospitals cooperate to send support staff to each other when there is a lack of personnel.

One of the reasons why transplants are declined at major hospitals is that patients tend to be concentrated in hospitals with a good track record. It is also said that patients tend to register with hospitals that carry out a large number of operations because the patients lack information on transplantation.

The central government intends to release the data on the number of patients on the waiting list and the survival rate after transplantation at each hospital that performs transplants. If there is not a large difference in treatment results, patients may select different hospitals and the overconcentration of patients at certain institutions could be eased.

It is hoped that efforts will be made to promote the sharing of information between the medical service and patients, leading to the creation of a fair and highly reliable transplant medical care system.

(From The Yomiuri Shimbun, June 26, 2024)