Organs Transplanted per Donor; Our Experience in Japan

Juntaro Ashikari¹, Setsuko Konaka¹, Kikuo Nomoto¹

¹Japan Organ Transplant Network, Tokyo, Japan

Since the Organ Transplant Act has been enacted in Japan in 1997, we have had 220 donations after brain death (DBD), resulting in 961 recipients receiving the transplants and 1,156 organs transplanted as of May 2013.

As the number of DBD per million population (PMP) is very low (0.35), we have attempted to maximize the utilization of organs transplanted per donor (OTPD).

The donor age was 46.2 plus minus 14.1. The male/female ratio was 123/97. The causes of death were cerebral vascular 60.0%, anoxia 21.4%, head trauma 17.7%, CNS tumor 0.5%, other 0.5%. The duration from hospital admission to organ recovery were 8.4 plus minus 8.9 days. From the 220 donors, 161 hearts (73.2%), 251 lungs (count in single lungs, 57.0%), 174 livers (79.1%), 156 pancreas (70.9%), 401 kidneys (91.1%), 13 small intestines (5.9%) were transplanted. The OTPD were average 5.3 plus minus 1.7, median 5.

Three major factors that are thought to have influenced the OTPD are aggressive donor evaluation and donor management by designated medical consultants, aggressive placements of the expanded criteria donor (ECD) organs by the Japan Organ Transplant Network, and aggressive utilization of the ECD organs by the transplant centers.

Despite the utilization of ECD organs, our five year survival rates were heart 95.4%, lung 70.5%, liver 78.2%, pancreas 69.1%, kidney 74.5%, and small intestine 72.2%.

As the numbers of DBD are limited in Japan, we have maximized the OTPD by aggressive donor evaluation, donor management, placement of organs and utilization by the transplant centers.