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Liver transplantation in Japan
Akihiko Soyama1, Susumu Eguchi1, Hiroto Egawa2
1Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Summary
Japan performs many living donor liver transplants but struggles to increase deceased donor liver transplants despite legal reforms. Efforts focus on maximizing organ viability and exploring strategies to boost deceased donations alongside successful living donor programs.
Area of Science:
- Transplantation Medicine
- Organ Donation Policy
- Surgical Innovation
Background:
- Japan has performed over 7,900 liver transplants, predominantly living donor liver transplantation (LDLT).
- Legal reforms in 2010 aimed to increase deceased donor liver transplantation (DDLT) by allowing procurement from brain-dead individuals with family consent.
- Despite legal changes, DDLT rates remain critically low, less than 1 per million population.
Purpose of the Study:
- To review the status of liver transplantation in Japan, focusing on deceased versus living donor contributions.
- To identify challenges and strategies for increasing deceased organ donation rates.
- To highlight ongoing efforts and future directions in liver transplantation in Japan.
Main Methods:
- Analysis of liver transplant data in Japan up to December 31, 2014.
- Review of organ donation policy changes and their impact.
- Description of strategies to maximize organ utilization and improve transplant surgeon training.
Main Results:
- A total of 7,937 liver transplants were performed, with 7,673 (96.7%) being LDLTs.
- Only 264 DDLTs were performed, indicating a persistent shortage of deceased donors.
- Systems for quality organ procurement training and maximizing organ viability have been implemented.
Conclusions:
- Living donor liver transplantation remains the cornerstone of liver transplantation in Japan due to the scarcity of deceased donors.
- Continuous efforts are needed to increase deceased organ donation rates.
- Integrating successful LDLT experience with strategies to boost DDLT is crucial for expanding liver transplant benefits.
