The first organ transplant in Japan took place at
Niigata University in 1956 when a kidney was temporarily transplanted to a patient with acute renal failure. In 1964 a permanent and full-scale
kidney transplant was successfully undertaken at the
University of Tokyo, and by 1992 nearly 9,000 kidney transplants had taken place. In the same year, a
liver transplant was performed at
Chiba University by Professor Komei Nakayama. The first heart transplant in Japan was conducted at
Sapporo Medical University in 1968 by Juro Wada. This operation attracted concerns that Wada's evaluation of brain death was inappropriate, and even though an investigation of possible criminal liability was dismissed, a distrust of organ transplanting developed, particularly of transplants from brain dead donors. This brought subsequent developments in transplanting to a halt. The 1997 law required dead donators to be over 15 alongside both written donor consent and family approval. The 2010 revision removed the age limit and made the system opt-out while retaining the need for family approval. Additionally dead donors could designate comparable family members as priority recipients beforehand. The law change resulting in a change of 7.2 dead donors per year between 1999 to 2010 to 53.4 between 2010 to 2016. The amount of dead donors fell during the
Covid-19 pandemic, but has rebounded with 150 cases in 2023.
Paediatric heart transplants are rare, resulting in transplant tourism to North America, where most foreign paediatric heart transplant receivers are Japanese. helps to educate and obtain consent from donor's families, transport organs and select recipients among other related activities. It has helped with potential donors declaring intent. Akabayashi et al. gives reasons for the relatively low amount of dead transplants as the low need due to live transplantations being common due to familism and national insurance coverage reducing the need, and the need for family consent. ==Cultural attitudes==