A man who received a kidney for transplant from a living donor at Tokushukai Hospital in Uwajima, Ehime Prefecture, and a woman close to him have been arrested on suspicion of giving cash to the donor for the donor’s left kidney. Since monetary exchange between a patient and donor threatens the ethical foundation of organ transplants, this case demands a thorough investigation. The government and the Japan Society for Transplantation need to coordinate measures to prevent payments.

JST stipulates that a blood relative or in-law may become a living donor. Another person may become a living donor only if it is confirmed there was no coercion. In the Sept. 28, 2005, kidney transplant operation, the man and woman told the hospital that the living donor was a sister of the woman. The hospital did not verify that. The case came to light after the donor complained to police that she had received only part of the money promised.

The basic problem in Japan is the availability of kidneys. Of the 900 kidney-transplant operations in 2004, 727 (80 percent) used kidneys from living blood relatives or in-laws. By comparison, the 28,108 kidney transplants in the United States in 2005 involved the use of kidneys from 9,914 people who had just died.

In Japan, before the organs of a brain-dead person can be removed for transplant, the donor must have expressed the will to be a donor while alive. For removal of organs for transplant from a person whose heart has stopped beating, approval from family members is sufficient. This last point should be publicized more.

A study group in the health ministry has found that at least 151 Japanese underwent kidney transplant operations abroad by the beginning of this year. Payment of money for kidneys abroad cannot be ruled out. An increase in the number of Japanese receiving kidneys overseas due to the lack of kidney offers at home could invite international criticism.

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