[Heart transplantation]

Area of Science:

• Medical Sciences
• Surgical Innovation
• Transplant Immunology

Context:

• Organ transplantation from brain-dead donors commenced in Japan in February 1999.
• The study covers the period from February 1999 to April 2002, encompassing over three years of transplant activity.
• The Japan Organ Transplant Network (JOTN) manages organ transplant candidate registrations and allocations.

Purpose:

• To report the initial outcomes and challenges of organ transplantation in Japan since its inception.
• To evaluate the early results of heart transplantation (HTx), including the use of left ventricular assist devices (LVAS).
• To document patient survival, complications, and recovery post-transplant.

Summary:

• A total of 77 organ transplantations were performed from 19 donors, including heart, lung, liver, pancreas-kidney, pancreas alone, small intestine, and kidney.
• For heart transplantation (HTx), 116 patients were registered as candidates. 13 underwent HTx in Japan and 8 abroad. 32 died while awaiting transplant.
• Ten of 13 HTx recipients utilized a left ventricular assist device (LVAS). All 13 HTx recipients were alive at the time of reporting, with manageable rejection and infection episodes. Most recipients were discharged and returned to work.

Impact:

• Demonstrates the feasibility and initial success of establishing a national organ donation and transplantation program in Japan.
• Highlights the critical role of left ventricular assist devices (LVAS) in managing heart transplant candidates and improving outcomes.
• Provides valuable data on patient survival, complication rates, and rehabilitation post-organ transplantation, informing future clinical practice and policy.