Consideration at the First Case of a Kidney Trade in Japan

Miyako OKADA-TAKAGIUniversity research Center, Nihon UniversityTokyo, JAPAN

Recipient 　　　　 Donor

First case of a kidney trade in Japan

gave the left kidney

after operation・ 300,000 yen in cash・ A car

Severe diabetes 　 his common law wife Faked his sister in law

Mr. A Ms. B Ms. C

The situation of T-hospital No ethics committee for transplantation

issues

A doctor-M managed everything for transplantation

1) He is famous for kidney transplantation

from living donors. 2) He has never been a member of the Japan Society for Transplantation.

Ethical guidelines of the Japan Society for Transplantation

Not specify concrete procedures

- to confirm the identities of donor

- to confirm kinship between donors and recipient

These procedures are left to the

discretion of individual hospitals

Some hospitals have set stricter regulations than those of the JST

…for managing the cases of

which a patient marries or

adopts a donor .

Shortage of organ donations

The number in artificial dialysis (Japan)

… 　 240,000 (2004)

　 A large gap between the number of patients requiring an organ transplant

and the number of organ donors.

11,564 were awaiting kidney transplants

( Aug. 31,2006.)

Living donors are common in Japan

4~6 cases from brain-dead patients (an average year)

112 (2002) cases from cardiac-arrest patients

727(2004) cases from living donors

from either a parent or child of the recipient, and donation between spouses is increasingly common.

Organ Transplant Law The Organ Transplant Law

standards for determining brain death and procedures for organ transplants

At present there are no legal provisions for organ donations from a living donor.

- except for a ban on organ trading and unlicensed brokering

The necessity to cover transplants from living donors

The necessity to reform brain-dead donors and cardiac-arrest

donors

Family members do not receive priority on organs donated from another family member.

　　

living donors

Relatives, within six degrees of consanguinity by blood or a relation by marriage within the

third degree of consanguinity, of a recipient can be accepted as a living donor.

The issues in living donors

In cases ・ Real family members are forced to donate

organs ・ Cash payments take place

The JST guidelines on exempting families from its ethical screening process should be reviewed.

This point should be publicized more

brain-dead donors

The donor must have expressed the will to be a donor while alive.

cardiac-arrest donors

The approval from family members is sufficient.