2024 年 59 巻 3 号 p. 237-241
Since the Organ Transplantation Act was passed in October 1997, a total of 819 heart transplantations (HTx) had been performed in Japan as of December, 2023. After the Revised Transplant Act came into effect in July 2010, the number of brain-dead organ donation increased and 84 HTx were performed in 2019. In 2020 and 2021, the number of HTx decreased due to the COVID-19 pandemic. However, as the severity and mortality of COVID-19 decreased in 2022, the number of HTx increased, with 115 HTx performed in 2023, the highest number to date. After approval of the use of an implantable continuous-flow ventricular assist device (iVAD) for bridge-to-transplant (BTT) in 2011, BTT cases using iVAD increased. Currently, most patients are waiting for transplantation with VAD implantation.
Although the survival rate after HTx in Japan is favorable, the waiting period is extremely long. The relatively high rate of death while waiting for HTx is big problem, and revision of the allocation system is being considered so that patients with higher urgency can receive transplantation.