Current status of pediatric transplantation in Japan

Abstract

Brain-dead donor organ transplantation has been available to children in Japan since the 2010 revision of the Organ Transplant Law. Of the 50-60 brain-dead donor organ transplants performed annually in Japan, however, very few (0-4 per year) are performed in children. Again, while those receiving liver, heart, and kidney transplants are reported to fare better than their counterparts in the rest of the world, organ shortage is becoming a matter of great concern. Very few organs become available from brain-dead donors or are transplanted to adults if made available at all, with some children dying while on the brain-dead organ waiting list. Against this background, living-donor transplants, split-liver transplants, domino transplants, and hepatocyte transplants represent alternative modalities, each of which is shown to be associated with favorable outcomes. Challenges exist, include streamlining the existing framework for promoting organ donation for children and between children.

Keywords: Brain-dead organ donation; Children; Living-donor organ transplantation; Organ transplantation.

Fig. 1

Number of pediatric deceased organ donations in Japan by year (<15 years; n = 43)

Fig. 2

Number of deceased organ donations in Japan by year

Fig. 3

Number of liver transplants performed in Japan (n = 6097). LDLT living-donor liver transplantation, DDLT deceased-donor liver transplantation

Fig. 4

Number of liver transplants in NCCHD

Fig. 5

Age distribution of heart transplant recipients and mean waiting durations in Japan

Fig. 6

Pediatric candidates traveling overseas for heart transplants (n = 104)

Fig. 7

Number of pediatric deceased-donor kidney transplants performed in Japan