DCD for Kidney Transplantation

The concept of brain death was introduced with the Harvard criteria in 1968 [1]. However, brain dead (DBD) donors were not used for organ transplantation in Japan until the enforcement of the Japanese Organ Transplant Law in 1997. Therefore, prior to this, all cadaveric kidney transplantations were performed using DBD donors according to the law regarding DCD for cornea and kidney transplantation. Due to a severe shortage of deceased donors, kidney transplantation is mainly performed using living donors in Japan. Changes in the number of kidney transplantation (Fig. 14.1) showed 212 patients underwent kidney transplantation from deceased donor in 2011, while 1,389 patients underwent living donor kidney transplantation [2]. Even after the enforcement of the Japanese Organ Transplant Law in 1997, the number of DBD donors remained low, such were only several donors per year. Although the number of DBD donors has been increased since the enforcement of the revised Japanese Organ Transplant Law in July 2010, deceased donor kidney transplantation is still mainly performed from DCD donors. Therefore, a history of deceased donor kidney transplantation is almost equal to the history of kidney transplantation using DCD donors.