A kidney was temporarily transplanted to a patient with acute renal failure at Niigata University in 1956-the first transplant in Japan. In 1964 a living kidney was transplanted to a patient with chronic renal failure at the University of Tokyo, the first full-scale transplant intended for permanent grafting. In the same year, a liver transplant was performed at Chiba University. The first heart transplant in Japan was conducted at Sapporo Medical University in 1968. Abroad, the first liver transplant and the first lung transplant were performed in 1963 and the first heart transplant took place in 1967. It can be said, therefore, that transplanting in Japan initially was on par with the rest of the world.

At the time, transplant research and its clinical applications became a boom throughout the world. Soon, however, researchers were confronted with a major problem-rejection. Additionally, progress in medical devices such as respirators made it necessary to define the concept of "brain death."

In Japan, the Wada heart transplant conducted at Sapporo Medical University drew harsh criticism that "it was done in secret," and "the surgeon performing the transplant carried out both the brain death evaluation of the donor and the selection of the recipient by himself." Detractors further asserted that "...the records of the whole process are questionable." As a result a great distrust of organ transplanting developed, particularly of transplants from brain dead donors, bringing any subsequent developments in transplanting to a complete standstill. In contrast, other advanced countries were making strides in this area, including the development of immunosuppressants to fight rejection as well as the establishment of criteria for brain death.