Japan’s New Heart Transplants Rules to Favor Patients Under 60 with Less Than 1 Month to Live

The Yomiuri Shimbun

2:00 JST, March 25, 2026

New criteria starting in April will give top priority for heart transplants from brain-dead donors to patients under 60 expected to have less than one month to live.

On Monday, the Japanese Circulation Society and other organizations said they hope to save more lives by shifting priority to patients in more urgent need and moving away from the current criteria, which tends to favor those who have been on the waiting list for longer periods.

While 798 patients were waiting for heart transplants as of late 2025, only 117 were performed that year, according to the Japan Organ Transplant Network. The society noted that many patients currently wait nearly six years before receiving a transplant.

The new criteria will target patients at high risk of death who cannot be fitted with ventricular assist devices (VAD), which support heart function. Priority will also be extended to those with VADs whose conditions deteriorate while on the waiting list.

In response to requests from the society and other groups, the Health, Labor and Welfare Ministry decided to revise the criteria in October 2024. Under the new system, a review panel of the society will select eligible patients.

The ministry has also decided to prioritize patients under 18 for small intestine transplants if the organ donor is also under 18.