How to promote organ donation after brain death?

Current status and problems from a neurosurgical point of view

Abstract

The number of organ donations has leveled off and been declining ever since the revised Act on Organ Transplantation was enacted in 2010. Whereas the number of organs from brain-dead donors has been rising slightly every year, that from non-heart-beating donors has fallen sharply. Particularly in pediatric medicine where organ donations are few, tragic cases of child patients who die while waiting for an organ transplant have occurred. How Japan can meet the demand for organs has become an urgent and serious national problem to be addressed. We experienced four cases of organ donation from brain-dead donors in three years at a general hospital in a local city that faces the problem of an aging and declining population. The shortage of manpower to handle those organ donation cases was offset by maintaining an on-call system in the department and requesting a doctor who belongs to the anesthesiology department and is in charge of the intensive care unit (ICU) to manage donors and preserve organs. To secure organs, the introduction of a system that presents options within the hospital is the issue at hand. While it remains important to continue educating the public in the same way as before, efforts with adolescents and younger people in mind will be required down the road. We must not forget that the motivation and resolve of doctors and hospitals will certainly move the hearts of a patient’s family members to commit to organ donation.