研究者詳細 - 小倉　靖弘

論文 - 小倉　靖弘

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Successful living-donor liver transplantation for sustained liver failure even after resolution of infiltrative massive hepatic invasion of stage 4S neuroblastoma: a case report

Jobara, K; Yamamori, A; Shizuku, M; Kurata, N; Fujimoto, Y; Muramatsu, H; Takahashi, Y; Ogura, Y

SURGICAL CASE REPORTS 9 巻 ( 1 ) 2023年6月

Recovery From Severe Systemic Peripheral Neuropathy Secondary to Erythropoietic Protoporphyria by Liver Transplant: A Case Report

Shizuku M., Kurata N., Jobara K., Tanaka T., Fukuta A., Hatanaka M., Hara K., Katsuno M., Nakano H., Ogura Y.

Experimental and Clinical Transplantation 20 巻 ( 10 ) 頁： 954 - 958 2022年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Experimental and Clinical Transplantation

Erythropoietic protoporphyria is a rare inherited metabolic disorder involving the heme biosynthesis pathway and leads to the accumulation of protopo-rphyrin in the erythrocytes or liver. Although peripheral neuropathy is known to develop occa-sionally in other types of porphyria, it rarely occurs in patients with erythropoietic protoporphyria. A 16-year-old boy was transferred to our hospital due to end-stage liver disease secondary to erythropoietic protoporphyria. Severe systemic peripheral neuropathy, similar to that presented in Guillain-Barré syndrome, developed; it was promptly managed with mechanical ventilation. Electrophysiological assessment of the presented neuropathy showed no responsiveness, indicating severe axonopathy. Six weeks after the transfer, liver transplant was performed. Postoperatively, hepatorenal syndromes improved immediately, and his erythrocyte protoporphyrin level decreased from 6291 to 174 μg/dL red blood cells. The patient started to move his limbs gradually and was weaned from mechanical ventilation 2 months after liver transplant. Eventually, he was discharged from hospital and was able to ambulate with assistance 10 months after liver transplant. To our knowledge, this is the first report detailing the clinical course in a patient with erythropoietic protoporphyria who recovered from severe systemic peripheral neuropathy after liver transplant.

DOI： 10.6002/ect.2022.0157

Scopus

Temporal dynamics of the plasma microbiome in recipients at early post-liver transplantation: a retrospective study

Okumura T., Horiba K., Kamei H., Takeuchi S., Suzuki T., Torii Y., Kawada J.i., Takahashi Y., Ogura Y., Ogi T., Ito Y.

BMC Microbiology 21 巻 ( 1 ) 頁： 104 2021年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC Microbiology

Background: Immunosuppression during liver transplantation (LT) enables the prevention and treatment of organ rejection but poses a risk for severe infectious diseases. Immune modulation and antimicrobials affect the plasma microbiome. Thus, determining the impact of immunosuppression on the microbiome may be important to understand immunocompetence, elucidate the source of infection, and predict the risk of infection in LT recipients. We characterized the plasma microbiome of LT recipients at early post-LT and assessed the association between the microbiome and clinical events. Results: In this study, 51 patients who received LT at Nagoya University Hospital from 2016 to 2018 were enrolled. Plasma samples were retrospectively collected at the following time points: 1) within a week after LT; 2) 4 ± 1 weeks after LT; 3) 8 ± 1 weeks after LT; and 4) within 2 days after a positive blood culture. A total of 111 plasma samples were analyzed using shotgun next-generation sequencing (NGS) with the PATHDET pipeline. Relative abundance of Anelloviridae, Nocardiaceae, Microbacteriaceae, and Enterobacteriaceae significantly changed during the postoperative period. Microbiome diversity was higher within a week after LT than that at 8 weeks after LT. Antimicrobials were significantly associated with the microbiome of LT recipients. In addition, the proportion of Enterobacteriaceae was significantly increased and the plasma microbiome diversity was significantly lower in patients with acute cellular rejection (ACR) than non-ACR patients. Sequencing reads of bacteria isolated from blood cultures were predominantly identified by NGS in 8 of 16 samples, and human herpesvirus 6 was detected as a causative pathogen in one recipient with severe clinical condition. Conclusions: The metagenomic NGS technique has great potential in revealing the plasma microbiome and is useful as a comprehensive diagnostic procedure in clinical settings. Temporal dynamics of specific microorganisms may be used as indirect markers for the determination of immunocompetence and ACR in LT recipients.

