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Last Updated: Wednesday, 29 November 2006, 20:25 GMT
Japan's long wait for organ donors
It is harder to get an organ transplant in Japan than almost anywhere else in the world. The problem is not a lack of funds or technology, but a lack of donors.

The BBC's Chris Hogg reports from Tokyo on why only small numbers of organs are available in Japan and what that means for those waiting.

Kiyo Matsuura
Kiyo Matsuura began dialysis 30 years ago

Imagine what it is like to be flat on your back hooked up to a machine for four hours every other day while it cleans your blood.

That is life for Kiyo Matsuura. She is 74 and started having the treatment 30 years ago.

"I know I have to do this in order to live," she tells me while the machines hum around her.

"I soon realised this was the only way I would survive. If I stop I will die. I have no choice."

If Kiyo lived elsewhere she might have had a transplant by now, but in Japan both an organ donor and their family have to agree in writing before a transplant can take place.

That is almost impossible if the donor has been seriously injured, for example, so many organs are wasted.

Mrs Matsuura's doctor, Takashi Akiba, says one-fifth of the dialysis patients being treated in the unit are waiting for a transplant.

"They will probably be waiting 10 years," he tells me.

"It's a very, very long time. In the United States and in European countries the waiting time can be less than a year. It's 10 times worse here in Japan."

In the UK, organs were donated from 773 deceased donors over a 12-month period in 2002/03, according to the British Department of Health.

In Japan, permission for organs to be donated has only been obtained in 50 cases since 1997.

No children's organs

On the southern Japanese island of Kyushu, another patient, Kenichiro Hokamura, is still recovering from an operation to receive a new kidney he bought in China.

Kenichiro Hokamura
I feel sorry for the executed man but he was going to die anyway, and now his kidney is contributing to a life again
Kenichiro Hokamura
Transplant patient

The kidney had belonged to a prisoner who had been executed. Mr Hokamura said he had few regrets about getting help this way.

"Dialysis treatment was just waiting to die. I felt that if I could buy an organ, it would be the start of a second life," he said.

"I feel sorry for the executed man but he was going to die anyway, and now his kidney is contributing to a life again."

For youngsters the situation is even worse.

The Akaishi family are trying to raise 10m yen ($85,000) in a street collection to pay for a heart transplant for the youngest daughter Shuri.

Japan has no children's organs available because the law says under 15s cannot consent to donate their organs.

So Shuri's father Hiroshi Akaishi knows her only chance of survival is if they can get her treatment overseas.

"10m yen is far beyond what we can find ourselves," he told me while taking a break from collecting.

"That's why we are here - to ask people to help us. This is really the only thing we can do to save our daughter, to ask people to help us."

Changing the rules

For adults there is one alternative to all this. You can try to find a living donor - someone who is prepared to give you part of their liver, perhaps, or a kidney.

Yohei Kono and son Taro Kono
If we can have organ transplants from the brain dead people we can alleviate those social pressures on living family members
Taro Kono
Lawmaker (pictured right)
With few organs available for transplant this for many people feels like the only option.

Yohei Kono, speaker of Japan's lower house of parliament, received part of his son's liver when his was failing. It was not easy for either of them, he said.

"I didn't want to live with the sacrifice made by my child as a parent. It may be a bit Japanese on my part. I could not accept the offer gallantly," he said.

"I was 65-years-old at the time and I didn't want a young person who has a lot to look forward to take a risk in order to extend my life. I felt really strongly about it."

His son Taro Kono, also a lawmaker, believes the law should be changed to make it easier to get a transplant.

"I can feel the social pressure is mounting on those possible donors. If we can have organ transplants from the brain dead people we can alleviate those social pressures on living family members," he said.

"In this country that is the first and the last option. And I think the Japanese are very unfortunate to be living in that situation."

Parliament has been given different options to loosen up the rules. So far no-one can agree which to choose.

The problem is that while they debate, the wait for those that need transplants just gets longer and longer.

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