No spare parts

2019-03-08 02:18:17

By Peter Hadfield in Tokyo A YEAR after Japanese law was changed to allow organ transplants, not a single operation has been performed, according to the Ministry of Health and Welfare. The Japan Organ Transplant Network (JOT) says that more than 23 million organ donor cards have been distributed to post offices, government buildings and on the streets. But there have been few takers. A nationwide poll by the Asahi newspaper conducted earlier this month found that only around 3 per cent carried the cards. The Organ Transplant Law, passed in October last year, for the first time recognised brain death as the end of life. Previously death had only been legally recognised when the heart stopped beating, by which time vital organs such as the liver and heart are often useless to recipients. As a result, dozens of Japanese in need of transplants went abroad for operations. The new law has not stemmed the tide. The JOT says only 32 patients over the past year have had donor cards on them when they died. Of those, three were diagnosed as brain dead and should have been suitable organ donors. But one had filled out his donor’s card incorrectly and another had hepatitis. The family of the third refused to give permission for his organs to be taken until his heart had stopped. “Two-thirds of Japanese people now accept that brain death is actual death,” says Kaoru Manabe, head of the Organ Transplant Section at the Ministry of Health and Welfare. “The problem is people are not filling out the organ donor cards.” Juntaro Ashikari, a coordinator with the JOT, says that a distrust of doctors is partly to blame. “They may want to donate their organs but they just do not trust doctors to make a correct diagnosis of brain death.” Relatives’ attitudes are also an obstacle. As in Britain, next-of-kin can veto the use of organs from people carrying donor cards. “Surveys have shown that while many people are willing to donate their organs, they do not want the organs taken from their loved ones,” says Ashikari. The JOT is now campaigning to change the law so that either the permission of next-of-kin or possession of a donor card would be sufficient to harvest organs. Ashikari adds that some potential donors may not have shown up in official statistics because they were certified brain dead in a hospital that does not have official permission to harvest organs. “There are only 340 donor hospitals in the country,” he says. Another problem is that even doctors are divided over the issue,