DOI： 10.1186/s12866-021-02154-w

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PubMed

Psychosocial characteristics of alcoholic and non-alcoholic liver disease recipient candidates in liver transplantation: a prospective observational study

Shizuku M., Kimura H., Kamei H., Kishi S., Tokura T., Kurata N., Jobara K., Yoshizawa A., Tsuboi C., Yamaguchi N., Kato M., Kawai K., Yamashiki M., Kanai E., Ishizuka K., Ozaki N., Ogura Y.

BMC Gastroenterology 21 巻 ( 1 ) 2021年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC Gastroenterology

Background: There are long-standing controversies about the transplant indications for alcoholic liver disease (ALD), because of the recognition that ALD is fundamentally self-inflicted. However, it is unclear whether psychosocial characteristics of ALD are different from that of non-alcoholic liver disease (NALD) in the selection of liver transplantation (LT) recipients. We aimed to clarify the psychosocial characteristics of ALD recipients (ALD-R)/ALD recipient candidates (ALD-RC) and NALD recipients (NALD-R)/ NALD recipient candidates (NALD-RC). Methods: From 2011 to 2019, 75 patients were enrolled in this prospective observational study (ALD-RC, n = 19; NALD-RC, n = 56), LT were carried out as follow; ALD-R, n = 6; NALD-R, n = 52. We evaluated psychosocial characteristics in the preoperative period and 3, 12 months after LT (ALD-R, n = 3/3; NALD-R, n = 28/25). The following scales were used to evaluate psychosocial characteristics: Visual Analogue Scale, Alcohol Use Disorders Identification Test, Hospital Anxiety and Depression Scale, Beck Depression Inventory, Brief Evaluation of Medication Influences and Beliefs, Social Support Questionnaire (SSQ), Temperament and Character Inventory, Parental Bonding Instrument (PBI), the Short Form Health Survey (SF-36). Results: When evaluating on the basis of abstinence rule, a comparison of ALD-RC and NALD-RC in the preoperative period identified similar patterns of psychosocial characteristics, except that the NALD-RC scored higher on the PBI item “overprotection from mother” (P < 0.05). The only significant difference between ALD-R and NALD-R after liver transplantation was in SSQ scores at 3 months. Conclusion: The psychosocial characteristics of ALD-RC and NALD-RC may be similar when evaluated on the basis of Japan’s abstinence rule. This result also imply that the psychosocial characteristics of ALD-RC may differ from the previously reported psychosocial characteristics of alcohol dependent patients. These findings have the potential to provide helpful information for the evaluation of ALD-RC.

DOI： 10.1186/s12876-021-02032-9

Scopus

The impact of chronic Epstein–Barr virus infection on the liver graft of pediatric liver transplant recipients: A retrospective observational study

Shizuku M., Kamei H., Yoshizawa A., Ito Y., Ogura Y., Yoshikawa J., Kurata N., Jobara K., Kodera Y.

Transplant Infectious Disease 23 巻 ( 5 ) 2021年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Transplant Infectious Disease

Background: Chronic high Epstein–Barr virus loads (CHEBV) are commonly observed in pediatric liver transplant patients. However, it is unclear how CHEBV impacts the liver graft. The aim of this study was to clarify the clinical and pathological impacts of CHEBV on the liver graft. Methods: From 2012 to 2020, we retrospectively investigated 46 pediatric liver transplant patients (under 16 years) who survived ≥6 months. The patients were divided into two groups: CHEBV group (EBV DNA >10 000 IU/ml of whole blood for ≥6 months) and nonchronic high EBV (NCHEBV) group (patients who did not meet CHEBV criteria). Tacrolimus was reduced to <3.0 ng/ml in patients with EBV DNA >5000 IU/ml. Blood biochemistry data and pathological findings, obtained at the time of protocol and episodic biopsies, were compared between the two groups. Results: Out of 46 patients, 28 CHEBV and 18 NCHEBV patients were enrolled. The blood biochemical examination did not show a significant difference between the two groups. In addition, no significant differences between the two groups were found in the pathological findings, including frequency of late acute rejection and the progression of fibrosis at the time of both protocol and episodic biopsies. Appropriate adjustment of immunosuppression for CHEBV management may have contributed to the prevention of the progression of fibrosis. Conclusion: CHEBV had little adverse effect on the liver graft. Graft fibrosis might have been avoided through optimal dose modification of tacrolimus. Further long-term monitoring is necessary because CHEBV may affect the pediatric liver graft in the long term.

