研究者詳細 - 小倉　靖弘

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

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

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

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

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

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

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

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

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

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

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

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

Diagnostic Usefulness of APRI and FIB-4 for the Prediction of Liver Fibrosis After Liver Transplantation in Patients Infected with Hepatitis C Virus

Imai H., Kamei H., Onishi Y., Ishizu Y., Ishigami M., Goto H., Ogura Y.

TRANSPLANTATION PROCEEDINGS 50 巻 ( 5 ) 頁： 1431 - 1436 2018年6月

Lung Metastases from Bile Duct Adenocarcinoma Mimicking Chronic Airway Infection and Causing Diagnostic Difficulty

Sato Mitsuo, Okachi Shotaro, Fukihara Jun, Shimoyama Yoshie, Wakahara Keiko, Sakakibara Toshihiro, Hase Tetsunari, Onishi Yasuharu, Ogura Yasuhiro, Maeda Osamu, Hasegawa Yoshinori

INTERNAL MEDICINE 57 巻 ( 10 ) 頁： 1429 - 1432 2018年

Brain death organ donor supported by a left ventricular assist device showing unexpected congestive liver fibrosis: A case report

Kamei Hideya, Komagome Masahiko, Kurata Nobuhiko, Ogiso Satoshi, Onishi Yasuharu, Hara Takanobu, Takatsuki Mitsuhisa, Eguchi Susumu, Ogura Yasuhiro

INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS 47 巻頁： 57-60 2018年

Successful post-transplant psychiatric interventions during long-term follow-up of patients receiving liver transplants for alcoholic liver disease

Kimura H., Onishi Y., Kishi S., Kurata N., Ogiso S., Kamei H., Tsuboi C., Yamaguchi N., Shiga A., Kondo M., Yokoyama Y., Takasato F., Fujishiro H., Ishizuka K., Okada T., Ogura Y., Ozaki N.

American Journal of Case Reports 18 巻頁： 1215 - 1219 2017年11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：American Journal of Case Reports

Objective: Unusual setting of medical care Background: Around 20-30% of patients who undergo liver transplantation (LT) for alcoholic liver disease (ALD) will resume heavy drinking after LT. It is crucial to control post-transplant relapse of alcohol use, because alcoholic recidivism has been shown to have a negative impact on post-transplant compliance and long-term outcomes of LT recipients. However, there is currently no specific, effective psychiatric intervention for preventing additional alcohol consumption in clinical practice. Case Report: We present 3 patients who underwent LT for ALD at Nagoya University Hospital who were followed up for prolonged periods (7.2, 8.8, and 11.3 years, respectively), and review the psychiatric interventions employed to address critical situations. Additional alcohol consumption was noted in Case 1, but prompt collaborative care led to stable abstinence. In Case 2, marked anger and irritation were exacerbated as a result of work, but the anger was controlled by anger management. Case 3 abused a minor tranquilizer, but limit-setting resulted in adequate medical adherence. Conclusions: Transplant teams need to provide comprehensive treatment for alcoholic recidivism to improve long-term health after LT for ALD.

DOI： 10.12659/AJCR.906446

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

Fibrosing Cholestatic Hepatitis in a Complicated Case of an Adult Recipient After Liver Transplantation: Diagnostic Findings and Therapeutic Dilemma

Hori Tomohide, Onishi Yasuharu, Kamei Hideya, Kurata Nobuhiko, Ishigami Masatoshi, Ishizu Yoji, Ogura Yasuhiro

AMERICAN JOURNAL OF CASE REPORTS 17 巻頁： 597 - 604 2016年8月

Early Conversion From Twice-Daily Tacrolimus to Prolonged-Release Tacrolimus in Liver Transplantation: A Single-Center Experience

Ogura Yasuhiro, Imai Hisashi, Kamei Hideya, Hori Tomohide, Kurata Nobuhiko, Onishi Yasuharu

ANNALS OF TRANSPLANTATION 21 巻頁： 448 - 55 2016年7月

How far can we lower graft-to-recipient weight ratio for living donor liver transplantation under modulation of portal venous pressure?

