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August 13th is recognized as World Organ Donation Day, and is observed globally every year to raise awareness about the importance of, and to clarify misconceptions about, organ donation.
Japan has an overwhelmingly low number of organ donations compared to Europe and the United States. Even neighboring South Korea has nine times as many organ donations compared to Japan.
In conjunction with World Organ Donation Day, CareNet and Macromill CareNet, Inc. (a joint venture between CareNet and Macromill) asked 71 member doctors, who had been involved in organ transplantation, about the challenges faced in executing organ transplants and what was required to promote transplantation medicine in the future.
・The most common problems “perceived in organ transplant implementation” by physicians were, “Insufficient awareness-raising activities in Japan,” at 41%, followed by, “Not enough personnel (nurses, anesthetists, etc.) for organ donation in hospitals ,” at 33%, “Not enough people expressing their willingness to donate organs,” at 32%, and “No explanation to potential donors and their families at an early stage,” at 29%.
・As for, “What should doctors do to increase the number of organ transplants,” 33% answered “Conducting awareness-raising activities,” followed by “Secure and train transplant doctors” (14%), and “Acquiring transplant knowledge for doctors themselves” (7%).
・Regarding “issues after organ transplantation,” 71% of doctors answered, “post-transplant infections (treatment at the time of onset),” 65% stated, “post-transplant infections (prevention).” Regarding “Infectious diseases that are difficult to deal with when they occur,” 65% of doctors answered “CMV (cytomegalovirus),” while 52% answered, “PCP (pneumocystis pneumonia).”
When asked, “Please tell us what you feel are the challenges in organ transplant implementation,” the most common response (41%) was “Insufficient awareness-raising activities in Japan,” followed by, “Not enough people expressing their willingness to donate their organs” (32%). Further issues include the lack of understanding among families of those who have indicated their willingness to become donors. It is thought that various issues, including the Japanese view of life and death, have led to a low number of organ donors in Japan.
However, 33% of the respondents felt that the medical personnel required for organ donation (nurses, anesthetists, etc.) were scarce in the hospital, and 29% said that potential donors and their families are not informed at an early stage.
Compared to Western countries, such as the USA (with 44.50 organ donors per million people) and Germany (10.34 per million ), Japan has by far the lowest number of organ donors (at 0.88 per million); some responses were related to the low number of organ transplants in Japan.
[Table 1]
When asked the open-ended question, “What do you think doctors should be doing to increase the number of organ transplants performed in Japan?” The most common answer was “Conducting awareness-raising activities,” at 33%, followed by “Securing and training transplant doctors,” at 14% and, “Acquiring transplant knowledge for doctors themselves,” at 7%.
To promote organ transplantation, raising awareness of organ transplantation among patients and their families, is of the utmost importance. In raising awareness and explaining to patients and their families, it may be necessary to increase the number of doctors involved in transplantation, including securing (including treatment) and training transplant doctors, and to expand the number of facilities for organ donation.
[Table 2]
“What are your thoughts on the period following the organ transplantation?” The most common response, with 74% of doctors terming it “troubling” or “somewhat troubling,” was the “Incidence of post-transplant rejection,” followed by “Post-transplant infections (treatment at onset)” (71%), “Complications related to immunosuppressive drugs other than infection” (71%) and “Post-transplant infections (prevention)” (65%).
Post-operative rejection, immunosuppressive drug-related complications, and infection control are challenges associated with the period after organ transplantation.
[Table 3]
When asked, “Which infections after organ transplantation do you think patients would have trouble dealing with, if they developed them?” CMV (cytomegalovirus) was the most common response (65%), followed by Pneumocystis pneumonia (PCP) (52%) and fungal infection (41%).
Early definitive diagnosis, antiviral treatment, and prophylactic administration are necessary because complications of serious infections can lead to the discontinuation of immunosuppressive drugs.
[Table 4]
*https://www.jotnw.or.jp/explanation/07/06/ (accessed August 1, 2023)
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