INTERNATIONAL ORGAN DONATION AWARENESS - JAPAN

10th brain death under new law / Transplants from 9th donor with only relatives' approval go forward The Yomiuri Shimbun A man in his 30s was diagnosed as brain dead Saturday under the criteria stipulated by the revised Organ Transplant Law, representing the 10th such diagnosis since the law came into effect in July, the Japan Organ Transplant Network said. The man had been hospitalized in the Kinki region. He had not expressed in writing a desire to be an organ donor, but his family agreed to the harvest of his organs--the ninth case of organ donation with only a family's consent under the new law. The revised law made it possible to transplant organs from a brain-dead person with only his or her family's permission, as long as the person had not clearly expressed the wish not to donate or be declared brain dead. The organ transplant network quoted one of the man's relatives as saying the man had told his family: "Organ transplants can save people's lives." "We wanted to respect his will. We're proud that parts of his body will be alive in other people and help them," the relative was quoted as saying. The man's heart, lungs, liver, kidneys and pancreas will be transplanted into six patients nationwide. The country's first organ transplant from a brain-dead donor was conducted in February 1999, about a year and four months after the initial Organ Transplant Law was put into force in October 1997. The 10th organ transplant from a brain-dead donor was not conducted until January 2001, about three years and three months later. Before the law's revision, organs could not be donated from brain-dead individuals unless they had left a written statement expressing their desire to do so. The relaxation of the criteria has clearly contributed to a sharp increase in organ transplants. Among the nine cases in which organ transplants have been conducted with only the families' consent, brain-dead patients had verbally expressed desire to donate in just three. In all the other cases, the families decided to donate the brain-dead persons' organs because they wanted parts of their loved ones' bodies to live on in others. "I believe the public's understanding of organ donations has deepened," said Prof. Atsushi Aikawa of Toho University, the top spokesman for the Japan Society for Transplantation. If the current pace continues, the annual number of organ donations from brain-dead donors will likely rise sixfold, to about 60, from the number that took place each year before the law's revision. The figure is still far less than the United States and Europe. The United States sees about 2,000 heart transplants from brain-dead donors each year, and there are several hundred in Europe. But if the number of organ donations from brain-dead patients continues to increase, it might make it difficult for workers in emergency medical care facilities and network personnel to follow all necessary procedures. Emergency facilities suffer from a chronic shortage of doctors, and the network has only 26 organ transplant coordinators. Whether organ transplants in Japan will be able to take root in this country as a medical treatment conducted at a global standard depends on the nation's efforts to improve its medical services. "Without long-term observation, we can't know whether this pace can continue," said Jiro Nudeshima, a bioethics researcher at the Tokyo Foundation. "But even the current number is among the lowest in the world. If many people feel the current pace is high, it means [the concept of] organ transplants still haven't taken root in this country."