Twenty years have passed since the Organ Transplant Law entered into force, and yet the number of organ transplant operations from brain-dead donors in Japan remains far lower than in many other countries. Parties concerned should uphold the spirit of the law and work ceaselessly so that the desire of people who agree to donate their own or their relatives' organs will not come to naught.

The law was enacted in 1997 after long and heated discussions, paving the way for heart, lung, liver, kidney, pancreas and small intestine transplants from patients diagnosed as having suffered brain death. Under the law, a patient declared brain dead should be regarded as being dead only in so far as the person's organs are to be removed for the purpose of transplant. Thus, in other circumstances a person who is in the state of brain death is not regarded as being dead in the usual sense. The law defines brain death as a condition in which the function of the total brain, including the stem, has irreversibly stopped.

Since the law took effect, there have been 477 cases in which patients were judged to have fallen into the state of brain death as stipulated by the law, and 2,072 cases in which organs removed from these patients were transplanted. The number of organ donations per capita remains far lower than in other countries — about one-fortieth the level in the United States and one-tenth that of South Korea. Some 14,000 patients are on waiting lists for a new organ, but only about 300 can receive a transplant each year. However, the five-year survival rate for patients who receive a heart or liver is 92 percent and 80 percent, respectively — indicating the skill of doctors and other staff involved in transplant operations in this country.