Organ Donation and Tissue Donation Divided: Decreased donation after cardiac death following enactment of the revised “Brain Death Act” in 2010 in East Japan

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IntroductionOrgan Donation Act introduced in 1997 provided legal supportive framework for organ donation under brain death for the first time in the history of Japan. However, the law mandated written consent by donor before death, resulting in poor enhancement of donation. Revision of the Act in 2010 allowed donation under brain death by family consent only. We herein report the changes in organ donation and tissue donation in East Japan covered by East Japan Tissue Transplant Network.MethodsRetrospective analysis of both organ donation, under brain and cardiac death, and tissue donation information reported in East Japan during the period of 2006 and 2016 was conducted. Comparison was made before and after Revised Organ Donation Act was enacted in 2010. Data were obtained from the registry supported by Ministry of Health, Labor and Welfare Grants-in-aid for Scientific Research on Effective Option Offering in Potential Tissue Donors.ResultsBetween 2006 and 2010, number of organ donation cases under brain death and cardiac death, and number of tissue donors were, 39 (7.8 per year) and 205 (41 per year), and 169 (33.8 per year), respectively. Between 2011 and 2016, number of organ donation cases under brain death and cardiac death, and number of tissue donors were, 146 (24.3 per year) and 105 (17.5 per year), and 83 (13.8 per year), respectively.ConclusionRevision of the Organ Donation Act enacted in 2010 intended in part to enlighten donation in a wider aspect has shown little effect. It has resulted in moderate increase of donation under brain death, but significant decrease in donation after cardiac death for both organ and tissue.Due to extremely low overall donation rate per-population unit, academic as well as social attention remain to be fixed on organ donation and organ transplant recipient outcomes. Importance of donation after cardiac death and tissue donation suffers from significant lack of media and social attention resulting in poor public awareness and understanding, resulting in poor funding support in many tissue banking centers.Improving awareness in the society as well as within the medical professionals with solidarity among all transplantation medicine field, including organ and tissue, remains a crucial issue.

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