Faculty Profiles - CHEN-YOSHIKAWA Toyofumi

Papers - CHEN-YOSHIKAWA Toyofumi

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Ischemia–reperfusion injury in lung transplantation

Chen-Yoshikawa T.F.

Cells Vol. 10 ( 6 ) 2021.6

Language：Japanese Publisher：Cells

Lung transplantation has been established worldwide as the last treatment for end-stage respiratory failure. However, ischemia–reperfusion injury (IRI) inevitably occurs after lung transplantation. The most severe form of IRI leads to primary graft failure, which is an important cause of morbidity and mortality after lung transplantation. IRI may also induce rejection, which is the main cause of mortality in recipients. Despite advances in donor management and graft preservation, most donor grafts are still unsuitable for transplantation. Although the pulmonary endothelium is the primary target site of IRI, the pathophysiology of lung IRI remains incompletely understood. It is essential to understand the mechanism of pulmonary IRI to improve the outcomes of lung transplantation. Therefore, we reviewed the state-of-the-art in the management of pulmonary IRI after lung transplantation. Recently, the ex vivo lung perfusion (EVLP) system has been clinically introduced worldwide. Various promising therapeutic strategies for the protection of the endothelium against IRI, including EVLP, inhalation therapy with therapeutic gases and substances, fibrinolytic treatment, and mesenchymal stromal cell therapy, are awaiting clinical application. We herein review the latest advances in the field of pulmonary IRI in lung transplantation.

DOI： 10.3390/cells10061333

Scopus

Preoperative paraspinous muscle sarcopenia and physical performance as prognostic indicators in non-small-cell lung cancer

Tanaka S., Ozeki N., Mizuno Y., Nakajima H., Hattori K., Inoue T., Nagaya M., Fukui T., Nakamura S., Goto M., Sugiyama T., Nishida Y., Chen-Yoshikawa T.F.

Journal of Cachexia, Sarcopenia and Muscle Vol. 12 ( 3 ) page： 646 - 656 2021.6

Language：Japanese Publisher：Journal of Cachexia, Sarcopenia and Muscle

Background: Despite the associations of both preoperative sarcopenia and physical performance with post-operative mortality in non-small-cell lung cancer (NSCLC), there have been no comprehensive studies of the impact of physical status on prognosis. This study was performed to investigate the prognostic significance of preoperative sarcopenia and physical performance in NSCLC. Methods: This retrospective cohort study was performed in NSCLS patients undergoing curative lung resection at a university hospital between January 2014 and December 2017. The patients were divided into four groups according to the skeletal muscle index [sarcopenia (lowest sex-specific tertile) and non-sarcopenia] and 6 min walking distance (6MWD) [short distance (<400 m) and long distance (≥400 m)]. Sarcopenia was assessed by preoperative cross-sectional areas of right and left paraspinous muscles at the level of the 12th thoracic vertebra from computed tomography images, and physical performance was determined by preoperative 6MWD. The primary and secondary endpoints were post-operative overall survival (OS) and disease-free survival (DFS). Results: The 587 patients [mean age: 68.5 ± 8.8 years, 399 men (68%)] included in the study were divided into the non-sarcopenia/long-distance group (58%), sarcopenia/long-distance group (26%), non-sarcopenia/short-distance group (9%), and sarcopenia/short-distance group (7%). A total of 109 (18.6%) deaths and 209 (35.6%) combined endpoints were observed over a mean follow-up of 3.1 ± 1.3 years. After adjusting for other covariates, the sarcopenia/short-distance group showed significant associations with shorter OS (hazard ratio, 3.38; 95% confidence interval, 1.79–6.37; P < 0.001) and DFS (hazard ratio, 2.11; 95% confidence, 1.27–3.51; P = 0.004) compared with the non-sarcopenia/long-distance group on multivariate analyses. Although not significant, adding skeletal muscle index and 6MWD to the pre-existing risk model increased the area under the curve on time-dependent receiver operating characteristic curve analysis for OS and DFS, except within 2 years of surgery. Conclusions: The presence of both preoperative paraspinous muscle sarcopenia and short distance in 6MWD had an adverse effect on post-operative prognosis in patients with NSCLC, suggesting that preoperative assessment of thoracic sarcopenia and physical performance may be useful for risk stratification of surgical candidates with potential for targeted interventions.

DOI： 10.1002/jcsm.12691

Scopus

Native lung complications after living-donor lobar lung transplantation

Mineura K., Chen-Yoshikawa T.F., Tanaka S., Yamada Y., Yutaka Y., Nakajima D., Ohsumi A., Hamaji M., Menju T., Date H.

