Nagahiro Shinji
Department of Neurosurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Brain Nerve. 2010 Jun;62(6):575-81.
The revised act on organ transplantation was passed in July 2009; it will be implemented in July 2010. This law allows organ donation from a brain-dead person with or without an Organ Donation Decision Card, if the family members permit this donation and the brain-dead person had not decided against it when conscious. In Japan, the legal definition of human death has not changed after the revision of the act on organ transplantation; therefore, brain death is considered human death for the purpose of organ transplantation. Certain minor revisions are required in the medical and legal criteria for diagnosis of brain death, especially for children under 6 years. Ancillary tests, including radioisotope measurement of cerebral blood flow and auditory brainstem evoked potentials, should be considered for younger children or in cases where comprehensive neurological examination was not possible because of injuries to the face, eyes, or ears. An increase in the number of organ donations from brain-dead persons because of the revised act will greatly increase the responsibility of and burden on hospitals and neurosurgeons that treat many emergency cases of severe brain injury and stroke. Adequate socioeconomic and systemic medical support should be provided to hospitals where organ donation is carried out.
修订后的《器官移植法》于2009年7月通过，将于2010年7月实施。该法律允许在家庭成员同意且脑死亡者在意识清醒时未明确表示反对的情况下，无论是否持有器官捐赠决定卡，均可从脑死亡者身上摘取器官。在日本，器官移植法修订后，人类死亡的法律定义并未改变；因此，就器官移植而言，脑死亡被视为人的死亡。脑死亡诊断的医学和法律标准需要进行某些细微修订，尤其是对于6岁以下儿童。对于年幼的儿童或因面部、眼睛或耳朵受伤而无法进行全面神经学检查的情况，应考虑进行包括放射性同位素测量脑血流量和听觉脑干诱发电位在内的辅助检查。由于修订后的法律，脑死亡者器官捐赠数量的增加将大大增加治疗许多严重脑损伤和中风急诊病例的医院及神经外科医生的责任和负担。应为进行器官捐赠的医院提供充分的社会经济和系统医疗支持。
