Organ Transplant System: Improve Ability to Handle Growing Number of Donors

Editorial

17:31 JST, June 6, 2026

Organ donations from people declared brain dead have increased, but hospitals involved in transplants have been slow to establish adequate systems. Efforts must be made to improve relevant systems to save as many patients as possible for whom organ transplantation is the only means of survival.

With a June revision to medical service fees, which are paid to medical institutions under the national health insurance program, the fee for organ transplants from brain-dead patients was significantly raised. Generous increases include a fivefold rise in the fee for transplant surgeries. 

Organ transplants require more medical staff than standard surgical procedures. Personnel such as coordinators who act as intermediaries between donors and patients are also indispensable.

Previously, these circumstances were not taken into consideration, and hospitals bore the burden of many costs, including personnel expenses. The revision of medical service fees for organ transplants, which reflects the higher costs compared to general surgeries, is understandable.

The number of organ donations from brain-dead patients is significantly lower in Japan than in other countries, but the nation saw a record high of 146 cases last year, double the number from five years ago.

In 2023, the director of a nonprofit organization was arrested on suspicion of illegally mediating an organ transplant performed overseas for a Japanese patient.

This incident led to extensive media coverage of organ transplants, raising public interest, which is believed to have contributed to the rise in the number of donors. At the same time, it has also been revealed that the medical system has not kept pace with the increase.

At major hospitals that have been performing transplants, such as those connected to the University of Tokyo and Kyoto University, there has been a spate of cases where, even when a transplant opportunity arises for a patient on the waiting list, the hospital is unable to perform the surgery immediately due to a lack of equipment or staff, resulting in the transplant being canceled.

When an organ donation from a brain-dead patient becomes possible, a patient on the waiting list receives the organ according to a priority system based on factors such as the severity of their condition. If a patient is denied a transplant due to insufficient systems at the recipient hospital, the organ is offered to a patient at another hospital.

Hospitals performing organ transplants should make use of the increased medical service fees to ensure that patients do not miss out on transplant opportunities.

However, relying solely on the efforts of individual hospitals has its limits. The central government should take the lead in creating a sustainable system.

To make transplant medicine viable with limited personnel, it is essential for the central government to designate core hospitals and concentrate both patients and medical personnel there. It is necessary to establish a system where operating rooms and medical staff are secured to perform organ transplants any time.

It is also important to introduce new technologies and conduct research and development to support organ transplantation. For example, technology has been developed to prevent the deterioration of removed organs.

Regarding kidneys from brain-dead donors or those who died from cardiac arrest, insurance coverage became available, starting this month, for the cost of preserving the organs with the use of this technology, after its efficacy and safety were confirmed. Expanding the use of the technology to livers and hearts also must be discussed.

 (From The Yomiuri Shimbun, June 6, 2026)