144 - Donor & Recipient

【ドナーとレシピエント、donaa to reshipiento】

When a patient must undergo organ transplant surgery due to a serious disease of some kind, the patient who is expected to receive the organ is called the "recipient" and the provider is called the "donor".

Donors can be healthy people who donate parts of themselves to people with serious illnesses, as in bone marrow and liver transplants, or they can donate organs after brain death or shortly after death.

Especially in the latter case, a donor is a person who has indicated their willingness to donate their organs after death through a letter that declares their intent or a will written before death in order to confirm the person's wishes.

The following organs can be donated after brain death: heart, lungs, liver, kidney, pancreas, and small intestine; also, the liver, pancreas, and cornea can be transplanted after cardiac arrest.

However, in both cases, the donation of organs is not possible without the consent of the family. In the case of liver and cornea transplants, even if the donor has not left a declaration of intent, they can still donate their organs after death if their family consented to the operation.

When a donor becomes available for transplant surgery, the recipient is selected equitably based on blood type, weight, and urgency of the procedure, and then the transplant is performed as soon as possible.

It may be natural for the recipient to want to know the donor, or for the donor to want to know if the recipient is living well, but the risk that this will create a conflict of interest or some kind of trouble between the two parties, as well as the need to protect the privacy of both, must be taken into consideration. Giving information about the donor and recipient to each other is currently forbidden.

However, there is a growing trend in other countries for donors and recipients to exchange necessary information when both parties wish to do so.

107 - Heart Transplant

【心臓移植、shinzou-ishoku】

The procedure of replacing one's own heart with another, donated by a brain-dead person, for the treatment of heart disease is generally called a heart transplant.

A heart transplant can only be performed if the patient has severe heart disease, there is no other option but a transplant, the patient has been judged to have little time to live, the patient is physically and mentally able to endure the operation and subsequent treatment, and the patient and their family give their consent.

The world's first heart transplant was performed in South Africa in 1967, but unfortunately, the patient died 18 days after the operation. The following year, 102 heart transplants were performed worldwide, many of which failed due to organ rejection.

However, with the introduction of the new immunosuppressant drug cyclosporine in the 1980s, the success rate of heart transplants improved significantly. Today, more than 4,000 heart transplants are performed annually worldwide, and about 70 percent of them are successful.

The human body has an immune system that attempts to eliminate foreign substances whenever they enter the body. Organ rejection occurs when the transplant of another person's heart results in the body's attempt to eliminate it due to considering it a foreign substance.

In order to suppress the rejection reaction, immunosuppressive drugs must be taken after the surgery, which also lowers immunity to other viruses, so the patient must undergo repeated tests and lifestyle restrictions after surgery.

In addition, since the current Japanese law stipulates that donors must be at least 15 years old to donate organs, including the heart, after brain death, there is a problem of not being able to provide heart transplants for children with congenital diseases.

103 - Shuten-douji

【酒吞童子、shuten-douji】

[Lit. Sake-drinking boy]

A legendary oni said to have lived on Mount Ooe in the province of Tanba during the Heian period (794-1185), famous for appearing in the "Otogi-zoushi" and the song "Ooeyama".

Shuten-douji was already inhuman from the time of his birth, as evidenced by the fact that he remained in his mother's womb for three years.

He grew up in a mountain temple until he eventually stabbed a Buddhist priest to death, then moved to Mount Hiei, but he was driven out and settled in Mount Ooe, where he began appearing in the capital at night to kidnap women and children.

Angered by the wickedness of Shuten-douji and his minions, the emperor of the time ordered Minamoto no Yorimitsu (a.k.a. Minamoto no Raikou) to exterminate Shuten-douji. Yorimitsu headed for Mount Ooe with his four Heavenly Kings: Sakata no Kintoki (famously known as Kintarou), Watanabe no Tsuna, Usui Sadamitsu, and Urabe no Suetake.

On the way to Mount Ooe, Yorimitsu and his men, disguised as mountain priests, obtain a special sake, which is said to instantly intoxicate and knock out demons if consumed. Pretending to be lost, Yorimitsu and his followers enter the demons' territory and offer them sake in return for a night's lodging, which they drink without suspecting. In no time at all, the demons were drunk and fell asleep. Taking advantage of this opportunity, Yorimitsu and his men defeated the demons one after the other, and even Shuten-douji was finally beheaded.

But their relief was short-lived, for the head of Shuten-douji, even after being severed, leaped at Yorimitsu. But it remained stuck to his hard armor, and eventually stopped moving.

It is said that the head of Shuten-douji stopped moving when it was about to be brought back to the capital and was buried in Mount Ooe, where it is still enshrined today as Kubizuka-daimyoujin. [Kubizuka is a specific type of burial mount where decapitated heads are buried.]

There are also various speculations as to the true identity of Shuten-douji, such as that he was a bandit who lived in Mount Ooe at that time, or that he was a ferocious mountain-dwelling creature, or that he was a pestilence-spreading god.