DOI： 10.1111/tid.13731

Scopus

Revisiting prognosis after liver transplant in patients positive for hepatitis c virus: Focus on hepatitis c recurrence-unrelated complications

Ishigami M., Honda T., Ishizu Y., Imai N., Ito T., Yamamoto K., Kamei H., Ogura Y., Fujishiro M.

Experimental and Clinical Transplantation 19 巻 ( 9 ) 頁： 935 - 942 2021年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Experimental and Clinical Transplantation

Objectives: In this study, we revisited the reasons for poorer prognosis after liver transplant in patients with hepatitis C virus, whose main causes of death were generally known to be recurrent disease. Materials and Methods: Between April 2003 and March 2017, among 132 patients who underwent liver transplant because of liver cirrhosis at our institution, 40 patients (30.3%) were positive for hepatis C virus. We retrospectively compared the overall survival after liver transplant in patients with and without hepatitis C virus infection. Furthermore, we investigated the causes of death in transplant recipients with hepatitis C virus infections. Results: In patients with hepatitis C virus infection, overall survival was 82.2%, 75.2%, and 50.8% at 1, 5, and 10 years, respectively, after liver transplant; these results were lower than those in patients without infection (94.5%, 87.0%, and 87.0% at 1, 5, and 10 years, respectively; P = .001). Among 40 patients with positive infection, 14 patients died after liver transplant. A main reason for death was hepatocellular carcinoma recurrence (3 patients). Surprisingly, only 1 patient died from hepatitis C virus-related complication (fibrosing cholestatic hepatitis); the remaining 10 patients died from reasons other than hepatitis C virus disease progression. Conclusions: Our results suggest that clinicians should not only be aware of hepatitis C virus recurrence but should also be aware of other unrelated complications in transplant recipients who are positive for this virus.

DOI： 10.6002/ect.2021.0197

Scopus

Incidental intrahepatic cholangiocarcinoma in patients undergoing liver transplantation: A multi-center study in Japan.

Hara T, Eguchi S, Yoshizumi T, Akamatsu N, Kaido T, Hamada T, Takamura H, Shimamura T, Umeda Y, Shinoda M, Ogura Y, Fukumoto T, Kasahara M, Hibi T, Umeshita K, Furukawa H, Ohdan H

Journal of hepato-biliary-pancreatic sciences 28 巻 ( 4 ) 頁： 346 - 352 2021年4月

A novel anatomic variation of the intrahepatic biliary tree in live liver donor surgery: A case report

Shizuku Masato, Kurata Nobuhiko, Jobara Kanta, Yoshizawa Atsushi, Ogura Yasuhiro

INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS 79 巻頁： 231 - 233 2021年

De novo hepatocellular carcinoma in living donor liver grafts: A Japanese multicenter experience.

Goto R, Kosai-Fujimoto Y, Yagi S, Kobayashi T, Akamatsu N, Shimamura T, Imura S, Ogiso S, Mizuno S, Takatsuki M, Fukuhara T, Kanto T, Eguchi S, Yanaga K, Ogura Y, Fukumoto T, Shimada M, Hasegawa K, Ohdan H, Uemoto S, Soejima Y, Ikegami T, Yoshizumi T, Taketomi A, Maehara Y

Hepatology research : the official journal of the Japan Society of Hepatology 50 巻 ( 12 ) 頁： 1365 - 1374 2020年12月

The role of living donor liver transplantation for acute liver failure

Ogura, Y; Kabacam, G; Singhal, A; Moon, DB

INTERNATIONAL JOURNAL OF SURGERY 82 巻頁： 145 - 148 2020年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：International Journal of Surgery

Acute liver failure (ALF) is a life-threatening illness that occurs in the absence of pre-existing liver disease. When symptoms seriously progress under continuous supportive medical care, liver transplantation becomes the only therapeutic strategy. However, the available sources of organs for liver transplantation differ worldwide. In regions in which organs from cadaveric donors are more common, deceased donor liver transplantation (DDLT) is performed in this urgent situation. Conversely, in countries where cadaveric donors are scarce, living donor liver transplantation (LDLT) is the only choice. Special considerations must be made for urgent LDLT for ALF, including the expedited evaluation of living donors, technical issues, and the limitations of ABO blood type combinations between recipients and donor candidates. In this review, we highlight the role of LDLT for ALF and the considerations that distinguish it from DDLT. LDLT is well-established as a life-saving procedure for ALF patients and there is often no alternative to LDLT, especially in countries where DDLT is not feasible. However, from a global perspective, an increase in the deceased donor pool might be an urgent and important necessity.

