The Enactment of the Organ Transplantation Law
Originally, JKTNW was established to create a nationwide transplant network dealing with a variety of organs, including the kidney, liver, heart, lung, and pancreas. But delayed enactment of necessary laws regarding organ transplants from brain dead donors forced the organization to limit its function to cadaver kidney transplanting.
In 1988, the Japan Medical Association professed that it would accept brain death as human death. In 1990, the Provisional Commission for the Study on Brain Death and Organ Transplantation was set up in 1990. The draft of the Organ Transplantation Law was proposed in 1994. In reality, however, no substantive deliberations had taken place and the matter was repeatedly suspended for "further review." Finally, on October 16, 1997, the Organ Transplant Law took effect, containing the most stringent of regulations, especially in light of the fact that transplants from brain dead donors were widely accepted around the world. That day, JKTNW was reorganized into the Japan Organ Transplant Network (JOTNW), to deal with heart and liver transplants in addition to kidneys.
The enactment of the Organ Transplant Law was greatly anticipated by patients with no other means for survival than obtaining a transplant as well as those involved in the transplanting process. This new law was expected to have a major impact on transplanting in Japan, but its regulations turned out to be extremely stringent. The donations of organs by a brain dead donor is permitted only if "...the donor expressed in writing prior to death his/her intent to agree to donate his/her organs and agree to be submitted to an authorized brain death declarations, and his/her family members (spouse, parents, siblings, children, grandparents, grandchildren, and live-in family members) did not object to the donation." In addition, the law states that "only persons 15 years and above can express an intent to donate." This stipulation has greatly reduced the possibility of transplants to small children; heart transplants to small children have become impossible.
With so many issues to be resolved, it will be a long time before full scale transplanting becomes available in Japan.