Interim report of the Japanese original donor evaluation and management system: the medical consultant system.
OBJECTIVE
Lung transplantation (LTx) is an established therapy for end-stage lung failure. However, in Japan, the donor organ shortage is extremely severe compared with other developed countries, because of the strict Japanese Organ Transplantation Law. To maximize LTx opportunities in Japan, we have established a special donor evaluation and management system termed the medical consultant (MC) system.


METHODS
Data from 171 lung donor candidates registered in Japan from May 1998 to May 2012 were obtained and investigated in a retrospective manner. The candidates were separated into the non-MC-intervened and MC-intervened groups, and then data regarding the PaO2/FiO2 ratio, donation rate and organ survival rate were analyzed and compared between the groups.


RESULTS
The PaO2/FiO2 ratio of the MC-intervened group was ameliorated from the time of first brain death diagnosis to organ harvest. Although the base condition of the MC-intervened group was significantly worse than that of the non-MC-intervened group, the donation rates showed no significant difference (0.64 and 0.66, respectively; p = 0.89). There was a difference in the organ survival rate between the non-MC and MC-intervened groups (5-year survival rates of 67.2 and 88.3 %, respectively; p = 0.16).


CONCLUSIONS
The MC system used for organ donor evaluation and management in Japan has achieved acceptable interim results.
Tomoyuki
T
Nakagiri
Masayoshi
M
Inoue
Masato
M
Minami
Yasushi
Y
Hoshikawa
Masayuki
M
Chida
Toru
T
Bando
Takahiro
T
Oto
Takeshi
T
Shiraishi
Naoya
N
Yamasaki
Juntaro
J
Ashikari
Yoshiki
Y
Sawa
Meinoshin
M
Okumura
D006085:Graft Survival; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016040:Lung Transplantation; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*