Uemura Tadahiro, Wada Seidai, Kaido Toshimi, Mori Akira, Ogura Yasuhiro, Yagi Shintaro, Fujimoto Yasuhiro, Ogawa Kohei, Hata Koichiro, Yoshizawa Atsushi, Okajima Hideaki, Uemoto Shinji

SURGERY 159 巻 ( 6 ) 頁： 1623 - 1630 2016年6月

Outcomes of Living Donor Liver Transplantation Alone for Patients on Maintenance Renal Replacement Therapy in Japan: Results of a Nationwide Survey.

Eguchi S, Furukawa H, Uemoto S, Umeshita K, Imamura H, Soyama A, Shimamura T, Isaji S, Ogura Y, Egawa H, Kawachi S, Kasahara M, Nagano H, Ku Y, Ohdan H, Maehara Y, Sato S, Inomata Y

Transplantation direct 2 巻 ( 6 ) 頁： e74 2016年6月

Impact of human T-cell leukemia virus type 1 on living donor liver transplantation: a multi-center study in Japan

Yoshizumi Tomoharu, Takada Yasutsugu, Shirabe Ken, Kaido Toshimi, Hidaka Masaaki, Honda Masaki, Ito Takashi, Shinoda Masahiro, Ohdan Hideki, Kawagishi Naoki, Sugawara Yasuhiko, Ogura Yasuhiro, Kasahara Mureo, Kubo Shoji, Taketomi Akinobu, Yamashita Natsumi, Uemoto Shinji, Yamaue Hiroki, Miyazaki Masaru, Takada Tadahiro, Maehara Yoshihiko

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 23 巻 ( 6 ) 頁： 333 - 341 2016年6月

Cytomegalovirus (CMV) Monitoring After Liver Transplantation: Comparison of CMV Pp65 Antigenemia Assay with Real-Time PCR Calibrated to WHO International Standard.

Kamei H, Ito Y, Onishi Y, Suzuki M, Imai H, Kurata N, Hori T, Tainaka T, Uchida H, Ogura Y

Annals of transplantation 21 巻頁： 131 - 6 2016年3月

Living Donor Liver Transplantation Using a Liver Graft With Congenital Intrahepatic Portosystemic Shunt

Kamei Hideya, Imai Hisashi, Onishi Yasuharu, Sugimoto Hiroyuki, Suzuki Kojiro, Ogura Yasuhiro

TRANSPLANTATION DIRECT 2 巻 ( 1 ) 頁： e46 2016年1月

Development of extensive inferior vena cava thrombosis due to the ligation of a large mesenteric-caval shunt during liver transplantation: A case report

Kamei Hideya, Onishi Yasuharu, Ishigami Masatoshi, Ishizu Yoji, Suzuki Kojiro, Ogura Yasuhiro

INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS 29 巻頁： 211 - 214 2016年

Fibrosing cholestatic hepatitis C in post-transplant adult recipients of liver transplantation

Hori Tomohide, Onishi Yasuharu, Kamei Hideya, Kurata Nobuhiko, Ishigami Masatoshi, Ishizu Yoji, Ogura Yasuhiro

ANNALS OF GASTROENTEROLOGY 29 巻 ( 4 ) 頁： 454 - 459 2016年

Current status of deceased donor split liver transplantation in Japan

Sakamoto Seisuke, Kasahara Mureo, Ogura Yasuhiro, Inomata Yukihiro, Uemoto Shinji

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 22 巻 ( 12 ) 頁： 837 - 845 2015年12月

Successful Living-Donor Liver Transplantation for Cholestatic Liver Failure Induced by Allopurinol: Case Report

Imai, H; Kamei, H; Onishi, Y; Yamada, K; Ishizu, Y; Ishigami, M; Goto, H; Ogura, Y

