Belarus Transplants Provided Breakthrough in NPO Probe

The Yomiuri Shimbun
An NPO document confiscated by the Metropolitan Police Department states the fees for transplants and other information.

The indictment of the head of a nonprofit organization for allegedly arranging overseas organ transplants has highlighted challenges Japanese authorities face in such cases, due to the fact that the operations were conducted outside Japan and because current legislation does not cover live donors.

Hiromichi Kikuchi, 62, the director of the Tokyo-based Intractable Disease Patient Support Association, has been arrested and indicted on suspicion of violating the Organ Transplant Law.

This is the first arrest and indictment in Japan in such a case.

The Metropolitan Police Department launched an investigation after an article published by The Yomiuri Shimbun in August last year revealed allegations of organ trafficking involving a live-donor kidney transplant in the Central Asian nation of Kyrgyzstan.

As the NPO was linked to patients who had recovered after transplants, there was initially some reluctance among the authorities to proceed with the case.

However, the tide turned after the MPD interviewed patients and others and retrieved taped recordings of Kikuchi.

The NPO’s website included misleading information, such as that patients would receive treatment at a university hospital after returning to Japan.

Kikuchi also showed disregard for the lives of patients in the taped recordings. In one recording he says, “All I need is to get the money.”

One of the NPO’s patients in Kyrgyzstan was temporarily in a critical condition, and two others died after transplants in Belarus. Such cases prompted the MPD to launch a full investigation.

The fact that the transplants were conducted overseas has been the largest hurdle in the investigation, as Japanese police do not have the authority to directly conduct inquiries abroad.

Japanese investigators had to seek the cooperation of authorities in the respective countries when they required information. However, the MPD decided it would be difficult to obtain detailed information about the operations and movement of funds from authorities in Kyrgyzstan.

Under such circumstances, the MPD focused on the charge of mediating transplants without permission from the central government, in violation of the Organ Transplant Law, which is punishable by up to one-year imprisonment.

Although the penalty is not as severe as the maximum five-year sentence for organ trafficking, the MPD decided it would not be able to establish a case against Kikuchi on any charge other than that of unlicensed mediation.

The Health, Labor and Welfare Ministry defines mediation as activities such as soliciting patients and coordinating treatment with hospitals.

Soliciting patients in Japan and writing letters of introduction to hospitals overseas can constitute mediation under the law, according to the MPD.

However, the charge of unlicensed mediation only covers transplants from dead donors, including those who are brain-dead.

It has been difficult to confirm whether the overseas transplants linked to the NPO involved living or dead donors.

The MPD initially learned of an overseas heart transplant involving a dead donor but failed to confirm whether such an operation had been conducted in the last few years. As a result, the investigation stalled temporarily.

The discovery of suspected cases in Belarus proved to be the breakthrough. Under Belarusian law, organs for live-donor transplants must come from relatives.

“A university hospital [in Belarus] would have only accepted a transplant for a foreign national if the organ was from a dead donor,” a senior investigator said.

According to investigators, Kikuchi said a transplant in Belarus involved a dead donor in a taped recording.

Also, in February last year, a Belarusian university hospital issued a document stating a transplant linked to the NPO involved a dead donor. The MPD has confirmed that a doctor named on the document works at the hospital.

“We’ve gathered material to establish a case against Kikuchi and the organization,” a senior MPD official said.

“The investigation has felt like walking a tightrope, because under the current law, even if an organization is involved in the mediation of overseas organ transplants, it is difficult to build a case.”