The number of kidney transplantations performed in Japan is small, whereas the number of hemodialysis patients is approximately 140, 000, a quarter of the total of hemodialyzed patients in the world. These results reflect ethical questions raised by transplantation and are largely due to reservations that the Japanese people have toward kidney transplantation.
While hemodialysis therapy has made excellent progress in recent years, chronic renal failure therapy must be reevaluated. Lewis Thomas suggested that hemodialysis and transplantation therapies are only halfway developed as technologies because of the huge cost and efforts involved. The purpose of chronic renal failure therapy must therefore be evaluated with the cooperation of the patients concerned. It should be made possible for all chronic renal failure patients to freely choose their own therapy.
We made a survey of the opinions of hemodialysis patients relating to their choice of therapy. The results indicated that hemodialysis patients did not understand kidney transplantation. They thought, for example, that transplantation therapy was riskier than hemodialysis therapy, and that kidney transplantation would only be beneficial if there was chronic renal failure in the near future.
We concluded, as a result of the survey, that we must provide more adequate information concerning kidney transplantation, hemodialysis and CAPD, to chronic renal failure patients in the future. That is the only way to ensure expansion of kidney transplantation therapy in Japan.