DOI： 10.1016/j.ijsu.2020.04.058

Web of Science

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PubMed

Revisiting the indications for liver transplantation in cirrhotic patients considering the long-term outcomes of cirrhotic patients

Ishigami M., Honda T., Kuzuya T., Ishizu Y., Ito T., Kamei H., Ogura Y., Fujishiro M.

Journal of Hepato-Biliary-Pancreatic Sciences 27 巻 ( 9 ) 頁： 655 - 662 2020年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Hepato-Biliary-Pancreatic Sciences

Background: In this study, we investigated long-term survival of cirrhotic patients without hepatocellular carcinoma (HCC) and the proper timing of liver transplantation in the era with recent progress of management. Methods: We first classified 217 non-transplant cirrhotic patients without HCC according to the long-term survival based on Child-Turcotte-Pugh (CTP) scores and the MELD scores. We then compared them with the survival after liver transplantation in 114 patients with liver cirrhosis. Results: We classified into four groups (class A as CTP score of 5,6, B as 7,8, C as 9-12, D as 13-15) according to the long-term survival of the patients, the survivals of patients with class C and D were significantly worse compared with transplant patients (P < 0.001 in each group). And we also classified into four groups based on the MELD scores (class A as MELD score of −8, B as 9-12, C as 13-19, D as 19-), the survivals of patients with class C and D were significantly worse compared with those of transplant patients (P < 0.001 in each group). Conclusions: Considering the long-term survival of patients with liver cirrhosis, CTP score of 9 and/or MELD score of 13 could be a proper timing for liver transplantation.

DOI： 10.1002/jhbp.777

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PubMed

Portal Vein Stenosis Following Liver Transplantation Hemodynamically Assessed with 4D-flow MRI before and after Portal Vein Stenting.

Hyodo R, Takehara Y, Mizuno T, Ichikawa K, Ogura Y, Naganawa S

Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine 2020年8月

Laparoscopic Kasai portoenterostomy is advantageous over open Kasai portoenterostomy in subsequent liver transplantation

Shirota Chiyoe, Murase Naruhiko, Tanaka Yujiro, Ogura Yasuhiro, Nakatochi Masahiro, Kamei Hideya, Kurata Nobuhiko, Hinoki Akinari, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Oshima Kazuo, Uchida Hiroo

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 34 巻 ( 8 ) 頁： 3375 - 3381 2020年8月

Computational Fluid Dynamics-Based Blood Flow Assessment Facilitates Optimal Management of Portal Vein Stenosis After Liver Transplantation

Ogiso Satoshi, Nakamura Masanori, Tanaka Takashi, Komiya Kenji, Kamei Hideya, Onishi Yasuharu, Jobara Kanta, Kurata Nobuhiko, Itatani Keiichi, Ogura Yasuhiro

JOURNAL OF GASTROINTESTINAL SURGERY 24 巻 ( 2 ) 頁： 460 - 461 2020年2月

Clinical Features and Long-Term Outcomes of Living Donors of Liver Transplantation Who Developed Psychiatric Disorders

Shizuku Masato, Kamei Hideya, Kimura Hiroyuki, Kurata Nobuhiko, Jobara Kanta, Yoshizawa Atsushi, Ishizuka Kanako, Okada Aoi, Kishi Shinichi, Ozaki Norio, Ogura Yasuhiro

ANNALS OF TRANSPLANTATION 25 巻頁： e918500 2020年1月

Decreased long-term graft survival in persistent biliary complications after right-lobe living-donor liver transplantation

Ogiso Satoshi, Kamei Hideya, Onishi Yasuharu, Kurata Nobuhiko, Jobara Kanta, Kawashima Hiroki, Ogura Yasuhiro

CLINICAL TRANSPLANTATION 34 巻 ( 1 ) 頁： e13771 2020年1月

Budd-Chiari Syndrome Associated With Hypereosinophilic Syndrome Treated by Deceased-Donor Liver Transplantation: A Case Report

Shizuku Masato, Kurata Nobuhiko, Jobara Kanta, Yoshizawa Atsushi, Kamei Hideya, Amano Nozomi, Genda Takuya, Ogura Yasuhiro

TRANSPLANTATION PROCEEDINGS 51 巻 ( 9 ) 頁： 3140 - 3146 2019年11月

Splenectomy in living donor liver transplantation and risk factors of portal vein thrombosis

Kurata, N; Ogura, Y; Ogiso, S; Onishi, Y; Kamei, H; Kodera, Y

HEPATOBILIARY & PANCREATIC DISEASES INTERNATIONAL 18 巻 ( 4 ) 頁： 337 - 342 2019年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Hepatobiliary and Pancreatic Diseases International

