Disclosures I have nothing to disclose Current Status of Organ - - PowerPoint PPT Presentation
9/30/2016 Disclosures I have nothing to disclose Current Status of Organ Donation in Japan Shigeyoshi Yamanaga, MD Chief of Renal Transplantation Program Department of Surgery, Japanese Red Cross Kumamoto Hospital Japanese Red Cross
Shigeyoshi Yamanaga, MD
Chief of Renal Transplantation Program Department of Surgery, Japanese Red Cross Kumamoto Hospital
I have nothing to disclose
From KUMAMOTO To the WORLD
International Relief Disaster Rescue
2014
Total
Population 127 M Population 324 M Organ Donation Organ Donation
112 8,126
2006
Deceased Organ Donation in Japan
1997 Organ Transplant Law 2010 Revised Organ Transplant Law
(n) (year)
2008 Istanbul Declaration
Deceased Living
Worldwide ORGAN DONORS 2015
1ST SPAIN 39.7 USA 28.5 … JAPAN 0.7 1ST TURKEY 45.4 USA 18.8 JAPAN 12.5
PMP : PER MILLION POPULATION
Medical consultant
Japan Organ Transplant Network started medical consultant system in 2002
Expanding the criteria for donation
Utilization of marginal organs
Especially for heart and lung. Decides whether it is suitable for donation or not.
Organ Quality.
Bench replacement of donor aortic valve before heart transplantation
63% over 40 years old 59% died of cerebrovascular attack Over 50% required multiple catecholamine treatments at the agonal phase.
Saito S et al; J Heart Lung Transplant. 2009 Sep;28(9):981-3. Egawa H, et al; AJT 2012; 12: 523-530
*Ventilator withdrawal is not allowed in Japan.
Organs Transplanted per donor; PMP (brain dead donor)
Egawa H, et al; AJT 2012; 12: 523-530
HEART TX LUNG TX PANCREAS TX LIVER TX KIDNEY TX
10Y PS 95% LIVING 10Y PS 76% DECEASED10Y PS 51% LIVING SPK 3Y GS 88% DECEASED SPK 5Y GS 74% LIVING 10Y PS 70% DECEASED 10Y PS 72% LIVING 5Y GS 91% DBD 5Y GS 85% DCD 5Y GS 77%
KDPI 97%
(5y GS 77%) KDPI 97% kidney in the US (5y GS 50%)
≥2001 1995-2000 1989-1994
1y 3y 5y GS
ABO incompatible RTx study group 2009
Number of Dialysis pt Number of Kidney Transplant Number of pt on waiting list LD DBD DCD
USRDS2009, Current status of dialysis therapy in Korea. Korean J Intern Med. 2011 Jun;26(2):123-31. , Fact book 2009 Japan
Rank Country Dialysis patients (1,000) % of total dialysis pts Prevalence of HD (per population)
1 USA 452 18% 1,420 2 China 330 13% 245 3 Japan 315 12% 2,505 4 Brazil 116 5% 575 5 Mexico 96 4% 820
In order to get kidney <8 years… Need 9 times more donors
Lack of transparency caused distrust of physicians and organ transplant…
“Ritually preparing the body, dressing the dead in white and applying making-up for the trip to the afterlife”
“Departures” Academy award 2009 best foreign language film
Chunichi newspaper 2011
EGUCHI S ET AL, THE CURRENT STATUS AND FUTURE PERSPECTIVES OF ORGAN DONATION IN JAPAN: LEARNING FROM THE SYSTEMS IN OTHER COUNTRIES; SURG TODAY; 46:387-392
DBD DONOR PROCURMENT: Surgeons bring EVERYTHING, book flights, go there, recover organ and transplant afterwards… 4-5 DOCTORS per team!
(%) Note their willingness on the card
Subjects in 2016
Education of Organ Donation/Transplantation Talk about Donation With Family Show Willingness Support Donation System
Detect Willingness to Donate Potential Donor Suggest Organ Donation to Donor Family
Increase Organ Donation/ Transplantation
Donor Action Support for Hospitals Education to the public
th th th April 21:26
th th th April 1:25
system and conflict of interests affect the donation rate.