Current situation of organ transplantation
We would like everyone to understand the reason why we seek for organ transplantation
outside Japan.
Just when we were considering an organ transplant for Soutaro, a meeting of
Japan Society for Transplantation was being held in Osaka.
We only participated for 1 day, but we were able to get and idea of the current
situation of medical transplantation in Japan.
In Japan, there is a law called the "Organ
Transplantation Act", which was brought into force on October 16, 1997.
Under the Organ Transplantation Act, the organs of donors are removed and transplanted
after brain death is confirmed by legal means, to patients who are in need
of transplantation. This is only possible when consent from his or her family
is gained. His or her wish to donate the organs must be put in writing (organ
donor card, etc.) prior to brain death. Japan is the only country in the world
in which the law requires the donor's wish to be expressed in writing prior
to his or her death.
Therefore, the number of organ donation after brain death in Japan is extremely
low compared to the US, Europe and Asia (Korea, Taiwan, etc.).
According to the Japanese Civil Code, a living will, in which a person's
wishes before death are expressed, is only effective for individuals over
15 years of age. Therefore, organ donation after brain death is prohibited
for individuals under 15 years of age.
Since the heart and lungs of human over 15 are too large for children, children
under 10 are unable to receive organ transplantations.
As a result, there is no other choice but to collect an immense amount of money through fund-raising, and to receive transplants in the US or Germany.
Up until the time of Soutaro's illness, we thought that everyone could receive medical care on an equal basis under the Japanese medical insurance system. When we decided that Soutaro needed heart transplantation, we were stunned to find out that there was no choice for children but to go abroad to receive transplantation (children are not given a chance to live; chances of an adult to receive transplantation is low as well). We were also dismayed at the fact that Japan is the only advanced nation where transplantation for children within the country is not possible.
The US and Germany are the only countries which accept Japanese patients who need transplantation. Even in these 2 countries, there is a long waiting list of patients awaiting transplantation. This led to the establishment of the 5% rule, where foreigners are accepted within a framework of 5% of transplantations which were performed in the previous fiscal year. Countries other than Japan are included in this 5%.
In Japan, liver transplantation, kidney transplantation, heart transplantation, etc. are covered by insurance. However, children cannot receive transplantation in Japan. Receiving transplantation overseas requires an immense amount of money since we Japanese are not covered by insurance overseas. There is no governmental aid.
Receiving transplantations overseas is recently drawing international criticism. WHO recommends that transplantations be performed within the patient's own country. We are concerned that transplantation overseas will become difficult in the future, and that young children will be deprived of their chance to live.
Although our knowledge concerning heart transplantation is shallow, we decided to write this so you would have a better understanding of our fund-raising campaign to save Soutaro's life, and because we want people to understand the current situation of heart transplantation in Japan.
Keichiro and Namie Nakazawa
