In November 2006, 42 patients were revealed to have received kidneys transplanted from unrelated living donors suffering from renal diseases. The procedures took place in a few hospitals within a restricted area in Japan, and all were performed by one doctor. There was no ethical discussion in the hospitals nor any reports to the public. In March 2007, the four main medical societies of Japan announced their opposition to such cases on the basis that it was not medically acceptable to transplant diseased kidneys.
The doctor responsible for the controversial procedures justifies the transplantations based on the right to self-determination of both donors and recipients. He also asserts that it will help solve the organ shortage crisis. In spite of the opposition of main medical societies, he and his group continued this method of transplantation as a clinical study at their hospitals. 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.
In 2016, the team reapplied to the Ministry of Health, Labour and Welfare of Japan for this method to be adopted as advanced medical care. Several patient groups and legal scholars support the position. Others 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”. On the other hand, it is particularly controversial due to low survival rates of renal transplantation recipients and grafts from living donors with preexistent renal diseases.
The conflicts are fundamentally linked to the lack of legal regulations on living organ transplantation in Japan.
A Workshop has been convened to discuss the issues surrounding “diseased kidney transplantation”, including the necessity and validity of legalizing living donor organ transplantation and the legal position in foreign countries.
The event 'Workshop on the legal issues of "Diseased Kidney Transplantation": A Possibility of extended criteria donors' will be held on 11 December; organised by Prof. Yuji Shiroshito (recent Visiting Scholar with the LML; Hokkaido University) and attended by Dr. Matt Dyson (University of Oxford; research collaborator with LML), who will be a keynote speaker.