In Japan, organ transplantation registries have historically been managed separately: the Japan Society of Transplantation (JST) and associated societies of each organ maintained registries for living and deceased donor organ transplantation, while the Japan Organ Transplant Network (JOT) was responsible for the deceased donation and transplantation registry as a national organ transplant management and procurement organization under the Organ Transplant Act. However, the non-unified management created challenges in data use, ethical oversight, and administrative burden for academic societies, JOT, and transplant institutions, raising concerns about long-term sustainability. To resolve these issues, JST and JOT jointly formed a collaborative committee in 2022 to restructure the registry system. Guided by the Declaration of Istanbul, the committee decided to centralize registry functions within JOT for both donor types and to establish a comprehensive platform, named the TRAnsplant Central Registry (TRACER). TRACER system covers all organs and both living and deceased donor organ transplantations. Given the scale of reform, the implementation proceeded in stages. In 2024, JOT created a Division of Investigation and Research for registry management. From 2025, JST managed only living donor transplantation, while JOT took responsibility for deceased donor transplantation. Finally, the TRACER system officially launched in July 2025, providing a unified national platform. The system is expected to improve transparency, enable timely dissemination of transplant data, and support both clinical and epidemiological research. Ultimately, the TRACER project represents a key step toward the sustainable advancement of transplantation in Japan through integrated data governance and more effective data utilization.