TRANSPLANTATION PROCEEDINGS 47 巻 ( 9 ) 頁： 2778 - 2781 2015年11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 39-year-old man was diagnosed with allopurinol-induced hepatic injury. He did not show any sign of hepatic encephalopathy, but his serum total bilirubin level was >40 mg/dL when he visited the local hospital. The therapeutic effects of initial medical treatments were transient, and both renal function and coagulation ability were gradually deteriorated. Four months after the onset of hepatic injury, he was referred to our hospital for the purpose of liver transplantation (LT). Although he was wasting and severely jaundiced, his consciousness level was not disturbed at all, with normal serum ammonia blood concentration before LT. Owing to allopurinol-induced severe cholestatic liver failure, living-donor LT (LDLT) was performed with the use of a right lobe graft from his younger brother. The explanted liver was extremely enlarged, with a weight of 2,480 g, and severely cholestatic. Microscopic findings were also compatible with drug-induced cholestatic liver injury. He was discharged from hospital 55 days after LDLT, whereas his renal dysfunction remained at 6 months after LT. There are 3 types of pathophysiology of drug-induced hepatotoxicity: hepatocellular, cholestatic, and mixed liver injury. Although allopurinol hepatotoxicity is rare, it can be severe and even fatal. This is the 1st case report of successful LDLT for a patient who had developed allopurinol-induced cholestatic liver failure.

DOI： 10.1016/j.transproceed.2015.09.038

Considerable Risk of Restenosis After Endoscopic Treatment for Hepaticojejunostomy Stricture After Living-Donor Liver Transplantation

Kamei H., Imai H., Onishi Y., Ishihara M., Nakamura M., Kawashima H., Ishigami M., Ito A., Ohmiya N., Hirooka Y., Goto H., Ogura Y.

TRANSPLANTATION PROCEEDINGS 47 巻 ( 8 ) 頁： 2493 - 2498 2015年10月

Change of strategies and future perspectives against hepatitis B virus recurrence after liver transplantation

Ishigami Masatoshi, Ogura Yasuhiro, Hirooka Yoshiki, Goto Hidemi

WORLD JOURNAL OF GASTROENTEROLOGY 21 巻 ( 36 ) 頁： 10290 - 10298 2015年9月

Changes in Surgical Site Infections after Living Donor Liver Transplantation

Yamamoto Masaki, Takakura Shunji, Iinuma Yoshitsugu, Hotta Go, Matsumura Yasufumi, Matsushima Aki, Nagao Miki, Ogawa Kohei, Fujimoto Yasuhiro, Mori Akira, Ogura Yasuhiro, Kaido Toshimi, Uemoto Shinji, Ichiyama Satoshi

PLOS ONE 10 巻 ( 8 ) 頁： e0136559 2015年8月

Liver Transplantation for Non-B and Non-C Hepatocellular Carcinoma.

Kaido T, Mori A, Ogura Y, Hata K, Yoshizawa A, lida T, Yagi S, Uemoto S

Hepato-gastroenterology 62 巻 ( 140 ) 頁： 933 - 6 2015年6月

Liver Transplantation in Adults with Acute Liver Failure: A Single Center Experience over A Period of 15 Years.

Kaido T, Ogawa K, Ogura Y, Hata K, Yoshizawa A, Yagi S, Ito T, Uemoto S

Hepato-gastroenterology 62 巻 ( 140 ) 頁： 937 - 41 2015年6月

Effectiveness and safety of immunization with live-attenuated and inactivated vaccines for pediatric liver transplantation recipients

Kawano Yoshihiko, Suzuki Michio, Kawada Jun-ichi, Kimura Hiroshi, Kamei Hideya, Ohnishi Yasuharu, Ono Yasuyuki, Uchida Hiroo, Ogura Yasuhiro, Ito Yoshinori

VACCINE 33 巻 ( 12 ) 頁： 1440 - 1445 2015年3月

Toxicokinetics of perfluoroalkyl carboxylic acids with different carbon chain lengths in mice and humans

Fujii Yukiko, Niisoe Tamon, Harada Kouji H., Uemoto Shinji, Ogura Yasuhiro, Takenaka Katsunobu, Koizum Akio

JOURNAL OF OCCUPATIONAL HEALTH 57 巻 ( 1 ) 頁： 1 - 12 2015年1月

Postoperative Psychiatric Complications in Living Liver Donors

Kimura H., Onishi Y., Sunada S., Kish S., Suzuki N., Tsuboi C., Yannaguchi N., Imai H., Kamei H., Fujisiro H., Okada T., Ishigami M., Ogura Y., Kiuchi T., Ozaki N.

TRANSPLANTATION PROCEEDINGS 47 巻 ( 6 ) 頁： 1860 - 1865 2015年

Toxicokinetics of perfluoroalkyl carboxylic acids with different carbon chain lengths in mice and humans.

