VZCZCXRO5766
RR RUEHHM RUEHLN RUEHMA RUEHPB
DE RUEHKO #2688/01 1360821
ZNR UUUUU ZZH
R 160821Z MAY 06
FM AMEMBASSY TOKYO
TO RUEHC/SECSTATE WASHDC 2112
INFO RUEHZN/EST COLLECTIVE
RUEHFK/AMCONSUL FUKUOKA 6198
RUEHNAG/AMCONSUL NAGOYA 6164
RUEHNH/AMCONSUL NAHA 8830
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RUEAUSA/DEPT OF HHS WASHINGTON DC

UNCLAS SECTION 01 OF 03 TOKYO 002688 
 
SIPDIS 
 
DEPT FOR EAPO/J MIDHA AND OES/IHA COMELLA 
DEPT PASS TO WHITE HOUSE OSTP 
DEPT PASS TO NIH/NIAID WESTERN 
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HHS FOR OGHA/BHAT AND ELVANDER 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: AMED TBIO SOCI JA
SUBJECT: JAPAN: GETTING ORGANS IN FOREIGN COUNTRIES 
 
REF: A)98 TOKYO 9778 
 
     B)99 TOKYO 3388 
 
TOKYO 00002688  001.2 OF 003 
 
 
¶1.  Summary.  On April 21, a study group of the Ministry 
of Health, Labor and Welfare (MHLW) study group conducted 
a survey to study the number of Japanese citizens seeking 
organ transplants in foreign countries.  The study report 
revealed that at least 522 individuals had organ 
transplant operations done overseas.  The actual number is 
likely underreported, because the study excluded cases 
where the individual died after having a liver or kidney 
transplant and only surveyed a limited number of medical 
institutions.  The reasons behind the increased number of 
individuals having the procedure done abroad for a full 
range of organ transplants include a shortage of donors 
and long waiting periods, legal problems that make it 
difficult for children to receive organs, and the fact 
that many patients can now obtain medical information on 
organ donors through the Internet.  There is concern that 
some patients may be purchasing their organs from 
unwilling donors such as prisoners and those who find 
themselves in dire straits.  As a result, health 
professionals established a committee to look at the 
ethical issues behind receiving organs abroad.  In order 
to increase the number of potential donors in Japan, 
members of the Liberal Democratic Party (LDP) and New 
Komeito submitted two amendment bills to the current Diet 
session.  End Summary. 
 
----------------- 
Survey Procedure 
----------------- 
 
¶2.  The survey was conducted by aA study group of the 
Ministry of Health, Labor and Welfare (MHLW) led by 
Professor. Eiji Kobayashi of Jichi Medical University 
conducted the survey from between January to and March of 
this year.  The team gathered collected data on the number 
of patients who are having undergoing medical treatments 
after having had an organ transplant operation dones 
abroad.  The group limited its  through survey to 
inquiring Japanese medical institutions where member 
medical doctors of the Japan Society for Transplantation 
work.  For heart transplants only, the group reported on 
all cases including those where the transplant recipient 
died.  For other types of transplants, the report did not 
include cases where the organ recipient subsequently 
diedRegarding organ transplant of a heart, all cases 
including dead cases were reported.  The survey covered 17 
institutions for heart transplants, 123 institutions for 
liver transplants and 154 institutions for kidney 
transplants.  The respondent response rate was 100 
percent, 97 percent, and 90 percent respectively. 
 
----------------- 
Heart Transplants 
----------------- 
 
¶3.  The survey reported that 103 patients (64 males and 39 
females) had heart transplant operations done in foreign 
countries from between 1984 through and 2005.  Eighty-five 
patients had operations done in the U.S., followed by nine 
patients in Germany, seven patients in the UK, and one 
patient each in Canada and France.  Eighteen death 
casesdeaths were also reported, but the survival rate 
after five years after surgery was 70.3 percent, higher 
than most international rates.  By the group of ageThirty- 
two, 32 patients in the group ofwere younger than 10 years 
old, 22 patients in the group of agewere between the ages 
of 10-17, and 49 patients werein the group of age older 18 
years of age or older.  After 1997 when the Japan's organ 
transplant law took effect in 1997, the number of 
individuals undergoing surgery has been steadily 
increasing. 
 
¶4.  The first heart transplant operation in Japan took 
place in 1968, but ended in failure.  This led to public 
discord over the definition of what constituted brain 
death.  As a consequence, no heart transplant operations 
 
TOKYO 00002688  002.2 OF 003 
 
 
were carried out in Japan until the 1997 law took effect. 
During the same time period, only one to four Japanese 
were receiving operations abroad per year.  Since 1999, 
however, the number of Japanese patients undergoing the 
surgery in both Japan and foreign countries has been on 
the rise. 
 
