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New Technologies Give New Hope to Patients

February 3, 1999

The Organ Transplant Law, which stipulates the conditions required to remove organs from a brain-dead donor for transplant, heightened awareness of the need for transplants and the issues related to them when it was enacted in June 1997. Now artificial organs, too, are attracting the attention of people urgently awaiting transplants. Development of artificial organs in Japan is focusing not only on the obvious aspects of safety and performance, but also on ways to enhance the quality of life so that transplant recipients can live more comfortably.

Making Artificial Hearts Smaller, Better
Heart transplants are urgently needed by patients suffering from dilated cardiomyopathy--a condition that keeps the heart's left ventricle from contracting properly--and other cardiac ailments. Battery-powered cardiac assist devices including an external control device and an implanted blood pump are used in the treatment of severe heart disease. These devices are used temporarily on patients diagnosed with acute cardiac failure who are expected to quickly regain their normal cardiac function. Loaded into a hand-held carrying case, the control device and battery weigh a full 2.7 kilograms (5.9 pounds). Add the fact that the batteries last only four or five hours and it becomes clear why cardiac assist devices are ill suited for long-term use.

That is why two universities and a medical institution have teamed up with a private research institute to develop an implantable total artificial heart (TAH): a self-contained unit that does not require replacement for three to five years. Researchers hope to have this device in practical use by 2005. This system employs an embedded drive unit that receives power from an external source without using wires. Researchers are working on different technologies for use in the TAH units, hoping to develop implants that do not cause clotting or other adverse effects.

Artificial Options for Larynxes, Lenses
Another artificial organ developed in Japan is the world's first electric larynx capable of intonation--on sale since April 1998. Artificial larynxes are inserted under the jaw to generate a vibration in the oral cavity, offering people who have had their larynx removed because of cancer or other reasons a means of regaining their voice. But many users complain that conventional artificial larynxes produce an unsettling, robot-like voice. This spurred the development of a device that is placed in an opening in the trachea where it senses fluctuations in breath, which it uses to create intonation in the voice. This new artificial larynx has received rave reviews from recipients who had previously shied away from speaking in front of people.

For the eyes, a common treatment for cataracts is to replace the eye's natural lens with an artificial implant. Ultrasonic waves are used to pulverize the inner part of the natural lens, which is then sucked out. An artificial lens, which measures about six millimeters (0.25 inches) in diameter and resembles a hard contact lens, is then inserted into the empty space. Debate persists, however, on their suitability for younger people, as the useful lifetime of these lenses has not yet been ascertained. Other shortcomings include the inability to adjust the focus. But according to one ophthalmologist, "Thanks to research advances, artificial lenses are becoming more and more like the real lenses in the human eye."

Increasing Options for Patients
The technological advances in artificial organs are good news for people suffering from various maladies. For many people, however, an organ transplant remains the only possible treatment. One doctor who uses cardiac assist devices to treat heart patients says he would prefer to use the devices only until a heart becomes available for transplant. Patients themselves would benefit most from a broader range of available treatments.

Despite the 1997 enactment of the Organ Transplant Law, as of the end of 1998 there had been no transplants in Japan. Two stumbling blocks have been identified: the ineffective distribution of donor cards and the fact that organs can be used only when brain death is declared at a designated donor hospital. The Japanese medical community is working hard to deal with these obstacles even as it continues to make further progress in the field of artificial organs.

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Trends in JapanEdited by Japan Echo Inc. based on domestic Japanese news sources. Articles presented here are offered for reference purposes and do not necessarily represent the policy or views of the Japanese Government.

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