Fujii Y, Niisoe T, Harada KH, Uemoto S, Ogura Y, Takenaka K, Koizumi A

Journal of occupational health 57 巻 ( 1 ) 頁： 1 - 12 2015年

Successful adult-to-adult living donor liver transplantation using liver allograft after the resection of hemangioma: A suggestive case for a further expansion of living donor pool

Onishi Y., Kamei H., Imai H., Kurata N., Hori T., Ogura Y.

International Journal of Surgery Case Reports 16 巻頁： 166 - 170 2015年

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 Case Reports

Introduction Hepatic hemangioma is one of the most common benign liver tumors. There are few published reports regarding liver transplantation using liver allografts with hemangioma. Presentation of case A 45-year-old man was evaluated as a living donor for 19-year-old son with cirrhosis due to hepatic fibrosis. Preoperative investigations revealed 20 and 7 mm hemangiomas, at segment 2 (S2) and 4 (S4) respectively. Considering the anatomical relation of S2 hemangioma and Glisson 2, liver graft was designed as left lobe excluded S2 hemangioma by partial resection. Estimated graft recipient weight ratio (GRWR) even after partial resection of hemangioma was reasonable. During the donor operation, a partial hepatic resection of S2 hemangioma was performed. Intraoperative pathologic findings revealed a cavernous hemangioma, and then, the left hepatic graft with the caudate lobe was harvested. Actual GRWR was 0.90%. Donor's postoperative course was uneventful. Recipient's post-operative course was almost uneventful. Postoperative computed tomography of the recipient showed the graft regeneration without increase or recurrence of hemangioma. Discussion Organ shortage is a major concern in the field of liver transplantation. A novel donor source with a further option is extremely crucial for a guarantee of liver transplantation. We experienced the first case of adult-to-adult living donor liver transplantation using liver allograft after the resection of hemangioma. Conclusion We advocate that the use of liver allograft with hemangiomas in adult-to-adult LDLT settings can be remarkable strategy to reduce the problem of organ shortage without any unfavorable consequences in both living donor and recipient.

DOI： 10.1016/j.ijscr.2015.09.043

Urinary Neutrophil Gelatinase-Associated Lipocalin: A Useful Biomarker for Tacrolimus-Induced Acute Kidney Injury in Liver Transplant Patients

Impact of preoperative uncontrollable hepatic hydrothorax and massive ascites in adult liver transplantation

Endo Kosuke, Iida Taku, Yagi Shintaro, Yoshizawa Atsushi, Fujimoto Yasuhiro, Ogawa Kohei, Ogura Yasuhiro, Mori Akira, Kaido Toshimi, Uemoto Shinji

SURGERY TODAY 44 巻 ( 12 ) 頁： 2293 - 2299 2014年12月

Tsuchimoto, A; Shinke, H; Uesugi, M; Kikuchi, M; Hashimoto, E; Sato, T; Ogura, Y; Hata, K; Fujimoto, Y; Kaido, T; Kishimoto, J; Yanagita, M; Matsubara, K; Uemoto, S; Masuda, S

PLOS ONE 9 巻 ( 10 ) 頁： e110527 2014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：PLoS ONE

Tacrolimus is widely used as an immunosuppressant in liver transplantation, and tacrolimus-induced acute kidney injury (AKI) is a serious complication of liver transplantation. For early detection of AKI, various urinary biomarkers such as monocyte chemotactic protein-1, liver-type fatty acid-binding protein, interleukin-18, osteopontin, cystatin C, clusterin and neutrophil gelatinase-associated lipocalin (NGAL) have been identified. Here, we attempt to identify urinary biomarkers for the early detection of tacrolimus-induced AKI in liver transplant patients. Urine samples were collected from 31 patients after living-donor liver transplantation (LDLT). Twenty recipients developed tacrolimus-induced AKI. After the initiation of tacrolimus therapy, urine samples were collected on postoperative days 7, 14, and 21. In patients who experienced AKI during postoperative day 21, additional spot urine samples were collected on postoperative days 28, 35, 42, 49, and 58. The 8 healthy volunteers, whose renal and liver functions were normal, were asked to collect their blood and spot urine samples. The urinary levels of NGAL, monocyte chemotactic protein-1 and liver-type fatty acid-binding protein were significantly higher in patients with AKI than in those without, while those of interleukin-18, osteopontin, cystatin C and clusterin did not differ between the 2 groups. The area under the receiver operating characteristics curve of urinary NGAL was 0.876 (95% confidence interval, 0.800-0.951; P<0.0001), which was better than those of the other six urinary biomarkers. In addition, the urinary levels of NGAL at postoperative day 1 (p= 0.0446) and day 7 (p=0.0006) can be a good predictive marker for tacrolimus-induced AKI within next 6 days, respectively. In conclusion, urinary NGAL is a sensitive biomarker for tacrolimus-induced AKI, and may help predict renal event caused by tacrolimus therapy in liver transplant patients.

