At age 56, Toshinobu Horiuchi was a desperate man. He had suffered kidney failure and needed a transplant. As a doctor, based in Tokyo, he knew better than most that he faced a long wait. In Japan, nearly 13,000 people, according to the Japan Organ Transplant Network (JOTN), were waiting for a kidney transplant last year, but in the first half of 2011 only 186 kidney transplants were carried out.