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Workshop on “Diseased Kidney Transplantation”: legal issues surrounding 'extended criteria' donors

last modified Dec 22, 2016 11:27 AM

In July 2007, the administrative guideline of the Ministry of Health, Labour and Welfare of Japan introduced a new clause prohibiting doctors from transplanting a “diseased kidney” except as part of clinical research. Several patient groups and some legal scholars support this position, while other legal scholars assert that “diseased kidney transplantation” lacks medical indication or medical adequacy (lege artis) and does not constitute a “justification of injury (with consent)”.

Transplanting diseased kidneys could be said to be part of the recent development of “extended criteria (or marginal) donors”, and it is particularly controversial due to low survival rates of renal transplantation recipients and grafts from living donors with pre-existent renal diseases. The conflicts are fundamentally linked to the lack of legal regulations on living organ transplantation in Japan.

Against this backdrop, a workshop organised by Prof. Yuji Shiroshito (recent Visiting Scholar with the LML; Hokkaido University) was convened on 11 December 2016 to discuss the issues surrounding “diseased kidney transplantation”. These included the necessity and validity of legalising living donor organ transplantation and the legal position in foreign countries.

Guest speakers included Dr. Matthew Dyson (University of Oxford; research collaborator with LML), Prof. Chul Woo Yang, M.D. (Cathoric University of Korea), and Prof. Junichiro Okuda (Sophia University, Japan). Dr. Dyson asserted that transplantation which transmitted disease should be mainly regulated by negligence and product liability, and spoke about the possibility of the "first party insurance system" as an alternative to tortious liability; Prof. Yang questioned whether using diseased (but repaired) kidneys was really needed to relieve the chronic organ shortage in Japan; and Prof. Okuda pointed out some problems from bioethical viewpoints.

The presentations and subsequent discussion were very well-received, and the LML looks forward further collaboration on future projects.