Consideration at the First Case of a Kidney Trade in Japan

1
Consideration at the First Case of a Kidney Trade
in Japan

• Miyako OKADA-TAKAGI
• University research Center,
• Nihon University
• Tokyo, JAPAN

2
First case of a kidney trade in Japan
gave the left kidney

• Recipient
  Donor

Mr. A
Ms. B
Ms. C
Severe diabetes his common law wife
Faked his sister in law
after operation 300,000 yen in cash A car
3
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.

4
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

5
Some hospitals have set stricter regulations than
those of the JST

• for managing the cases of which a patient
  marries or adopts a donor .

6
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.)
7
Living donors are common in Japan

• 46 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.

8
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
9
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.
10
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.
11
This point should be publicized more
brain-dead donors The donor must have expressed
the will to be a donor while alive. cardiac-arres
t donors The approval from family members is
sufficient.