[Current status and future prospect of organ transplant network in Japan]

Transplant network plays a indispensable role in the organ transplantation, which consists of the registration of patients, collection of donor information, recipient selection and shipping of the organs, retrieval of transplant data and their analysis. Since 1977 the cadaveric kidney transplantation have had been done in the kidney transplant network, which was run by National Sakura Hospital as the transplant center and 14 subcenters. As the number of cadaveric kidney transplantation, however, was decreased year by year since 1989, there raised some problems, such as allocation policy of kidney grafts, lack of standardized HLA examination and review system, management within each administrative district and so on. Based upon the report of ad hoc committee of the Multiorgan Transplant Network, there substituted the new kidney transplant network system, Japan Kidney Transplant Network for the former kidney transplant network since 1995. The new system is operated not only by transplant surgeon, but by transplant coordinators, nephrologists, doctors in charge of dialysis therapy, representatives of kidney bank and other organizations/associations, and others. After the legislation of the transplant act, the network will be reorganized into the network system for multiorgan sharing. To establish the multiorgan sharing network, uniform protocol of multiorgan procurement, insurance of informed consent, propagation of donor cards for multiorgan donation, registration for waiting lists, allocation system for other organs than kidney, and education of transplant coordinator for multiorgan procurement are required.