Backgrounds: Heart transplantation had been withheld for long time in Japan. In October 1997, organ transplant legislation was implemented and heart transplantation began. In February 1999, the first heart transplantation was performed. Since then a total of 17 successful transplantations were done. Methods: This report describes the profiles of heart transplant applicants presented to the Heart Transplant Candidate Registry Committee of the Japanese Circulation Society from 1997 to 2003. Results: Two hundred eighty-four applications were submitted to the Committee for the evaluation. All applicants were below 60 years old with a mean of 32. Ninety-two% of these applicants had chronic severe heart failure with NYHA III or IV. The etiology of heart failure was dilated cardiomyopathy in 80% of the total applicants and only 6% had ischemic heart disease, which is a big contrast to western countries. Most applicants died while waiting for transplantation and only 17 patients underwent heart transplantation with an average waiting time of 514 days. The prognosis of the recipients was satisfactory, demonstrating 100% survival. Conclusion: In Japan heart transplant is not yet considered to be treatment options of severe heart failure.
