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Heart and liver transplants from a brain-dead donor got under way in Osaka and Kyoto prefectures Monday in the third case since Japan legalized the procedure in 1997.

The donor, a man in his 20s, was confirmed brain-dead Sunday following an accident.

He had indicated on his donor card in April that he was prepared to donate all his organs in the event of brain death, and his family had signed the card as required by law.

The removal of his organs began at 2:54 p.m. at a hospital in Furukawa, Miyagi Prefecture, the Health and Welfare Ministry said.

The man’s heart arrived in Osaka airport on a chartered plane at 6:30 p.m. and was transported to the National Cardiovascular Center in Suita, Osaka Prefecture.

The Japan Organ Transplant Network, the only entity in Japan authorized to arrange organ transplants from brain-dead donors, said a heart transplant was being performed at the center on a male patient in his 20s suffering from dilated cardiomyopathy.

The heart patient, a resident of the Kansai region, was admitted to the center in April, according to the network.

The liver reached Osaka airport at 7:57 p.m., and was delivered by chartered helicopter to Kyoto University Hospital, officials said.

The network said the recipient of the liver is a 2-year-old Kyoto boy suffering from stenosis of the bile duct.

University hospital authorities said only about 20 percent of the donated liver is needed for the operation and that the organ was trimmed to fit the patient.

At Sendai Shakai Hoken Hospital in Miyagi Prefecture, a transplant operation using a kidney from the donor was completed at 9:15 p.m. Monday, doctors said. The recipient is a male in his 20s suffering from chronic nephritis.

Another kidney was transplanted in a 39-year-old male also suffering from chronic nephritis at Fukushima Medical College in Fukushima.

Although the donor’s lungs had been prepared for a man in his 30s with primary pulmonary hypertension in Okayama, an Okayama hospital announced it had given up on the operation due to the deteriorated condition of the organs.

The operation would have been the first transplant of lungs in Japan from a brain-dead donor.

The boy in Kyoto will be the first child in the nation to receive an organ from a brain-dead donor. A number of Japanese children have undertaken organ transplants overseas.

The donor was taken to a hospital Wednesday after the accident, and was officially confirmed brain-dead Sunday following two tests based on the 1997 Organ Transplant Law.

His family refused to reveal the nature of the accident.

They reportedly decided to respect the man’s intentions to donate his organs Sunday morning, after talking with network officials Friday night.

The man was the third person to undergo tests for brain death based on the 1997 law allowing organ donations from brain-dead patients.

Unlike the cases of the two earlier donors, whose brain death was caused by illness, the fact that an accident was involved in the latest case required doctors to call police to examine the donor’s body before they could extract his organs.

The Organ Transplant Law, which took effect in October 1997, allows doctors to remove organs only from brain-dead donors who have given advance written consent and whose relatives agree to the operation.

In late February, Japan’s first organ donor under the law was confirmed in Kochi Prefecture. Operations to transplant the donor’s heart, liver, kidneys and corneas to six patients were performed from Feb. 28 to March 1.

Japan’s second set of organ transplants, from a man legally confirmed brain-dead in Tokyo, was carried out in May, saving the lives of three patients who received the man’s heart and kidneys.

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