A child organ donor

The Toyama University Hospital on June 14 declared a boy under age 6 brain dead. Later his heart was transplanted into a girl under age 10, his liver into another girl younger than 10, and his kidneys into a woman in her 60s.

As much information as possible about the brain death and the organ transplants should be made public while protecting the boy’s and his family’s privacy. Such information disclosure is necessary to examine whether the procedures leading to the transplants were proper and to ensure the integrity of the system under which young children become organ donors.

The Organ Transplant Law went into effect in 1997. But the law, placed strict conditions on organ transplants, including the preparation of signed donor cards for potential donors, and prohibited organ transplants from children under age 15.

A revision of the law went into force in July 2010, making it lawful to take organs from any brain-dead person regardless of age if the family consents, unless the individual in question has explicitly refused to be a donor. Thanks to the revision, organs have been transplanted from nearly 90 people older than 15.

To determine brain death, various diagnoses, including a determination of the depth of a coma and dilation of the pupils, must be carried out twice after an interval of more than six hours.

In the case of a person under age 18, it must be confirmed that there was no child abuse involved. For children under age 6, an interval of more than 24 hours is required for the diagnosis because children are believed to have a better chance of recovering from brain damage than adults.

In April 2011, a boy between 10 and 14 who had been declared brain dead by a hospital in the Kanto-Koshinetsu region became the first person under age 15 from whom organs were transplanted. But the Japan Organ Transplant Network, Japan’s sole entity certified as an intermediary for organ transplants, made public only limited information about the boy’s case.

As for the latest case, the network said that the boy’s family asked for information about making him a donor, that eight relatives including the parents agreed to offer his organs, and that no traces of abuse were found. It also said that a pediatric emergency doctor and an intensive care doctor, both from outside, were added to the hospital team to confirm the brain death diagnosis.

The network should disclose detailed information on these matters such as damage to the boy’s brain, the brain death diagnoses, care given to the family and how the family overcame the difficulties, in order to help further ordinary people’s understanding of organ transplants.