Current Issues Surrounding Transplants and Recipients
JOTNW has registered prospective recipients of kidney, heart, liver and lung transplants. Patients diagnosed with end stage renal failure are registered for kidneys. Patients registered for hearts or livers have been judged to be in need of transplants by the Assessment Committee of indication for Transplantation. The conference of Lung/Heart-Lung Transplantation of the Assessment Committee of Indication for Lung Transplantation determines which patients are in need of transplants, and places those patients on the registry.
As of 1996, the Japan Transplant Society estimates that there are 387 to 1264 patients in need of heart transplants due to the fact that they are in the end stages of dilated cardiomyopathy or ischemic heart disease and suffer from decreased heart function. The number is estimated to increase by 205 to 670 annually.The number of patients in need of liver transplants due to the fact that they are in the end stage of progressive hepatic disease such as biliary atresia and congenital metabolic disorder or suffer from fulminant hepatitis is reported to be about 3,000 a year. The number of patients in need of lung transplants due to primary pulmonary hypertension, idiopathic pulmonary fibrosis, pulmonary emphysema and bronchiectasis is approximately 730. The registration of patients in need of lung transplants began in August 1998.
The number of patients who, instead of waiting in Japan, obtained transplants in foreign countries such as Australia and the US is reported to be 49 for heart, 200 plus for liver, and five for lungs as of the end of 1999. These numbers continue to increase despite the enactment of the Organ Transplant Law.
The annual number of transplants worldwide is about 4,000 for hearts, 7,000 for livers, and about 20,000 for kidneys (The International Society for Organ Transplantation, 1995). Lung transplants number about 1,200 per year according to the International society for heart and Lung Transplantation (1998). Several Japanese patients benefited from transplants in other countries that have special quotas for foreigners. Criticism toward such Japanese has begun to surface since the shortage of donors is a serious problem in every country. It remains to be seen when and if there will be enough good will in Japan such that transplants can be performed on a daily basis.