研究者詳細 - 小倉　靖弘

Successful Blood Transfusion Management of a Living Donor Liver Transplant Recipient in the Presence of Anti-Jr<SUP>a</SUP>: A Case Report

A MULTICENTER, RANDOMIZED, PLACEBO-CONTROLLED TRIAL OF EXTRACT OF JAPANESE HERBAL MEDICINE DAIKENCHUTO TO PREVENT BOWEL DYSFUNCTION AFTER ADULT LIVER TRANSPLANTATION (DKB 14 STUDY)

Sugawara Yasuhiko, Kaido Toshimi, Shinoda Masahiro, Inomata Yukihoro, Yagi Takahito, Akamatsu Nobuhisa, Takada Yasutsugu, Ohdan Hideki, Shimamura Tsuyoshi, Ogura Yasuhiiro, Eguchi Susumu, Eguchi Hidetoshi, Yamamoto Masakazu, Maehara Yoshihiko, Miyagawa Shinichi, Uemoto Shinji

TRANSPLANT INTERNATIONAL 30 巻頁： 351-351 2017年9月

SUCCESSFUL SERIES OF RITUXIMAB DESENSITIZATION FOR LIVER TRANSPLANTATION WITH PREFORMED DONOR SPECIFIC ANTIBODIES

Ogura Yasuhiro, Kamei Hideya, Komagome Masahiko, Kurata Nobuhiko, Onishi Yasuharu

TRANSPLANT INTERNATIONAL 30 巻頁： 57-57 2017年9月

Kurata, N; Onishi, Y; Kamei, H; Hori, T; Komagome, M; Kato, C; Matsushita, T; Ogura, Y

TRANSPLANTATION PROCEEDINGS 49 巻 ( 7 ) 頁： 1604 - 1607 2017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：Transplantation Proceedings

A 48-year-old Japanese woman was diagnosed with Budd-Chiari syndrome and transferred for possible living donor liver transplantation (LDLT). Examinations before LDLT revealed that the recipient had anti-Jra and preformed donor-specific anti–human leukocyte antigen (HLA) antibodies (DSA). Rituximab was administrated at 16 days prior to the patient's scheduled LDLT for the prophylaxis of antibody-mediated rejection by DSA. The clinical significance of anti-Jra has not been clearly established because of the rarity of this antibody, so we discussed blood transfusion strategy with the Department of Blood Transfusion Service and prepared for Jra-negative packed red blood cells (RBCs). Intraoperative blood salvage was used during LDLT procedures to reduce the use of packed RBCs. Although post-transplantation graft function was excellent, a total of 44 U of Jra-negative RBCs were transfused during the entire perioperative period. Because sufficient amounts of Jra-negative packed RBCs were supplied, Jra mismatched blood transfusion was avoided. The patient was discharged from our hospital on postoperative day 102 without clinical evidence of any blood transfusion–related adverse events. Although there are some controversies of blood transfusion related to anti-Jra antibodies, the current strategies of blood transfusion for liver transplantation with anti-Jra are as follows: (1) sufficient supply and transfusion of Jra-negative matched packed RBCs and (2) application of intraoperative blood salvage to reduce the total amount of rare blood type RBCs. These strategies may be changed when the mechanism of anti-Jra alloimmunization is fully understood in the future.

DOI： 10.1016/j.transproceed.2017.06.009

Risk of alcohol use relapse after liver transplantation for alcoholic liver disease

Donor Selection and Prophylactic Strategy for Venous Thromboembolic Events in Living Donors of Liver Transplantation Based on Results of Thrombophilia Screening Tests

Kamei Hideya, Onishi Yasuharu, Kurata Nobuhiko, Ishigami Masatoshi, Ogura Yasuhiro

ANNALS OF TRANSPLANTATION 22 巻頁： 409-416 2017年7月

Donor Selection and Prophylactic Strategy for Venous Thromboembolic Events in Living Donors of Liver Transplantation Based on Results of Thrombophilia Screening Tests.

Kamei H, Onishi Y, Kurata N, Ishigami M, Ogura Y

Annals of transplantation 22 巻頁： 409-416 2017年7月

Chronic High Epstein-Bar Virus Loads in Pediatric Liver Transplant Recipients - Risk Factors and Long-term Outcomes

Kamei H., Ito Y., Ohnishi Y., Kawada J., Kurata N., Komagome M., Ogura Y.

TRANSPLANTATION 101 巻 ( 5 ) 頁： 83-83 2017年5月

A Multicenter, Randomized, Placebo-controlled Trial of Extract of Japanese Herbal Medicine Daikenchuto to Prevent Bowel Dysfunction after Adult Liver Transplantation (DKB 14 Study)

Mizota T., Kaido T., Shinoda M., Hibi T., Inomata Y., Yagi T., Akamatsu N., Takada Y., Ohdan H., Shimamura T., Ogura Y., Eguchi S., Eguchi H., Yamamoto M., Maehara Y., Miyagawa S., Uemoto S.

