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2008年11月15日 (土)


2008/11/15 --The Asahi Shimbun, Nov. 14(IHT/Asahi: November 15,2008)

EDITORIAL: Overseas transplants


More Japanese are going abroad to undergo organ transplants, including kidney and liver operations, without proper referral by medical specialists. Behind the trend are individuals and organizations acting as brokers to refer patients to overseas hospitals.


Individual patients must be moved by an earnest wish to seek organ transplants. But the growing trend to go abroad to undergo transplants has many problems. It is also a target of harsh international criticism.


A report put together two years ago by a study group of the Ministry of Health, Labor and Welfare also gives us a glimpse into the problem. According to the report, at least 522 Japanese had undergone heart, liver or kidney transplants overseas in the past, including cases referred to by doctors.


What is noteworthy is that China topped the list of destinations of the 198 people who received kidney transplants, followed by the Philippines. Thailand, India and Pakistan also appeared on the list.


Behind the situation is poverty in those countries. Even now, there seem to be many poor people trying to make ends meet by selling one of their kidneys.


There are also reports that organs extracted from the bodies of condemned prisoners were used in many cases in China.


When we think about overseas organ transplants, we must not turn a blind eye to such harsh realities.


In addition to word of mouth by patients and families, the prevalence of the Internet has prompted overseas trips for organ transplants. But transplants that rely solely on brokers without referral by doctors are troublesome.


It is difficult to assess the quality of medical care in countries where the transplants are performed. Some people come home without receiving proper postoperative care.


Transparency is also lacking in terms of expenses for overseas organ transplants.


It is a fundamental principle of transplant medicine that organs must not be sold or bought. Japan's organ transplant law also bans organ donors and brokers from making a profit from the operations. But there are suspicions that cannot be dispelled that some businesses are making money under the guise of necessary expenses.



What groups are acting as intermediaries? What methods are they using and how do they find donors? How are operational expenses and remuneration being paid? The government should look thoroughly into the actual situation.


Just recently, news spread that a Japanese representative of a group acting as a go-between in China was convicted on Oct. 30 in China of false advertising concerning organ transplants.


One reason for the spread of overseas organ transplants is the fact that there are few organ donors in Japan.


Compared with other countries, Japan has far fewer organ donations from people pronounced brain-dead. Many patients who register with the Japan Organ Transplant Network, the nation's only authorized brokering entity, die while waiting for a donor to become available.


Since the enactment of the organ transplant law in 1997, there have been fewer than 80 organ transplants from brain-dead donors.


Bills to revise the law to facilitate transplants by easing requirements or other means have been submitted to the Diet, but they remain in limbo.


In order to have more people accept transplant medicine by mutual consent, the actual situation of overseas organ transplants must be urgently clarified.



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