3 Major Hospitals Declined 62 Organ Transplants Last Year; Forgoing Surgeries Essentially Jumbled the Waiting List

Japan’s three leading hospitals for organ transplants declined to perform 62 transplants with organs from brain-dead donors last year, due mostly to insufficient systems and manpower, according to a recent survey.

The operations were turned down even while the overall number of organ donations in Japan has been on the rise. Against this background, the Japan Society for Transplantation conducted a first-of-its-kind survey of the University of Tokyo Hospital, Kyoto University Hospital and Tohoku University Hospital.

Before the survey was conducted, The Yomiuri Shimbun reported in January that even when hospitals were offered organs, they were occasionally unable to carry out transplants.

Thirty percent of the 62 forgone transplants were due to a lack of vacancies in intensive-care units (ICUs). At Kyoto University Hospital, one patient who missed the opportunity to undergo the surgery died.

On top of a lack of ICU space, deficiencies related to operating rooms were cited as a cause of 12 operations being forgone, while such in-house rules as “not performing a transplant the day after two such operations were performed” were a cause of 10 operations being turned down. The survey allowed multiple answers for each operations.

The University of Tokyo Hospital gave up on transplants with 36 organs, followed by Kyoto University Hospital with 19 and Tohoku University Hospital with seven.

By organ type, 36 cases involved lungs, 16 were livers and 10 were hearts.

The Japan Organ Transplant Network maintains a prioritized waiting list of patients, based on factors such as how long they have been waiting and the severity of their condition, and asks hospitals to direct organs toward patients from the top of the list.

Of the 62 organs that the three hospitals declined to transplant, 54 were transplanted to patients further down on the waiting list at other hospitals. The remaining eight were not transplanted at all on the medical grounds that the hospitals deemed them to be “not in a good condition for transplant.”

As for the deceased patient, Kyoto University Hospital told The Yomiuri Shimbun in writing: “We gave up on the transplant after an overall assessment of a series of factors such as medical matters of the donor, the difficulty of performing an operation due to the deterioration of the patient’s full-body condition and our preparedness for operations.”

The organ’s presumed destinations were concentrated at the three hospitals. Last year saw a record 132 brain-dead donors, with 352 transplants performed with donated lungs, livers and hearts. The University of Tokyo Hospital performed the highest number of transplants at 88, followed by 36 at Kyoto University Hospital and 34 at Tohoku University Hospital.