Pediatric Cardiology and Cardiac Surgery
Vol.27 No.3 2011 (118-120)

Norihide Fukushima

Division of Transplant Medicine, Osaka University Hospital, Osaka, Japan


Children under 15 years of age could not donate organs after brain death until the Japanese Organ Transplantation was reissued on 17 July 2010 because only persons who had written consent for organ donation after brain death could donate organs in Japan. Therefore, small children could not undergo heart transplantation (HTx) in Japan, and many Japanese children traveled abroad for HTx.
Through renewal of the law, organs can be donated after brain death with the consent of relatives, if the person did not refuse organ donation. For this reason, there is currently the possibility of small children receiving HTx in Japan. However, the Japanese government made special rules and guidelines for organ donation involving children under 18 years of age. The rules do not allow organ donations by children who have a history of abuse in their family. However, it is very difficult to completely rule out child abuse in a clinical situation after brain death. Moreover, it is very difficult for Japanese parents to accept the brain death of their own child because of the significant differences in education, religion, and culture between Japan, and the USA, and European countries. For these reasons, it may take a long time before we have organ donations by small children. Although we need to establish systems to rule out child abuse and to take care of grieving families, cadaveric pediatric organ transplantation will be established as soon as possible in Japan.