Tadamasa Goto—UCLA

Tadamasa Goto’s relationship with UCLA was shaped by a life-threatening need for a liver transplant and an extraordinary route to receiving one: Goto offered intelligence to the FBI in exchange for a visa to enter the United States for treatment. He underwent surgery at UCLA in 2001 and returned to Japan later that year. The account makes the transplant consequential not only as a medical intervention, but as the center of unresolved questions about intelligence bargaining, scarce organs, the identities of other patients, and the possible origins of money paid to the hospital.

Medical Need and the Route to UCLA

In January or February 2001, doctors at Showa University told Goto that he would die unless he received a liver transplant soon. He had hepatitis C and a heart condition, and the account describes him as a very unlikely transplant candidate in Japan. The urgency of his condition set the terms for the approach that followed: he needed access to treatment in the United States, where he could seek a transplant at UCLA.

In April, Goto approached the FBI through Hoshi Hitoshi, a former fixer with deep connections to Japan’s Liberal Democratic Party. The FBI wanted information on important yakuza figures because Japan’s National Police Agency had refused to share that information, citing privacy concerns. Goto offered a comprehensive list of Yamaguchi-gumi members, related front companies and financial institutions, and information on North Korean activities. In exchange, he wanted a visa to travel to the United States for treatment at UCLA.

The account distinguishes the visa arrangement from the medical care itself. Goto had arranged the UCLA treatment on his own; the FBI did not provide him with a liver. Rather, the FBI pressured U.S. immigration authorities to issue a visa, which they did reluctantly. UCLA provided the transplant care after Goto gained entry to the country. The transaction thus connected federal intelligence interests to a patient’s access to a hospital without making the FBI the provider of his medical treatment.

Transplant and Unequal Returns

The surgery took place on July 5, 2001. Goto supplied only a fraction of the information he had promised, then returned to Japan and did not speak to the FBI again. The account presents the arrangement as a poor result for the bureau but a major success for Goto: he secured the treatment he needed, left the United States, and was back in Japan before the end of the year, healthier than before. There were no records of his return to Japan, a detail that further complicated the official trail described in the book.

The financial account is also uncertain. Goto reportedly told an associate that he paid a total of $3 million for the liver. Police reports gave a lower figure of $1 million and speculated that his doctor received $100,000 for each visit to Japan, usually made at the Imperial Hotel. These figures are reported claims, not a settled accounting of the transplant’s cost or of who received each payment. The book notes that knowledge of Goto’s FBI deal was confined to his inner circle.

Other Patients and Organ-Allocation Questions

Materials about the Yamaguchi-gumi led the narrator to suspect that Goto was not the only yakuza figure to receive a liver transplant at UCLA; there were probably three others. The reported patients included Yoshiro Ogino, a gang boss in the Matsuba-kai and Goto’s blood brother; Hisatoshi Mio, a name supplied by Shibata; and Saburo Takeshita, a financial figure associated with Goto-gumi. Ogino allegedly donated $100,000 to UCLA after his surgery. A footnote adds that, to the narrator’s knowledge, the other three did not make deals with the FBI and entered under false names or false pretenses. Goto may have helped them reach UCLA, but how they were placed on the transplant waiting list remained unclear.

The possibility of four Japanese patients with yakuza ties sharpened the ethical stakes. Japan had a stringent transplant system, few donors, and relatively rare operations; people needing organs often had to leave the country or die waiting. From the American perspective, the account asks whether Japanese criminals may have received access ahead of law-abiding U.S. patients. That question concerns allocation and fairness, not proof that any individual patient was medically undeserving or that UCLA violated its rules.

Findings, Uncertainty, and Significance

UCLA and Dr. Busuttil said they did not make moral judgments about patients and treated them according to medical need. It was never proven that either knew, at the time of the transplants, that any of the patients had ties to the Japanese mafia. They did not explicitly deny knowing of those ties, but declined to address what they knew or when they knew it. An investigation conducted by the U.S. Centers for Medicare and Medicaid Services together with UCLA found no evidence of improper conduct by the medical center or its staff. That finding did not resolve the broader moral dispute over giving organs to foreign patients with criminal records, nor did it establish what UCLA knew about the patients’ affiliations.

A separate concern arose from the money. Federal law-enforcement sources suggested that UCLA might unknowingly have become involved in money laundering if payments from patients with yakuza ties came from criminal proceeds in Japan. The account presents this as a possibility, not a proven offense: to the narrator’s knowledge, none of the four patients had been investigated for money laundering, and such an inquiry would require cooperation from Japanese authorities. It also remained unknown whether UCLA knew of the patients’ yakuza ties or whether any payments or donations derived from illegal activity.

The relationship between Goto and UCLA therefore remains defined by a contrast between a completed medical outcome and unanswered institutional questions. Goto’s need was urgent, his access depended on a visa secured through an intelligence bargain, and UCLA performed the transplant; later reporting raised issues of scarcity, disclosure, and financial scrutiny without demonstrating misconduct by the hospital. The book preserves that distinction: the existence of troubling questions is not the same as proof of wrongdoing.