Japan lifts ban on children donating organs

TOKYO - Japan lifted a ban Monday on organ donations from children, reversing a restriction that created such a dearth of small organs in the country that young patients were forced to seek transplants abroad.

The law will allow children, defined as those under 15, who are brain dead to donate their organs — a sea change in this country, where organ donating is sensitive because of Buddhist beliefs consider the body sacred and reject its desecration.

Until 1997, Japan barred organ donations from even adults who were brain dead. A law enacted that year lifted the ban but continued to prohibit children from donating, citing their inability to make such a mature decision. It also only authorized organs to be taken from patients who specifically gave their consent — contributing to a severe shortage in the country.

The law passed Monday will give relatives the authority to consent to donations in cases where the patient's own intentions were unclear, according to the document, which was posted on the legislature's Web site. It will take effect in the summer of 2010, a parliamentary official said on condition of anonymity, citing policy.

Keiichiro Nakazawa, whose 1-year-old child died in the U.S. this year while waiting for a heart donor, said the law came too late for his son, but "opened a new big door for other patients who are in need."

The new law brings Japan more in line with World Health Organization guidelines, though it still places more restrictions than some countries that consider consent for organ donation the default in the absence of specific instructions that the body be left intact.

"WHO welcomes this," said spokesman Joel Schaefer, calling it "a very positive step by Japan."

"The new law opens the way for Japan to progress towards self-sufficiency in organ transplantation, and this will improve access to organ transplantation for Japanese people from Japanese society," he said.

Largely because of its historically stringent laws on organ transplant and donation, Japan performs only a tiny fraction of the number of transplants that the U.S. and Europe do. Since 1997, just more than 2,100 transplants were performed in Japan, according to the Japan Organ Transplant Network, the country's only organ donation coordinator. By contrast, the U.S. performs thousands and many European countries perform hundreds each year.

Despite years of campaigning by activists, the legal revision has long been on hold because of sensitivity over the definition of death in Japan, where many believe one is alive until the heart fails. Though for the past decade Japan has allowed donations from brain dead patients, the new law goes further, defining brain death as legal death for the first time.

The reform was expedited this year after the Japanese branch of the international Transplantation Society adopted the group's policy calling for every country to achieve organ self-sufficiency in a move to reduce "transplant tourism." Several countries, including Germany, have rejected Japanese patients seeking transplants there.

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