Donor management and extremely high donor lung utilization rate in Japan.

Owing to the extremely short supply of donor lungs in Japan, a unique medical consultant (MC) system was initiated in 2002 to increase the organ availability through intensive management of donors. First, heart transplant surgeons were sent to procurement hospitals as MCs to assess donor organ function and provide intensive care to donors. MCs requested that donor attending doctors perform frequent phlegm aspiration with a bronchoscope, leading to a higher lung availability and better outcomes after lung transplantation.

Interim report of the Japanese original donor evaluation and management system: the medical consultant system.

Purpose: Lung transplantation (LTx) is an established therapy for end-stage lung failure. However, in Japan, the donor organ shortage is extremely severe compared with other developed countries, because of the strict Japanese Organ Transplantation Law. To maximize LTx opportunities in Japan, we have established a special donor evaluation and management system termed the medical consultant (MC) system.

[The certification and recruitment of the procurement coordinator].

In Japan, Japan Organ Transplant Network is responsible for the certification and recruitment of the procurement coordinators since April 1995. Individuals that have a medical license or are recognized to have similar knowledge, and who have passed an aptitude test including curriculum vitae, paper test, and practice assessment in an emergency unit, concluding in a recruitment interview are granted certification. As the Revised Organ Transplant Act has been enacted in 2010, we predict the rise in donors, and also the importance of the role of the coordinators.

[The financial status and organization of the organ transplant system in Japan].

The Japan Organ Transplant Network is the only organization in Japan that maintains a waiting list for organ transplants and also functions as a procurement agency recovering organs. The yearly budget of fiscal year 2009 is 692 million Japanese yen, 74% from government funding, and the rest from transplant center membership fees, potential recipient registration fees, transplant recipient coordination fees, and contributions. The registration fee is 30,000 yen for the first year, and 5,000 yen for every following year.