Japan's first heart, liver and kidney transplant operations involving a legally declared brain-dead donor were successfully completed early Monday morning, hospital officials said.
The operations came 16 months after a law finally permitting them took effect in October 1997.
A man in his 40s received a heart Sunday night at Osaka University Medical School Hospital after the organ was transferred from Kochi Red Cross Hospital in Kochi Prefecture the same evening.
The operation on the man, who suffers hypertrophic cardiomyopathy, began around 7:30 p.m. Sunday and lasted more than five hours. "Honestly speaking, we are quite relieved to have completed our task," said Dr. Hikaru Matsuda, a professor at Osaka University Medical School Hospital. "I performed the operation while keeping in mind that so many others had died while waiting for transplants."
According to Matsuda, the patient recovered consciousness in the morning and "has been in stable condition." The recipient had his respirator removed around 1 p.m., doctors said.
The patient spoke with his family for 12 to 13 minutes through the window of the intensive care unit at 3 p.m. and signaled he was feeling fine, according to the hospital. Hospital staff were giving him water and liquid medicine later that evening.
It was Japan's second heart transplant, following the controversial one performed in 1968 by Dr. Juro Wada at Sapporo Medical College. The attempt failed and led to a murder complaint against Wada, though prosecutors did not press charges.
But the repercussions were long-lasting. The incident made organ transplants from brain-dead donors taboo until the current donor law was passed by the Diet in 1997. Sunday's heart transplant was the first in Japan since the Wada case.
A 43-year-old man from Nagano received a liver from the donor in an operation performed at Shinshu University Medical School Hospital in Matsumoto, Nagano Prefecture. The operation lasted 12 hours and ended at 5:16 a.m. Monday. "Everything went well, without any trouble," said Atsushi Sugiyama, who performed the operation.
The donor's kidneys were transplanted into two middle-age patients, including one woman in her 40s, early Monday. The first operation took place at Tohoku University Hospital in Sendai, the other at the state-run Nagasaki Central Hospital in Omura, Nagasaki Prefecture. Both operations were completed shortly after 6 a.m., according to the hospitals.
Cornea transplants were done at Kochi Medical School in Kochi Prefecture Monday afternoon.
The heart, liver, kidneys and corneas were removed on Sunday after doctors officially confirmed the patient legally brain dead following three days of drawn-out tests.
Plans to transplant the patient's lungs were canceled after doctors found them to be unfit, according to the Health and Welfare Ministry.
The Japan Organ Transplant Network -- the only organization in the country licensed to arrange transplants from brain-dead donors -- selected the recipients based on their health and location, network officials have said.
The donor was hospitalized Feb. 22 with a brain hemorrhage following a stroke, gaining widespread media attention Thursday evening when the hospital announced it was beginning a procedure required before legally confirming a patient clinically brain dead.
The donor had signed an organ donor card allowing all organs to be used for transplants in the event of brain-death.
Under the transplant law, brain-death can be established only on the basis of two tests that fulfill five legal criteria -- flat brain waves showing absence of brain activity, a state of deep coma, absence of pupil movement, the loss of seven brain stem reflexes and cessation of natural breathing.
The law equates brain-death with actual death only when a donor is tested and confirmed to be brain dead by two or more doctors twice, with a six-hour interval between the two tests.
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