INTERNATIONAL ORGAN DONATION AWARENESS - JAPAN

Despite law, child heads overseas for transplant The Yomiuri Shimbun A 7-year-old girl departed for Toronto on Tuesday to receive a heart transplant ahead of Saturday's enactment of the revised Organ Transplant Law enabling organ transplants from brain-dead donors younger than 15. Nazuna Koga, a second-year primary school student in Nakano Ward, Tokyo, went to Canada with her parents because it was uncertain when a heart transplant would be available for her in Japan. Nazuna's remark, "I can take anything if I can be cured in Canada," compelled her parents, Koichi, 51, and Miho, 45, to let their daughter undergo a transplant overseas. "We wanted to set our minds at ease as soon as possible," said Miho in a telephone interview from a Toronto hospital. Nazuna was diagnosed at age 5 with restrictive cardiomyopathy, in which heart muscles gradually become rigid, and her doctor said a heart transplant would be required in the future. Her parents had hoped she could receive a heart transplant in Japan at an early date. Nazuna had a sudden heart attack in May the following year, shortly after she entered primary school. Although she went into cardiac arrest, her life was saved thanks to emergency surgery. Her condition worsened again in April this year and a doctor said she had six months to live. A heart transplant is only possible from a brain-dead donor. There was no way to know whether a child donor would emerge shortly after the revised law took effect. In June, Nazuna's classmates' parents and others began raising funds to help pay for her medical expenses, and raised more than the 90 million yen necessary for an overseas transplant. Miho said they had hoped to have the operation in Japan if possible. "I've mixed feelings when thinking about the child [who will be the heart donor], but I do hope medical transplant procedures will become widespread in Japan," she said. Since the Organ Transplant Law was implemented in 1997, only 86 transplants from brain-dead donors have been carried out. Yuya Tashiro, 20, of Higashi-Murayama, Tokyo, hopes to have a liver transplant in the United States. However, he currently has no prospect of undergoing the operation because financial contributions have not reached the necessary target of 50 million yen. Suffering from congenital biliary atresia, in which the bile duct between the liver and small intestine is blocked or absent, Tashiro received a living donor liver transplant from his father, Junichiro, 50, when he was 1 year old. Tashiro was able to live like an ordinary child until primary school age, but cirrhosis, a consequence of chronic liver disease, has progressed and doctors have given him six months to live. Tashiro's mother, Keiko, 51, thought about donating part of her liver but had to gave up the idea because their blood types are different. "Even if the revised law has expanded the possibility of transplants in Japan, Takuya has only a little time to live. I hope he'll have a healthy life again," she said. Organ transplants overseas According to the Japan Society of Transplantation, 137 people from Japan received heart transplants overseas between 1984 and the end of October. A Health, Labor and Welfare Ministry study group said 221 people had received liver transplants overseas between 1984 and 2005. With the full implementation of the revised law, experts expect the number of transplants from brain-dead donors to increase to more than 30 cases annually from the current 10. Some even expect the number to increase to as much as 80. However, the numbers are still small compared with those in Europe and the United States. Kazuko Takahashi, director of the nonprofit Japan Transplant Support Association, which supports families with members who hope to have overseas organ transplants, said the number of such operations would not decrease immediately even after the law's enactment. "In the current situation, where organ donors are scarce in Japan, it's necessary to promote discussion about organ transplants to deepen people's understanding of their medical options," Takahashi said.