Ascertain precise situation regarding suspected trafficking

Editorial

12:01 JST, August 29, 2022

Cases of suspected organ trafficking have recently emerged with regard to overseas organ transplants mediated by a private organization. The government must ascertain the precise situation and background of the mediation scheme to clarify the problem.

A Tokyo-based nonprofit organization received nearly ¥20 million for arranging a living donor transplant in Central Asia for a patient seeking a kidney transplant. About ¥2 million was reportedly given to the donor, who was a Ukrainian having financial difficulties.

The donor was introduced to the NPO by a Turkish national who was on trial after being arrested by Ukrainian authorities on suspicion of involvement in separate organ trafficking. The NPO denies any involvement in organ trafficking, but in principle, living organ transplants are only allowed between relatives, making it hard to eliminate suspicions.

The Organ Transplant Law prohibits organ trafficking, demands for or promises of organ trade, and includes provisions for criminal offenses committed outside Japan. Organ trafficking is banned worldwide as an inhumane act that takes advantage of the poor.

The NPO is said to have arranged about 170 cases of overseas transplants in the past, but there have also been cases in which patients have had difficulty receiving medical care after returning to Japan. This is because in some cases hospitals become suspicious of organ trafficking and refuse to examine recipients, or report them to police.

Even if an overseas transplant is carried out successfully, if it remains uncertain whether recipients will be able to receive medical consultation in Japan, they face great health risks.

One factor behind patients in Japan relying on overseas transplants is the shortage of donors available in this country compared to other nations. In 1968, a heart transplant conducted at Sapporo Medical University raised the issue of a lack of transparency in diagnosing brain death, leading to widespread distrust of medical transplantation.

Even after the Organ Transplant Law went into effect in 1997, the number of donors remained remarkably low. A 2010 law revision relaxed the conditions for organ donation after brain death, and recently there have been nearly 100 organ donations from brain-dead donors a year, but even that is still low in global terms.

In the case of kidneys, livers and lungs, it is possible for patients to receive living donor transplants, but without a relative who can be a donor, it is difficult to do so.

Overseas transplants have drawn severe scrutiny from the international community. Not every country has a sufficient number of donors, therefore such methods deprive patients seeking organ transplants in their home countries of the opportunity to receive them. The World Health Organization has also called for refraining from overseas transplants.

Measures are needed to increase the number of donors in Japan. In the case of brain death, even if the donor has expressed their intention to donate, their decision may not be realized due to an inadequate hospital system, such as the absence of doctors who can determine brain death. It is hoped that measures to improve the situation will be sought by learning from the example of other countries with large numbers of donors.

(From The Yomiuri Shimbun, Aug. 29, 2022)