Current status of pediatric transplantation in Japan

Area of Science:

• Pediatric Organ Transplantation
• Organ Donation and Allocation

Background:

• Brain-dead donor organ transplantation for children has been legally available in Japan since 2010.
• Despite availability, very few pediatric brain-dead donor organ transplants (0-4 annually) are performed, contributing to a significant organ shortage.
• Children awaiting organ transplants face critical risks, with some succumbing to their conditions while on the waiting list.

Purpose of the Study:

• To address the critical organ shortage in pediatric transplantation in Japan.
• To explore alternative organ transplant modalities for children facing organ scarcity.
• To identify challenges and potential improvements in the framework for pediatric organ donation.

Main Methods:

• Review of pediatric organ transplantation data and outcomes in Japan post-2010.
• Analysis of the effectiveness of alternative transplant strategies, including living-donor, split-liver, domino, and hepatocyte transplants.
• Examination of the existing organ donation framework for children.

Main Results:

• Pediatric recipients of liver, heart, and kidney transplants in Japan show favorable outcomes compared to global counterparts.
• A severe shortage of organs from brain-dead donors for pediatric recipients persists.
• Alternative transplant methods such as living-donor, split-liver, domino, and hepatocyte transplants demonstrate positive outcomes.

Conclusions:

• Alternative organ transplant modalities offer promising solutions to the organ shortage affecting pediatric patients in Japan.
• Streamlining the framework for promoting organ donation, particularly for and between children, is essential.
• Continued efforts are needed to increase organ availability and ensure timely transplants for pediatric recipients.