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Current situation of Organ Transplantation and Social Background in - - PowerPoint PPT Presentation
Current situation of Organ Transplantation and Social Background in - - PowerPoint PPT Presentation
Current situation of Organ Transplantation and Social Background in Japan and Social Background in Japan Teleconference at APAN 2011-8-25 Naohiko Fukami, M.D., Jyunichi Yoshida, M.D., Atsushi Sugitani, M.D., Ph.D. Department of Urology and
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The number of cadaveric donors in the world
Spain
34.6
35 30
20.2
20 25
Japan
10.8
15
Japan
0 75
5 10
0.75
Organ and Tissue 8(2), 79-82, 2005
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Patients on dialysis and of Renal transplantation in Japan Patients on dialysis and of Renal transplantation in Japan
300,000
Dialysis
Dialysis
250,000 200,000
NHBD LD
150,000 100 000
NHBD HBD
Recipients
Candidates
100,000 1200 1000
Candidates
10000 800 600 400 200
78 79 80 81 82 83 84 85 86 87 88 89
200
90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06
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ABO incompatible renal transplantation ABO incompatible renal transplantation
% 5.2% 0.5% 0.8% 1.1% 0.4% 0.0% 0.2% 0.8%
100%
Unknown
21 1% 13.3% 11.9% 15.5% 14.6% 17.7% 20.9% 23.3% 23.3%
80%
ABOi
18.2% 21.1% 19.9% 18.6% 20.4% 19.7% 21.3% 20.2%
60%
Mismatch
60%
63.3% 66.4% 63.8% 65.7% 61.5% 59.4% 55.1% 55.8%
40%
M t h
ABOc
20%
Match
0%
2000年 2001年 2002年 2003年 2004年 2005年 2006年 2007年
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Public opinion （1998～ 2008）
YES YES NO NO Donation after Brain death YES YES NO NO
31.6% 37.6%
1998 1998
32.6% 35.4%
2000 2000
32 8% 35 4% 31.8% 36.0%
2002 2002
32.8% 35.4% 27 5% 41 6%
2004 2004 2006 2006
27.5% 41.6%
2006 2006
24 4% 43 5%
2008 2008 20 40 60 80 100 ％
24.4% 43.5%
2008 2008
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Revision of Transplant Law (July 17, 2010)
“Brain death is a whole death under the law”
- Brain death is a whole death under the law
Consent by donor family without written consent (Opting-out) consent (Opting-out) Possible donation from a pediatric patient Allocation priority for the family member p y y
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36 Brain Death Donors after the law revised
From July 17 till February15, 2011
H t 30 34 out of 36 cases were based on Family Consent. Heart 30 Lung 29 Lung 29 Liver 32 Pancreas 28 Small intestine 2 Kidney 36
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The current status of organ transplantation and Bioethics in Asia–Proposal of new p bioethics to advance the transplantation in Eastern Asia Eastern Asia
Delhi India, August 25, 2011
Atsushi Sugitani, M.D., Ph.D.
Department of Organ Transplantation and Regenerative Medicine, Fujita Health University, Aichi, JAPAN
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Asia
- 1. Huge population
- 2. Difference of medical standards due to diversity of cultures, races, and religions
y g
- 3. Specific diseases in Asia, such as thalassemia, chicken flu, SARS, etc
- 4. Little time difference and short distance among countries
10
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Beijing Sapporo Seoul Tokyo KJCN KJCN Busan Nagoya 500 km Shjanghai Fukuoka 1000 km Taipei 11 p 1500 km
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Pancreas Transplantation Teleconference on 18th March 2005
Kyushu University Hospital (Venue) Seoul National University Kyushu University Hospital (Venue) Seoul National University Taipei Veterans General Hospital Tsinghua University
12
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Living donor nephrectomy g p y
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Haｎd assisted retopertoscopic surgery
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Donation from the Non- heart beating donor
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② ① ② ③
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Waiting
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Super Rapid Technique p p q
Video Presentation
Kidney procurement from the non-heart beating donor (Cadaver) beating donor (Cadaver)
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Simultaneous pancreas kidney transplantation p y p
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Questionnaires
(September 2008)
Seoul, Korea 22 f 227 people in medical field including doctors, nurses, medical students, clerks, etc. Nagoya, Japan 182 people in medical field including doctors, nurses, medical students, clerks, etc.
I. When are you dead? (Death and Life Concept)
- II. Knowledge about Organ Transplantation
- III. Idea about Organ Donation
- IV. Whose is the transplanted organ? (Organ Property)
- V. If you or your family become a patient?
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Let’s discuss What’s common and What’s different!!
1.
- 1. The current situation of
The current situation of kidney/pancreas kidney/pancreas transplantation in transplantation in Asia Asia 2.
- 2. The history
The history, culture and religion in culture and religion in Asia Asia 3.
- 3. Bioethics in
Bioethics in Asia Asia 4.
- 4. Medical insurance and medical finance in
Medical insurance and medical finance in Asia Asia 5.
- 5. Legislative
Legislative problems roblems in Asia sia 5.
- 5. Legislative
Legislative problems problems in in Asia Asia
P id b t “Lif d D th” Propose a new idea about Life and Death” which is different from the Western philantorpism lt i
22
- r altruism.
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The 22nd Annual Meeting of Japan Association for Bioethics November 20-21, 2010, Fujita Health University
“Transplantation and Bioethics” and Bioethics
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Configuration diagram of DVTS （Fujita Health University)
2. 3. Speaker Microphone Video Camcorder Display (Receiving image) Analog RGB A di li Analog RGB (D-Sub15) 7. 4. Audio line (Mono) Audio line (Stereo) 5. Analog-digital 1. Composite/S-video DVTS PC (Reception) video converter IEEE1394 Analog RGB 6. DVTS PC HUB / VPN Router Analog RGB (D-Sub15) (Transmit) Display (Sending image)
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Items list of DVTS configuration （Fujita Health University)
No Company Product Analog-digital Anycast Station 1 video converter Sony AWS-G500 1 2 Microphone Panasonic WA-531 1 3 Video camera Sony BRC-300 (NTSC) 1 4 Cable XLR×1 -> XLR×1 5m 1 5 Cable RCA×1->RCA×1 5m 1 6 Cable IEEE1394 4PIN-6PIN 1 6 Cable IEEE1394 4PIN 6PIN 1 7 Cable RCA×2->RCA×2 5m 1
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Conclusion and Proposal
- 1. Let’s investigate the factors to affect the ideas
p about life and death in Eastern Asia. 2 Let’s find out the difference compared to the
- 2. Let s find out the difference compared to the
Western countries.
- 3. Let’s educate the people for better life and for
mutual understanding.
- 4. Let’s develop a solidality culture as do in the West.
- 5. Let’s propose a “New Bioethics for Organ