Some problems on the organ transplantation in Japan from the viewpoint of the neurocritical care units

The authors have referred to several issues encountered in the neuroemergency and critical care facilities in our country through the declaration of brain death to the successful removal of organs for donation. One of the most important is the fact that the legal validity of death in brain dead patients is only assured when the patient shows the advance directive for organ donation in Japan. So far as the selection of the recipient is not started until the brain death is declared legally, longer than 12 hours are to be spent in vain between the declaration of brain death and the beginning of the operation of removing the organs for donation. As there remain such several problems to be solved as mentioned above for organ donation in Japan, so it is suggested that the medical sciences and ethics should be respected and adopted in the rules for the organ donations by the national government.