Development of ventricular assist device and heart transplantation in Japan: How people worked

A Cooperative Environment for Ventricular Assist Device Development and Application: The Japanese Experience

“…The first heart transplantation (HTx) in Japan occurred in 1968, about eight months after the world’s first case in South Africa. However, the event fell into controversy regarding brain death and medical indication, leading to the interruption of organ transplantation from brain-dead donors for the next three decades [ 1 ] . The Japanese Organ Transplant Act came into effect in 1997, and the restart of HTx took place in Osaka, in 1999, under new legislation.…”

“…The Japanese Organ Transplant Act came into effect in 1997, and the restart of HTx took place in Osaka, in 1999, under new legislation. Two of the three transplanted patients were bridged by ventricular assist devices (VADs), with the first by a Novacor implantable VAD and the second by a Toyobo paracorporeal VAD [ 1 , 2 ] . At that time, Novacor had already finished the official trial (started in 1996), and the first patient was supported for compassionate use by courtesy of Medtronic.…”

“…At that time, Novacor had already finished the official trial (started in 1996), and the first patient was supported for compassionate use by courtesy of Medtronic. The Toyobo VAD, implanted in the second HTx patient, was first applied to a postcardiotomy patient in 1982, and as bridge to transplantation in 1992 by an overseas transfer of a patient from Osaka (Japan) to Houston (United States of America) [ 1 - 4 ] . With the revision of the transplant law in 2010, accepting the donation without donor’s written will, the number of HTx rose sharply from 10 per year (before revision) to 44 in 2015 and to 70 in 2019.…”

“…With the revision of the transplant law in 2010, accepting the donation without donor’s written will, the number of HTx rose sharply from 10 per year (before revision) to 44 in 2015 and to 70 in 2019. The cumulative number of HTx in Japan has reached a total of 476 in 2019, with an impressive number of 449 patients bridged by VADs [ 1 , 2 ] . The development of VADs started very early in Japan, considering the historical absence of organ donation for HTx until the regulatory law of 1997.…”

“…The development of VADs started very early in Japan, considering the historical absence of organ donation for HTx until the regulatory law of 1997. At the beginning, research efforts were conducted for the development of extracorporeal VADs, headed by two groups, one at the University of Tokyo (UT) and the other at the National Cardiovascular Center (NCVC) [ 1 , 3 ] . The UT project started in the early 1970s and released a pneumatic sack-type pulsatile extracorporeal VAD, in collaboration with Tohoku University, Nippon Zeon, and Aishin Seiki corporations.…”