XV Issue 10 Organ donation from brain-dead patients has become a psychiatric issue in Japanese transplant medicine. Brain death is recognized as human death only in the context of organ transplantation in Japan. Since many Japanese physicians deny that brain death constitutes the death of an individual, there is no solid, general consensus in Japan about what constitutes brain death. Recently, even the number of kidney transplantations have been reduced as advancements in dialysis have increased the chance of survival.
Liver transplantation is a different story.
Japanese patients who know the procedure exists cannot understand why they are not able to receive transplantation. In the absence of other life-saving options, patients and their families want a transplant at any cost. However, there are other patients and families who may be reluctant to turn to such drastic measures, and would not accept a transplant even if it were offered. Japanese patients do not want to feel labeled as murderers, and may feel that the life of the donating patient is in their hands. Many of the psychiatric problems patients face concerning liver transplantation stem from the circumstances that force them to accept the transplantation.