Japanese Organ Transplants

In researching yesterday’s post, I came across some information on Japanese donation that I found fascinating:

1) Donor deaths from Live Donor Liver transplantation (LDLT) in Japan is almost zero compared to 0.3% in the US.^{[1 &2]} Have the Japanese used their knowledge of car manufacturing and statistics to perfect liver transplantation? The US also lagged behind Japanese manufacturing in the 1980s which resulted in a large number of US companies to adopt statistical management methodologies–like Kaizen and Six Sigma–similar to those employed in Japanese companies in the 1990s ^[3]

2) Japan has a significantly lower donation rate from deceased donors than other countries: In 2003: 1.1 kidney transplants for every 1 million people in Japan compared with 46.7 in Spain, 32.5 in France, 29.5 in the United States and 22 in Britain.^[1]

a) This partially explains why Japan has a higher rate of live organ donation – the demand is still there, and live donors make up the difference

b) The major religions in Japan, Shintoism and Buddhism, consider death to be impure and therefore people are reluctant to receive a ‘tainted’ organ. This appears to be in contrast to the selflessness typically associated with  Japanese culture, and I’m surprised the culture hasn’t successfully modified the religious belief.[1]

c) The Japanese culture hasn’t embraced the idea of ‘brain dead’. The United States only recently, in 1981 in fact, created a legal definition of brain death.^[4] For the liver specifically, the organ transplantation is much more successful from a brain dead donor than from a heart dead donor. Other organs, such as lungs, hearts, and kidneys have machines that keep them fresh outside the body, and/or have a smaller difference in survival rate between brain and heart death.

References:
[1]  http://www.japantimes.co.jp/news/2012/11/11/national/japans-live-organ-donors-enjoy-better-health-than-normal-citizens-do/
[2] http://srtr.transplant.hrsa.gov/annual_reports/2011/pdf/03_%20liver_12.pdf
[3] http://www.pqa.net/ProdServices/sixsigma/W06002009.html
[4] http://en.wikipedia.org/wiki/Brain_death#Legal_history