Japanese organ transplant law: a historical perspective.

Although organ transplantation following brain death has progressed in the West, it has lagged far behind in Japan, following the first such case in 1968. As effective immunosuppressants made transplantation a better option, Japanese patients increasingly sought treatment overseas. Japanese physician groups studied issues related to transplantation but did not succeed in making brain-dead donor transplants available to patients, and the matter was referred to the government. However, transplant medicine was still marked by controversy, and as political pressure was applied the controversy deepened, splintering public opinion. At the same time, transplant groups continued working to establish structures to allow transplantation to proceed. Public awareness and knowledge of brain death grew, and acceptance widened. Eventually, legislation was passed in June 1997 that allowed organ donations from some brain-dead donors. The law is restrictive, and such organ transplants in Japan are still limited.