Special report from the heart transplant candidate registry committee in Japan

Heart transplantation had been withheld for long time in Japan. In October 1997 organ transplant legislation was implemented and the heart transplantation program began. In February 1999 the first heart transplantation was performed. Since then a total of 17 successful transplantations have been done.

This report describes the profiles of heart transplant applicants presented to the Heart Transplant Candidate Registry Committee of the Japanese Circulation Society from 1997 to 2003.

Two hundred eighty-four applications were submitted to the Committee for the evaluation. All applicants were <60 years of age (mean 32 years). Ninety-two percent of these applicants had chronic severe heart failure with New York Heart Association (NYHA) Class III or IV status. Etiology of heart failure was dilated cardiomyopathy in 80% of applicants, although only 6% had ischemic heart disease, which is in notable contrast to Western countries. Most applicants died while waiting for transplantation and thus only 17 patients underwent heart transplantation, with an average waiting time of 514 days. Recipient prognosis was satisfactory with a survival rate of 100%.

In Japan, heart transplantation is not yet considered a viable treatment option for severe heart failure.