Comparison between Japan and Korea in liver transplantation: Focusing on a higher deceased donation rate in Korea

Over the past 30 years, liver transplantations (LTs) and deceased-donor LTs (DDLTs) have been higher in Korea than in Japan. In 2019, the number of DDLT reached 88 (22.3% of LTs) in Japan and 391 (24.7% of LTs) in Korea. The deceased-donor rate (per million population) was 0.70 in Japan and 7.56 in Korea. Presently, Korea is one of the Asian countries with the highest rate of DDLT. Factors conducive to the deceased donation rate in Korea encompass the socio-legal system, including the Korean Network for Organ Sharing, Korean Organ Donation Agency, the healthcare system and public awareness. During 2009-2019, two major indications of DDLT were hepatitis B cirrhosis and alcoholic liver disease in Korea, and acute liver failure and metabolic diseases in Japan. For living-donor LT, two major indications were hepatitis B cirrhosis and neoplastic diseases in Korea, and biliary atresia and neoplastic diseases in Japan. During the COVID-19 pandemic, the indications for DDLT in Korea were alcoholic liver disease and hepatitis B cirrhosis with a higher rate of alcoholic liver disease than during the pre-pandemic period. In 2021, the 5-year survival rate of DDLT was 66.5% in Korea compared with 82.6% in Japan, whereas that rate of living-donor LT in Korea reached 80.8% compared with 79.4% in Japan. To promote LT in Japan and Korea, mutual understanding and intercommunication between the two countries is crucial.