DOI： 10.1371/journal.pone.0110527

Frequent Incidence of Escape Mutants After Successful Hepatitis B Vaccine Response and Stopping of Nucleos(t)ide Analogues in Liver Transplant Recipients

Ishigami Masatoshi, Honda Takashi, Ishizu Yoji, Onishi Yasuharu, Kamei Hideya, Hayashi Kazuhiko, Ogura Yasuhiro, Hirooka Yoshiki, Goto Hidemi

LIVER TRANSPLANTATION 20 巻 ( 10 ) 頁： 1211 - 1220 2014年10月

Plasma cell hepatitis induced by the termination of antiviral therapy for recurrent hepatitis C after living donor liver transplantation

Ueda Yoshihide, Yoshizawa Atsushi, Ogura Yasuhiro, Miyagawa-Hayashino Aya, Haga Hironori, Chiba Tsutomu, Uemoto Shinji

HEPATOLOGY RESEARCH 44 巻 ( 10 ) 頁： E279 - E283 2014年10月

Hepatic arterial complications in adult living donor liver transplant recipients: a single-center experience of 673 cases

Iida T., Kaido T., Yagi S., Hori T., Uchida Y., Jobara K., Tanaka H., Sakamoto S., Kasahara M., Ogawa K., Ogura Y., Mori A., Uemoto S.

CLINICAL TRANSPLANTATION 28 巻 ( 9 ) 頁： 1025 - 1030 2014年9月

Living Donor Liver Transplantation Using a Right Liver Graft With Additional Vein Reconstructions for Patient With Situs Inversus

Kamei H., Onishi Y., Ogawa K., Uemoto S., Ogura Y.

AMERICAN JOURNAL OF TRANSPLANTATION 14 巻 ( 6 ) 頁： 1453 - 1458 2014年6月

SECTION 7. A NEW THERAPEUTIC STRATEGY ON PORTAL FLOW MODULATION THAT INCREASES DONOR SAFETY WITH GOOD RECIPIENT OUTCOMES

Kaido, T; Ogawa, K; Fujimoto, Y; Ito, T; Tomiyama, K; Mori, A; Ogura, Y; Uemoto, S

TRANSPLANTATION 97 巻 ( 8 ) 頁： S30 - S32 2014年4月

Section 7. A new therapeutic strategy on portal flow modulation that increases donor safety with good recipient outcomes

Kaido T., Ogawa K., Fujimoto Y., Ito T., Tomiyama K., Mori A., Ogura Y., Uemoto S.

Transplantation 97 巻 ( 8 ) 頁： S30 - S32 2014年4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

The goal of this study was to examine whether the lower limit of the graft-to-recipient weight ratio (GRWR) can be safely reduced to make better use of the left lobe graft in adult-to-adult living donor liver transplantation in combination with portal pressure control. Beginning December 2007, the acceptable limit for GRWR was lowered to ≥0.7% and by April 2009, it was further lowered to ≥0.6%. A portal pressure control program targeting a final portal pressure <15 mm Hg was also introduced. The donor complication rate decreased from 13.8% to 9.3%. The overall survival of recipients with GRWR <0.8% did not differ from recipients with a GRWR ≥0.8%. In conclusion, the lower limit of the GRWR can be safely reduced to 0.6% using a left lobe graft in adult-toadult living donor liver transplantation in combination with portal pressure control.

DOI： 10.1097/01.tp.0000446268.26771.59