Photo/Illutration Rikuto Hirata undergoes rehabilitation training at the Saitama Medical University International Medical Center in Hidaka, Saitama Prefecture, in September. He is connected to a ventricular assist device via a tube. (Kazuhiro Fujitani)

Although more organs from those certified as brain-dead are being donated in Japan, there are still not enough to cover the number of patients waiting for transplants.

Rikuto Hirata, a 5-year-old diagnosed with dilated cardiomyopathy, has been waiting for a heart transplant for four years at the Saitama Medical University International Medical Center in Hidaka, Saitama Prefecture.

“We never thought we would have to wait for so long,” said his mother, Hiroko, 36.

She said her one hope is to bring her son back to the family’s home in Fukushima Prefecture as soon as possible and lead a normal everyday life together.

According to the Japan Society for Transplantation, 60 patients under the age of 18 who received heart transplants in the country by the end of 2021 waited an average two years before the operation.

At least one patient waited for about five years.

The number of organs donated from brain-dead people, including those that were not transplanted, totaled 996 as of Oct. 16, exactly 26 years after the Organ Transplant Law went into effect.

This year, 100 were donated as of Oct. 16, exceeding the annual record of 98 set in 2019.

However, about 16,000 people registered with the Japan Organ Transplant Network are waiting for available organs.

Only 455 people, or about 3 percent of those registered, received organs, including those donated from people in a state of cardiac arrest, in 2022.

There are extremely few donors in Japan.

The number of organs donated here, including those from people in a state of cardiac arrest, was 0.88 per 1 million people in 2022. The figure was about 50 times fewer than in the United States and about nine times fewer than in South Korea.

Few people in Japan declare their intentions to donate their organs, such as on donor cards, upon their deaths.

According to a Cabinet Office survey in September 2021, about 40 percent of respondents said they “want to” or “somewhat want to” donate their organs if they are certified as brain-dead.

The figure has remained about the same for the past two decades.

But only about 10 percent of respondents had officially indicated their intentions to do so.

In addition, many medical institutions are ill-equipped to handle organ donations from brain-dead people.

About 900 facilities nationwide, such as university hospitals and accident and emergency centers, are allowed to conduct such operations.

However, more than half of them do not have the capacity to do so, according to a survey by the Japan Organ Transplant Network.

The number of organs donated from brain-dead people substantially increased after the Organ Transplant Law was revised in 2010 to allow donations based on the consent from family members, even if the person had never declared an intention to donate his or her organs.

Currently, 80 percent of organs are provided through the consent of donors’ families.

In recent years, medical institutions with extensive experience in organ donations have provided support to less-experienced facilities, which has contributed to the increase in the number of organs donated.

But the number of donors is still limited in Japan, and many patients go abroad for organ transplants.

As of the end of March, 543 patients were visiting medical institutions in Japan after receiving organ transplants in other countries, according to a survey by the health ministry.

(This article was written by Kazuhiro Fujitani and Kenta Noguchi.)

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