While kidney transplants from donors whose hearts have arrested enjoyed overall success due to improved technologies, problems remained in the allocation of donated organs. Until recently, transplants were conducted mainly through kidney banks located in each prefecture as well as local university hospitals and medical facilities. When a donated kidney became available, a recipient in the same facility was usually given priority. But if the organ was not compatible, rejection would result in lower take rate, and the transplant would fail to make the most of the donor's good will. Thus, the Japan Kidney Transplant Network (JKTNW) was founded in April, 1995 under the guidance of the Ministry of Health and Welfare, using as a model the United Network for Organ Sharing (UNOS) which had effectively promoted transplanting throughout America.
JKTNW set up a system, limited to cadaver kidney transplants in Japan, whereby donors and recipients would be monitored on a national level. A computer would select the most compatible recipient when a donated kidney becomes available, and the organ could be transported rapidly, even to remote areas. JKTNW placed itself in a neutral position, between those who provide organs and those who perform transplants, thereby assuring a measure of fairness and equity in the administration of transplants. It was determined that all cadaver kidney transplants would be performed through JKTNW, and information regarding kidney transplanting became easier to access.
Currently, JKTNW is the only entity in Japan that procures and distributes kidneys. The nationwide network consists of seven regional blocks. Each block has a center that employs experienced transplant coordinators that perform various activities that include:
- Educating the public about organ transplants; registering recipients
- Collecting donor information
- Arranging with hospitals and donor families that provide organs
- Conducting blood tests on donors
- Organizing and coordinating removal teams
- Selecting appropriate recipients in a fair manner based on established criteria
- Ensuring rapid transportation of organs.