Since 1978, the donation of kidneys after cardiac death (DCD) has been legally accepted in Japan, if family consent was obtained. Small children had been able to donate their kidneys after cardiac death. The Japanese Organ Transplantation
Act for brain dead (BD) donation was issued in October 1997. The Act required a living written consent for BD and organ donation and did not allow BD donation from children younger than 15 yrs. From these reasons, only 81 BD organ donations have been performed in Japan for 13 years since the Act was issued in October 1997 .
When the Japanese Organ Transplant Act was issued, Japanese Organ Transplantation Network (JOT) was established in 1997. JOT plays roles in listing recipients, management, public education and head-quarter at the time of organ donation. JOT procurement transplant coordinators (PTC) play roles in getting consent for organ donation from relatives, donor evaluation and management, organ transport, management of organ recovery and taking care of donor families during and after donation.
Every prefecture has at least one own prefectural PTC who is mainly working for public education and hospital development. They also collaborate with JOT PTC at the time of organ procurement. Most prefectures commission hospital staffs in procurement hospital to be in-hospital PTC (In-Hp PTC), who make their hospital staffs be aware of organ donation and support organ procurement (see Figure 1) [2, 3].
Finally the Act was revised on 17th July in 2010 . By renewal of the Act, organs can be donated after BD with consent from their family, if he or she did not deny organ donation. Although the Act was revised in 2010 and BD organ donation increased from 13 to 44 cases in a year, the number was still extremely smaller than other developed countries. The revised Act accept organ donation from BD children younger than 15 year. However, only 158 of 504 (42.4%) procurement hospitals where BD organ donation is allowed by the Government have established organ procurement system from children. In these circumstances, In-Hp PTC may play great roles in increasing organ donation and making procurement procedure smooth.
In USA , the American Board for Transplant Certification (ABTC) provides four types of certification, depending on the area of specialty: Certified Procurement Transplant Coordinator (CPTC), Certified Clinical Transplant Coordinator (CCTC), Certified Clinical Transplant Nurse (CCTN), and Certified Transplant Preservationist (CTP). In Japan, Japanese Joint Committee for Certification of Clinical Transplant Coordinators organized by Japan Transplant Society, Japan Academy of Transplantation and Regeneration Nursing, and 5 affiliate associations, started to provide certification for clinical transplant coordinators in 2011. However, there is no certification system for PTC in Japan yet.
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(Author: Norihide Fukushima, Setsuko Setsuko Konaka, Osamu Osamu Kato, Juntaro Juntaro Ashikari