抄録
Donor shortage in heart transplantations is a worldwide common issue. The revised organ transplantation law became effective in July 2010 to change the situation in which overseas transplantations were required for pediatric patients. Since then, the number of heart transplantations has increased to 30-40 cases per year, from 10 or less before the revised law. However, the number of patients on a waiting list is skyrocketing, and an expected waiting period is lengthening to far longer than 3 years. The medical consultant system, which is a Japanese unique system of brain-dead donor management, was started in 2002. It enabled us to procure and transplant hearts from marginal donors frequently. In this review, the results of marginal donor heart use in the United States and Europe and the present status of marginal donor use and influence on long-term results are examined.
