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Donor card registration system in Japan: an obstacle to procuring kidneys for transplantation

T Hasegawa1, Y Maeda, K Yamakawa

  • 1Teikyo University School of Medicine, Tokyo, Japan.

Insights

Low organ donor card prevalence in Japan can be increased by introducing a free delivery system. This system would address the lack of opportunity to obtain donor cards, boosting organ donation consent rates.

Area of Science:

  • Medical Ethics
  • Public Health Policy
  • Organ Donation Research

Background:

  • Organ donor cards are crucial for consent to organ donation after unexpected death.
  • Japan has a low donor card prevalence (0.4%) despite high willingness to donate (approx. 50%), contrasting with the US (24.6%).
  • The current donor card registration system may contribute to low prevalence in Japan.

Purpose of the Study:

  • To investigate the reasons for low donor card prevalence in Japan.
  • To test the hypothesis that a free delivery system would increase donor card prevalence.
  • To identify factors influencing willingness to carry donor cards among the Japanese population.

Main Methods:

  • A questionnaire survey was conducted among 402 high school students and 3391 workers in the Tokyo metropolitan area between April 1992 and April 1993.
  • Respondents were asked about their awareness of donor card registration and willingness to carry donor cards under different conditions.
  • Data analysis focused on identifying barriers to donor card acquisition and the potential impact of a free delivery system.

Main Results:

  • Only 15.5% of respondents knew how to register as a donor card holder.
  • A significant majority (48.8%) expressed willingness to carry donor cards if delivery was free and registration was not required.
  • The primary reason cited for not carrying a donor card was the lack of opportunity to obtain one.

Conclusions:

  • Implementing a free delivery system for organ donor cards can dramatically increase prevalence in Japan.
  • Providing sufficient opportunities for obtaining donor cards is essential for increasing organ donation consent.
  • A free delivery system is recommended to align with the deceased's will for organ donation, rather than family decisions.

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