1. Consideration at the First Case of a Kidney Trade in Japan Miyako OKADA-TAKAGI University research Center, Nihon University Tokyo, JAPAN

2. Recipient Donor First case of a kidney trade in Japan gave the left kidney after operation ・ 300,000 yen in cash ・ A car Severe diabetes his common law wife Faked his sister in law Mr. A Ms. B Ms. C

3. The situation of T-hospital No ethics committee for transplantation issues A doctor-M managed everything for transplantation 1) He is famous for kidney transplantation from living donors. 2) He has never been a member of the Japan Society for Transplantation.

4. Ethical guidelines of the Japan Society for Transplantation Not specify concrete procedures - to confirm the identities of donor - to confirm kinship between donors and recipient These procedures are left to the discretion of individual hospitals

5. Some hospitals have set stricter regulations than those of the JST …for managing the cases of which a patient marries or adopts a donor.

6. Shortage of organ donations The number in artificial dialysis (Japan) … 240,000 (2004) A large gap between the number of patients requiring an organ transplant and the number of organ donors. 11,564 were awaiting kidney transplants ( Aug. 31,2006.)

7. Living donors are common in Japan 4~6 cases from brain-dead patients (an average year) 112 (2002) cases from cardiac-arrest patients 727(2004) cases from living donors from either a parent or child of the recipient, and donation between spouses is increasingly common.

8. Organ Transplant Law The Organ Transplant Law standards for determining brain death and procedures for organ transplants At present there are no legal provisions for organ donations from a living donor. - except for a ban on organ trading and unlicensed brokering The necessity to cover transplants from living donors

9. The necessity to reform brain-dead donors and cardiac-arrest donors Family members do not receive priority on organs donated from another family member. living donors Relatives, within six degrees of consanguinity by blood or a relation by marriage within the third degree of consanguinity, of a recipient can be accepted as a living donor.

10. The issues in living donors In cases ・ Real family members are forced to donate organs ・ Cash payments take place The JST guidelines on exempting families from its ethical screening process should be reviewed.

11. This point should be publicized more brain-dead donors The donor must have expressed the will to be a donor while alive. cardiac-arrest donors The approval from family members is sufficient.