The hospital information packet advised me to bring my own chopsticks, but I prefer a knife and fork. That was just the start of my experience as the first-ever Western woman to donate a kidney at Osaka University Hospital, in Japan.

While the treatment of chronic kidney failure in Japan is overwhelmingly done through dialysis, kidney transplant surgeries are slowly trending upward. The number of transplants per year has risen from 705 in 2001, to 1742 in 2017.

But across the country, the kidney transplant rate is low in comparison to the West, partially because of a stigma that remains in Japan regarding organ donors.

My transplanted kidney, about the size of a fist, went to my brother, Guy DeSantis. He has called Japan home since moving there with his young family in 1985.

In early 2016, after dealing with deteriorating kidney function for more than a decade, his nephrologist told him the time had come to discuss his fate. He was facing what is called end-stage renal disease — the complete failure of his kidneys to cleanse the body’s blood.

His choices were two. Begin the intensive mechanical filtration of the blood through either hemodialysis or peritoneal dialysis. Or he could accept a donor kidney transplant, from either a living person or someone recently deceased.

My family helped with his decision and we went about finding a living donor. After a complex series of tests for both me and my brother, it was determined that I was the best match. I would give him one of my two kidneys. We would each be able to live with one.

My brother wanted to stay near his home in Japan, where his family and life roots had taken hold. As a retiree with the flexibility to travel between the United States and Japan, I was able to make the three trips necessary for the procedure.

In 2017, I entered Japan’s national health care system. We soon learned that Japan and the U.S. follow a universal protocol for transplant and postoperative drug therapy.

The total cost for kidney transplant surgery is approximately 10 percent of what it would be in the U.S., where there is no national system and health care prices are dictated by the insurance companies.

The surgery occurred in March 2018 at Osaka University Hospital. Walking from our rooms to the elevator that took us down to the operating room, was one of my life’s most hopeful, but also scary, moments.

We had excellent preparation for the operation by Dr. Ryoichi Imamura and Dr. Taigo Kato and their team. My brother, a man of great faith, and the calm clarity of Dr. Imamura’s care, sustained us through a challenging few days after the surgery.

I was in the hospital for 11 days, my brother for 39.

I learned that the Japanese medical system keeps patients in the hospital until the doctors determine that their job is done. The U.S. medical system discharges a kidney transplant donor after just two or three days and the recipient after five to 10 days.

Memories of my recovery include serenity provided by the beautiful surroundings at the hospital. The state-of-the-art teaching facility has a wonderful Japanese garden, which I saw and enjoyed from my 12th-floor room, in addition to the city of Osaka stretching beyond.

Over a year later, my brother is healthy. His choice to accept a living donor transplant instead of dialysis has allowed him to return to a full and active life.

I have fully recovered as well and am now swimming, playing the piano and enjoying my family in America. For my brother and me, the kidney transplant was the best choice and we are forever grateful for the exceptional care that Japan provided.

And while I still eat with a knife and fork, I cherish my special pair of chopsticks from Osaka.


The opinions expressed in this letter to the editor are the writer’s own and do not necessarily reflect the policies of The Japan Times.

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