¶5.  Kobayashi writes in the report that many patients 
undergo heart transplant operations overseas because of 
the rigid organ transplant law and the shortage of donors 
in Japan.  Other factors for the full range of organ 
recipients include the shortage of donors and long waiting 
periods, legal problems that make it difficult for 
children to receive organs, and the fact that many 
patients now can obtain medical information through the 
Internet on potential organ donors. 
 
----------------- 
Liver Transplants 
----------------- 
 
¶6.  According to the survey, 2,982 patients are currently 
have aundergoing follow-up medical treatment in 83 
Japanese medical institutions after having a liver 
transplant operation.  Of the 2,982 patients, 221 
individuals had a transplant operation done in a foreign 
county, reported by 43 medical institutions.  The survey 
does no't provide the exact breakdown number of patients 
by countryies, but 20 medical institutions reported that 
they are treating a liver-transplant recipients in who had 
work done in Australia, 19 institutions reported that they 
have a liver-recipient in the Ushad patients who had the 
procedure done in the U.S., and 14 institutes reported 
that their patients had a liver transplant operation in 
traveled to China for the operation.  The survey couldn't 
did not obtain information on cases involving death of the 
patient after f dead cases after the operationsthe 
transplant. 
 
------------------ 
Kidney Transplants 
------------------ 
 
¶7.  CThere are currently 8,297 patients have awho are 
undergoing medical treatment in 136 Japanese medical 
institutions after having a kidney transplant operation. 
Out of the 8,297 patients, 198 individuals had thea 
transplant operation done abroad, reported byaccording to 
the data provided by 63 institutions.  Forty-eight medical 
institutions reported that their patients received their 
newa kidneys in China, while .  Twenty20 institutions 
reported the source as the Philippines.  Eighteen 
institutions said that their patients had a transplant 
operation done in the U.S.  The survey couldn't did not 
obtain information on cases involving death of the patient 
after f dead cases after the operationsthe transplant. 
 
--------------- 
Ethical Debates 
--------------- 
 
¶8.  On April 21, In order to continue the survey, the 
Japan Society for Transplantation has established a 
committee to consider the safety and ethics of receiving 
organ transplant operations in foreign countries.  There 
is concern that some patients may be purchasing their 
organs from unwilling donors such as prisoners and those 
who find themselves in dire straits.  For example Yuki 
Hasegawa of Toho University reported in an attached report 
that some in China feel that those on death row should pay 
for their crimes through organ donations, and in India, a 
kidney donation can support a family of four for ten 
years.  A February 4 edition of the Asahi Newspaper 
devoted much space to the issue of organ donations by 
prisoners in China.  The article quoted an interview with 
a senior PRC health official who admitted that more than 
90 percent of the organs used for transplants were from 
prisoners sentenced to death.  The Sankei Newspaper 
reported on a study conducted by Professor Tsuyosi Kuriya 
 
TOKYO 00002688  003 OF 003 
 
 
of Okayama University who also said that more than 90 
percent of the organ donors in China were prisoners on 
death row. 
 
------------------------------------- 
Amendment of the Oorgan Ttransplant Llaw 
------------------------------------- 
 
¶9.  From 1997 (when Japan's new law took effect) to 
September 2005, only 41 transplants have taken place that 
used organs from brain-dead patients.  As of February 
2006, there were 85 heart patients, 119 lung patients, 109 
liver patients and 12,112 patients needing new kidneys 
listed on the Japan Organ Transplant Network's official 
list of recipients awaiting transplants. 
 
¶10. In order to increase the number of potential donors 
and help reduce the number of individuals waiting for 
organs, members of the Liberal Democratic Party (LDP) and 
New Komeito have submitted two amendments in the current 
Diet session.  The current law requires donors to have a 
donor card that shows their willingness to donate their 
organs in addition to their family's consent.  One of the 
proposed amendments will designate an individual as 
deceased if there is brain death and will allow organ 
donation with family consent, provided that the donor does 
not specify in his or her will that he or she does not 
want to donate their organs after death.  The other 
amendment will keep the current definition of brain death 
as is, but will lower the age of donors from 15 years of 
age to 12.  (Note: The current law does not define brain 
death as actual death.  It provides that organs can be 
taken from a dead body including from the body of a brain- 
dead person for the purpose of transplants, but under very 
strict conditions.)  Because the Diet members drafting the 
changes could not reach an agreement on the definition of 
brain death, they submitted the two different amendments. 
 
DONOVAN