TRANSPLANTATION 101 巻 ( 5 ) 頁： 157-158 2017年5月

Rituximab Desensitization for Liver Transplantaiton with Preformed Donor Specific Antibodies

Ogura Y., Kamei H., Komagome M., Kurata N., Onishi Y.

TRANSPLANTATION 101 巻 ( 5 ) 頁： 206-207 2017年5月

Onishi, Y; Kimura, H; Hori, T; Kishi, S; Kamei, H; Kurata, N; Tsuboi, C; Yamaguchi, N; Takahashi, M; Sunada, S; Hirano, M; Fujishiro, H; Okada, T; Ishigami, M; Goto, H; Ozaki, N; Ogura, Y

WORLD JOURNAL OF GASTROENTEROLOGY 23 巻 ( 5 ) 頁： 869 - 875 2017年2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：World Journal of Gastroenterology

AIM To investigate factors, including psychosocial factors, associated with alcoholic use relapse after liver transplantation (LT) for alcoholic liver disease (ALD). METHODS The clinical records of 102 patients with ALD who were referred to Nagoya University Hospital for LT between May 2003 and March 2015 were retrospectively evaluated. History of alcohol intake was obtained from their clinical records and scored according to the High- Risk Alcoholism Relapse scale, which includes duration of heavy drinking, types and amount of alcohol usually consumed, and previous inpatient treatment history for alcoholism. All patients were assessed for eligibility for LT according to comprehensive criteria, including Child- Pugh score, Model for End-Stage Liver Disease score, and psychosocial criteria. RESULTS Of the 102 patients with ALD referred for LT, seven (6.9%) underwent LT. One (14.3%) of these seven patients returned to heavy drinking, but that patient was able to successfully quit drinking following an immediate intervention, consisting of psychotherapeutic education and supportive psychotherapy, by a psychiatrist. A comparison between the transplantation/registration (T/R) group, consisting of the seven patients who underwent LT and 10 patients listed for deceased donor LT, and 50 patients who did not undergo LT and were not listed for deceased donor LT (non-T/R group), showed statistically significant differences in duration of abstinence period (P < 0.01), duration of heavy drinking (P < 0.05), adherence to medical treatment (P < 0.01), and declaration of abstinence (P < 0.05). CONCLUSION Patients with ALD referred for LT require comprehensive evaluation, including evaluation of psychosocial criteria, to prevent alcoholic recidivism.

DOI： 10.3748/wjg.v23.i5.869

Changes in Muscle Strength and Six-Minute Walk Distance Before and After Living Donor Liver Transplantation

Mizuno Y., Ito S., Hattori K., Nagaya M., Inoue T., Nishida Y., Onishi Y., Kamei H., Kurata N., Hasegawa Y., Ogura Y.

TRANSPLANTATION PROCEEDINGS 48 巻 ( 10 ) 頁： 3348 - 3355 2016年12月

Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation

Hori T., Ogura Y., Onishi Y., Kamei H., Kurata N., Kainuma M., Takahashi H., Suzuki S., Ichikawa T., Mizuno S., Aoyama T., Ishida Y., Hirai T., Hayashi T., Hasegawa K., Takeichi H., Ota A., Kodera Y., Sugimoto H., Iida T., Yagi S., Taniguchi K., Uemoto S.

World Journal of Hepatology 8 巻 ( 25 ) 頁： 1047 - 1060 2016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：World Journal of Hepatology

Advanced liver cirrhosis is usually accompanied by portal hypertension. Long-term portal hypertension results in various vascular alterations. The systemic hemodynamic state in patients with cirrhosis is termed a hyperdynamic state. This peculiar hemodynamic state is characterized by an expanded blood volume, high cardiac output, and low total peripheral resistance. Vascular alterations do not disappear even long after liver transplantation (LT), and recipients with cirrhosis exhibit a persistent systemic hyperdynamic state even after LT. Stability of optimal systemic hemodynamics is indispensable for adequate portal venous flow (PVF) and successful LT, and reliable parameters for optimal systemic hemodynamics and adequate PVF are required. Even a subtle disorder in systemic hemodynamics is precisely indicated by the balance between cardiac output and blood volume. The indocyanine green (ICG) kinetics reflect the patient's functional hepatocytes and effective PVF, and PVF is a major determinant of the ICG elimination constant (k ICG) in the well-preserved allograft. The k ICG value is useful to set the optimal PVF during living-donor LT and to evaluate adequate PVF after LT. Perioperative management has a large influence on the postoperative course and outcome; therefore, key points and unexpected pitfalls for intensive management are herein summarized. Transplant physicians should fully understand the peculiar systemic hemodynamic behavior in LT recipients with cirrhosis and recognize the critical importance of PVF after LT.

DOI： 10.4254/wjh.v8.i25.1047