Introduction: Although organ procurement has been regulated by The Organ Transplantation Act since 1978, there has been no Act or governmental procurement network of tissue transplantation in Japan. Since the late 1980s, some university hospitals developed original banks. Finally, in 2001 guidelines for tissue procurement were established by The Japanese Society of Tissue Transplantation and East and West Japan Tissue Transplant Network (JTTN) started to coordinate harvesting of heart valves, bone, skin and islet. Because the size of tissue banks is small and the number of tissue transplant coordinators (TTCo) is few, every bank cooperates together on tissue procurement, but they cannot entirely cover Japan. The West -JTTN started to establish cooperation programs including education of TTCos, procurement surgeons and regional organ transplant coordinators (OTCos) since 2015. The aim of this study was to clarify the effects of these trials on heart valve procurement in Osaka, Hyogo and Nara, which were the region covered by the tissue bank of National Cerebral and Cardiovascular Center (NCVCTB).
Method: The West JTTN has an office at NCVC and organizes monthly meeting to discuss cooperation system and every potential tissue donor in the three regions with 5 TTCos and 8 regional OCTCos in west Japan, 2-day education program twice a year (Lectures, Role play, etc.) for TTCos and regional OCTos and 1-day education program twice a year (Lectures, Hands-on of heart valve procurement and trimming of valves, etc.) for cardiovascular surgeons of NCVC and 8 institutes in west Japan. We asked to Japan Organ Transplant Network (JOT) to give us information of potential donor as soon as possible.
Results: The number of referrals of potential donor to NCVCTB from JOT or regional OCos and the number of obtaining consent to heart valve donation increased from 12 and 1 in 2013 to 41 and 19 in 2017, respectively. The tissue procured increased from one aortic valve (AoV) and one pulmonary valve (PV) in 2013 to 8 AoVs, 8 PVs and 15 aortas in 2017. Especially brain-dead donor tissue donation increased from none in 2013 to 8 in 2017, which were performed cooperatively with JOT.
Conclusion: Cooperation programs including education of TTCo and regional OTCos and collaboration with JOT may have a role in increasing heart valve donation.