Shadowy Organ Transplant / Japan Struggles to Prosecute Mediators of Shadowy Organ Transplants Overseas

The Yomiuri Shimbun
Hiromichi Kikuchi, the director of Intractable Disease Patient Support Association, is sent to prosecutors on Feb. 9.

This is the second installment in a series looking into the organ transplant situation in Japan, including shadowy organ transplants overseas, the lack of legal oversight and the low number of organ donors.


Japanese police have built their first-ever case involving shadowy organ transplants overseas, alleging the unauthorized mediation of organ transplants by the nonprofit Intractable Disease Patient Support Association. According to a senior official of the Metropolitan Police Department, however, police have investigated many such incidents in the past.

For example, the Kanagawa prefectural police and others interviewed in 2008 a representative of an organization alleged to have mediated organ transplants in China for more than 100 Japanese people. In 2011, the Hyogo prefectural police investigated an organization that had guided a patient with renal failure to China.

The MPD are also investigating a case involving a live-donor organ transplant for a Japanese citizen that took place in Bulgaria in 2021.

All these incidents have been reported on by newspapers or magazines. However, investigative sources say there are still others for which police obtained relevant information and conducted investigations.

There are two main reasons why the police have not built a case over those suspicious transplants — one is the difficulty in conducting investigations in other countries.

The Organ Transplant Law prohibits organ trafficking and remuneration in return for mediating an organ transplant, and contains a provision on crimes committed by Japanese nationals outside Japan. However, since the actual organ transplants took place overseas, it is difficult to obtain specific testimony about the transfer of money and actual mediation processes from the local doctors and organ donors involved.

Whether the donors are alive also affects police investigations, because the law only recognizes as a crime the unauthorized mediation of organ transplants from dead donors, including those who are brain-dead. It does not cover live-donor transplants.

In a case involving the Intractable Disease Patient Support Association, a document issued to a patient by a hospital in Belarus stated that the organ involved came from a deceased donor.

The other problem in building a case is the difficulty in judging the level of wrongdoing in each incident.

Patients with severe illnesses went abroad of their own free will, and some regained their health after successful operations. Trafficking involving poor organ donors is suspected in these overseas transplants, but it cannot be denied that they have saved patients’ lives.

For that reason, some police officers doubted that these situations involved sufficient wrongdoing for the police to build a case.

However, in the organ transplants mediated by the Tokyo-based NPO in question, two patients died and the condition of another became critical over just one year from December 2021. Although patients who receive organ transplants overseas are highly likely to be rejected by Japanese hospitals after they return home, the NPO was found to have told patients that they could stay in university hospitals.

The NPO allegedly received large payments ranging from ¥18 million to ¥85 million from each patient and made significant profits, another reason for the police to open a criminal investigation.

“The police launched a criminal investigation into the NPO not because it did greater wrong than other mediation organizations but probably because the police have gathered enough evidence,” said Katsunori Kai, a professor at Waseda University who specializes in medical law and is familiar with organ transplant issues.

“Neither the Health, Labor and Welfare Ministry, which regulates organ transplants, nor municipalities, which supervise nonprofit organizations based on the law to promote specified non-profit activities, understand the activities of these mediation organizations,” Kai said. “Under these circumstances, police investigations are the only way to ascertain what they’re doing, which is a problem, The central government should create a system to grasp the activities and situation of such organizations.”