Problems in Organ Procurement from Brain-dead Donors in Japan.

Since Japan's organ transplantaion law went into effect in 1997, more than a dozen donations have been made from braindead donors. We discuss 2 problems with organ procurement in Japan, based on 14 cases, including our own, for which we obtained information on the donation time line. The first problem is the need to diagnose clinical brain death before Japanese criteria for brain death are met. The second problem is inputting data on newly available organs to the Japan Organ Transplantation Network computer system. An organ may be input for shipping only after brain death is diagnosed. Beause of these 2 problems, organ donations take much time and place a heavy burden on donor hospitals. The organ procurement procedure is strictly regulated by legal guidelines, and we propose that the procedure is redesigned within the existing legal framework.