ECD for Pancreas Transplantation

  • Toshinori Ito


In terms of absolute shortages of donors, organ transplantation in Japan is in a more serious position than in Europe or the United States. In Japan, a law allowing organ transplantation from brain-dead donors finally came into force in October 1997. The first organ procurement after the enactment of this law was carried out from a deceased donor in February 1999. The heart, liver, and kidneys were successfully transplanted into four recipients. The first pancreas transplantation (PTx) was successfully performed at Osaka University Hospital in April 2000. Since then, however, only 86 cases of procurement occurred over the approximately 13 years from the introduction of the law, because the law was very strict and limited for organ procurement to donors who provided prior written consent. The law was eventually revised to more closely resemble laws in Europe and the United States in July 2010. Since then, procurement numbers have rapidly increased to 118 in 2 and a half years. After revision of the law, the number of donations has increased 7.1-fold. The number of PTx was 84 (33.6 year, as of December 31, 2012) after the revision, compared to 64 (4.9 year) before the revision.

Although the number of donors increased, donor shortages and severe environment surrounding donors as described later still exist in our country. Transplant outcomes, however, are comparable to those in Europe and the United States. Most organ transplantations have been covered by health insurance since April 2006. This is probably due to recognition of the high quality of organ transplantation in Japan.

Unlike lifesaving organs such as the heart, liver, and lung, PTx is recognized as a treatment mainly focused on quality of life. Recently, however, PTx, particularly simultaneous pancreas and kidney transplantation (SPK), has been reported to improve life expectancy in recipients [1]. With the passage of the waiting period after registration to the Japan Organ Transplant Network (JOTN), both deaths and serious cases of diabetic complications necessitating withdrawal of the registration have increased. Therefore, as potential solutions, so-called marginal donors as well as living donors have been considered in Japan.

This chapter examines the present status and problems of PTx in Japan from the perspective of “marginal donors.”


Brain Death Marginal Donor Organ Procurement Graft Survival Rate Pancreaticoduodenal Artery 
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I wish to thank all the members of Practical Committee of 17 Centers for Pancreas Transplantation in Japan, Ms. Y. Saito and Dr. Iwamoto in Japan Diabetes Foundation, and Dr. M. Gotoh, president of Japan Society for Pancreas & Islet Transplantation

 1. Dr. Shimamura, Hokkaido Univ. Hospital

 2. Dr. Miyagi, Tohoku Univ. Hospital

 3. Dr. Saitoh, Fukushima Medical Univ. Hospital

 4. Dr. Kubota, Dokkyo Medical Univ. Hospital

 5. Dr. Shimazu, Tokyo Medical Univ. Hospital

 6. Dr. Nakajima, Tokyo Women’s Univ. Hospital

 7. Dr. Wakai, Niigata Univ. Hospital

 8. Dr. Akutsu, National Chiba-Higashi Hospital

 9. Dr. Narumi, Nagoya Red Cross Hospital

10. Dr. Kenmochi, Fujita Health Univ. Hospital

11. Dr. Dr. Yoshimura, Kyoto Prefectural Medical Univ. Hospital

12. Dr. Iwanaga, Kyoto Univ. Hospital

13. Dr. Nagano, Osaka Univ. Hospital

14. Dr. Matsumoto, Kobe Univ. Hospital

15. Dr. Ohdan, Hiroshima Univ. Hospital

16. Dr. Okano, Kagawa Univ. Hospital

17. Dr. Kitada, Kyushu Univ. Hospital


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Copyright information

© Springer Japan 2014

Authors and Affiliations

  1. 1.The Japan Registry of Pancreas Transplantation, The Japan Society for Pancreas and Islet Transplantation. Departments of Complementary & Alternative Medicine and Gastroenterological Surgery, Graduate School of MedicineOsaka UniversitySuitaJapan

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