Background: Graft inflow modulation (GIM) during adult-to-adult living donor liver transplantation (LDLT) is a common strategy to avoid small-for-size syndrome, and some transplant surgeons attempt small size graft strategy with frequent GIM procedures, which are mostly performed by splenectomy, in LDLT. However, splenectomy can cause serious complications such as portal vein thrombosis and overwhelming postsplenectomy infection. Methods: Forty-eight adult-to-adult LDLT recipients were enrolled in this study and retrospectively reviewed. We applied the graft selection criteria, which routinely fulfill graft-to-recipient weight ratio ≥ 0.8%, and consider GIM as a backup strategy for high portal venous pressure (PVP). Results: In our current strategy of LDLT, splenectomy was performed mostly due to hepatitis C and splenic arterial aneurysms, but splenectomy for GIM was intended to only one patient (2.1%). The final PVP values ≤ 20 mmHg were achieved in all recipients, and no significant difference was observed in patient survival or postoperative clinical course based on whether splenectomy was performed or not. However, 6 of 18 patients with splenectomy (33.3%) developed postsplenectomy portal vein thrombosis (PVT), while none of the 30 patients without splenectomy developed PVT after LDLT. Splenectomy was identified as a risk factor of PVT in this study (P < 0.001). Our study revealed that a lower final PVP could be risk factor of postsplenectomy PVT. Conclusions: Using sufficient size grafts was one of the direct solutions to control PVP, and allowed GIM to be reserved as a backup procedure. Splenectomy should be avoided as much as possible during LDLT because splenectomy was found to be a definite risk factor of PVT. In splenectomy cases with a lower final PVP, a close follow-up is required for early detection and treatment of PVT.

DOI： 10.1016/j.hbpd.2019.06.011

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PubMed

Effect of herbal medicine daikenchuto on oral and enteral caloric intake after liver transplantation: A multicenter, randomized controlled trial

Kaido Toshimi, Shinoda Masahiro, Inomata Yukihiro, Yagi Takahito, Akamatsu Nobuhisa, Takada Yasutsugu, Ohdan Hideki, Shimamura Tsuyoshi, Ogura Yasuhiro, Eguchi Susumu, Eguchi Hidetoshi, Ogata Satoshi, Yoshizumi Tomoharu, Ikegami Toshihiko, Yamamoto Michio, Morita Satoshi, Uemoto Shinji

NUTRITION 54 巻頁： 68 - 75 2018年10月

Risk factors and long-term outcomes of pediatric liver transplant recipients with chronic high Epstein-Barr virus loads

Kamei, H; Ito, Y; Kawada, J; Ogiso, S; Onishi, Y; Komagome, M; Kurata, N; Ogura, Y

TRANSPLANT INFECTIOUS DISEASE 20 巻 ( 4 ) 頁： e12911 2018年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Transplant Infectious Disease

Background: Serial monitoring of Epstein-Barr virus (EBV) reveals that certain pediatric liver transplant (LT) recipients exhibit high EBV loads for long periods. We investigated the incidence and risk factors of chronic high EBV (CHEBV) loads (continuous EBV DNA >10 000 IU/mL of whole blood for ≥6 months) and long-term outcomes. Methods: This single center, retrospective observational study investigated pediatric LT recipients who survived ≥6 months. We quantitated EBV DNA weekly during hospitalization and subsequently every 4 or 6 weeks at the outpatient clinic. Tacrolimus was maintained at a low trough level (<3 ng/mL, EBV DNA load >5000 IU/mL). Results: Thirty-one of 77 LT recipients developed CHEBV. Univariate analysis revealed that age <2 years and body weight <10 kg upon LT, operation time <700 minutes, warm ischemia time (WIT) >35 minutes, graft-to-recipient weight ratio (GRWR) >2.7%, and preoperative EBV seronegativity were significantly associated with the development of CHEBV loads. Multivariate analysis identified significant associations of CHEBV with WIT >35 minutes, GRWR >2.7%, and preoperative seronegative. None of the recipients developed post-transplantation lymphoproliferative disorder. Survival rates of patients with and without CHEBV loads were not significantly different. Conclusions: A significant number of pediatric LT recipients developed CHEBV loads. Long WIT, high GRWR, and preoperative EBV seronegativity were significantly associated with the development of CHEBV loads. Although the long-term outcomes of patients with or without CHEBV loads were not significantly different, further studies of more subjects are warranted.

DOI： 10.1111/tid.12911

Web of Science

Scopus

PubMed

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