Abstract
Since the Organ Transplantation Law was passed in October 1997, a total of 185 heart transplantations (HTx) have been performed in Japan as of December, 2013. Of those, 116 HTx was performed after activation of modified transplant law. Most recipients had dilated cardiomyopathy; waiting condition of all patients, except for one pediatric patient, was status 1 at HTx. The mean waiting time as status 1 was 864 days. Ninety percent of the patients (166) were bridge-to-transplant (BTT) cases by several types of left ventricular assist devicess (LVAD), and mean support duration was 896 days. Most received a modified bicaval method of operation with Celsior for cardiac preservation, and all recipients were administered triple therapy with calcineurin inhibitor (cyclosporine or tacrolimus), mycophenolate mofetil, and steroid as initial immunosuppressive regimen. Two patients have been doing well >14 years after HTx, and ten-year survival rate was 89.8 %, which is superior to that of the international registry. Five pediatric HTx （<10 years: one, 10-18 years: 10） performed under modified transplant law. In this year, the number of HTxs in Japan exceeded the number of HTxs of Japanese patients in abroad. However, pediatric HTxs of Japanese patients abroad, especially <10 years old, still has much HTx in abroad. This surveillance documented that the results of HTx in Japan were excellent despite a severe shortage of donors and long waiting time with LVAS as BTT.
