Post Istanbul Declaration

: In May, 2008, the Istanbul Declaration calling for completely against organ traffic and for self-sufficiency in organ donation was presented by a Steering Committee convened by The Transplantation Society (TTS) and the International Society of Nephrology (ISN) under the cooperation with WHO. The chief principles are to spread cadaver transplant worldwide for prevention of improper organ donation, and to protect and secure living organ donors. On the other hand, in Japan brain-dead transplantation had been legalized in 1997. Since the first Organ Transplant Law went into effect without sufficient common view of brain death as legal death, autonomy of donor has taken top priority, and it imposed donors on preconditions to sign a donor card indicating the willingness to donate their organs. However, the lowest rate of organ donation has been kept annually. All heart transplant in children had been done in other countries. In 2009, the point issue of self-sufficiency in organ donation in the Istanbul Declaration directly affected the revised law in Japan. Now, the newly passed law reaches a world standard. It is a start line to reconsider the reason why the brain-dead transplant has not been accepted by Japanese society and to move self-sufficiency in organ donation. There is also a pressing need to develop new medical treatment or technology which requires no organ donation.