Journal of Heart and Lung Transplantation Vol. 40 ( 5 ) page： 343 - 350 2021.5

Language：Japanese Publisher：Journal of Heart and Lung Transplantation

Background: Living-donor lobar lung transplantation (LDLLT) is viable for critically ill patients in situations of donor shortage. Because it is sometimes difficult to find 2 ideal living donors with suitable graft sizes, we developed native lung-sparing procedures, including single LDLLT and native upper lobe-sparing LDLLT. This study aimed to investigate native lung complications (NLCs) in native lung-sparing LDLLT. Methods: Between April 2002 and March 2019, 92 LDLLTs and 124 cadaveric lung transplantations (CLTs) were performed at the Kyoto University Hospital. Our prospectively maintained database and clinical records were reviewed to compare NLCs among recipients who underwent native lung-sparing LDLLT (n = 21) with those among recipients who underwent single CLT (n = 61). Results: Among 21 recipients who underwent native lung-sparing LDLLT, 11 NLCs occurred in 8 recipients. No fatal NLC was noted; however, 2 required surgical intervention. Post-transplant survival was not significantly different between native lung-sparing LDLLT recipients with NLCs and those without NLCs. The incidence of NLCs was comparable between native lung-sparing LDLLT recipients and single CLT recipients (8/21 vs 26/61, p = 0.80); however, NLCs occurred significantly later in LDLLT recipients than in CLT recipients (median: 665 vs 181.5 days after transplantation, p = 0.014). Conclusions: NLCs after native lung-sparing LDLLT had favorable outcomes. Therefore, native lung-sparing LDLLT is a useful treatment option for severely ill patients who cannot wait for CLT. However, it is important to recognize that NLCs may occur later in LDLLT than in CLT.

DOI： 10.1016/j.healun.2021.01.1562

Scopus

Postoperative outcomes of lung transplant recipients with preformed donor-specific antibodies

Kayawake H., Chen-Yoshikawa T.F., Gochi F., Tanaka S., Yurugi K., Hishida R., Yutaka Y., Yamada Y., Ohsumi A., Hamaji M., Nakajima D., Date H.

Interactive cardiovascular and thoracic surgery Vol. 32 ( 4 ) page： 616 - 624 2021.4

Language：Japanese Publisher：Interactive cardiovascular and thoracic surgery

OBJECTIVES: Few studies have evaluated the outcomes of lung transplantation (LTx) in recipients with preformed donor-specific antibodies (DSAs). This study investigated the postoperative changes in preformed DSAs based on prospectively collected data of DSAs, and the influences of preformed DSAs on postoperative outcomes among LTx recipients. METHODS: Between July 2010 and December 2019, 216 recipients underwent LTx (81 living-donor lobar lung transplants and 135 deceased-donor lung transplants). We reviewed 8 cases with preformed DSAs to determine postoperative changes in DSAs and compared postoperative outcomes between recipients with and without DSAs. RESULTS: The preoperative mean fluorescence intensity of preformed DSAs ranged from 1141 to 14 695. Two recipients experienced antibody-mediated rejection within 2 weeks after LTx. DSAs disappeared in 7 recipients; however, 1 recipient experienced the relapse of DSAs and died from chronic lung allograft syndrome (CLAD), whereas 1 recipient had persisting DSAs within the study period and died from CLAD. Neither overall survival (OS) nor CLAD-free survival was significantly different between recipients with and without DSAs (P = 0.26 and P = 0.17, respectively). However, both OS and CLAD-free survival were significantly lower in recipients with DSAs against HLA class II than in those without these antibodies {5-year OS: 25.0% [95% confidence interval (CI): 0.9-66.5%] vs 72.1% (95% CI: 63.8-78.9%), P = 0.030 and 5-year CLAD-free survival: 26.7% (95% CI: 1.0-68.6%) vs 73.7% (95% CI: 66.5-79.5%), P = 0.002}. CONCLUSIONS: Prognosis in recipients experiencing the relapse of preformed DSAs and those with persisting DSAs may be poor. The recipients with anti-HLA class II preformed DSAs had a significantly worse prognosis.

DOI： 10.1093/icvts/ivaa311

Scopus

閉塞性細気管支炎における気管支拡張の意義について

古郷摩利子, 松本久子, 田辺直也, 芳川豊史, 中島直樹, 吉澤明彦, 小熊毅, 佐藤晋, 野村奈都子, 森本千絵, 砂留広伸, 後藤慎平, 大角明宏, 伊達洋至, 平井豊博

日本呼吸器学会誌 Vol. 10 ( 増刊 ) page： 195 - 195 2021.4

Fluorescence-guided thoracic surgery Invited Reviewed

Shota Nakamura, Masaki Goto, Toyofumi F. Chen-Yoshikawa

Journal of Visualized Surgery Vol. 7 page： 18 - 18 2021.4

Left brachiocephalic vein aneurysm: a case report

Ueno Harushi, Yazawa Mari, Tsubouchi Hideki, Nakanishi Keita, Sugiyama Tomoshi, Kadomatsu Yuka, Goto Masaki, Ozeki Naoki, Nakamura Shota, Fukui Takayuki, Mutsuga Masato, Yoshikawa Toyofumi Fengshi Chen

SURGICAL CASE REPORTS Vol. 7 ( 1 ) 2021.3

胸部CT画像による脊柱起立筋の術前指標が術後の運動耐容能および生命予後に及ぼす影響

大島洋平, 佐藤晋, 芳川豊史, 田中里奈, 山田義人, 豊洋次郎, 中島大輔, 濱路政嗣, 大角明宏, 伊達洋至, 松田秀一

移植 Vol. 55 ( 4 ) page： 515 - 516 2021.3

胸部CT画像による脊柱起立筋の術前指標が術後の運動耐容能および生命予後に及ぼす影響

大島洋平, 佐藤晋, 芳川豊史, 田中里奈, 山田義人, 豊洋次郎, 中島大輔, 濱路政嗣, 大角明宏, 伊達洋至, 松田秀一

移植 Vol. 55 ( 4 ) page： 515 - 516 2021.3

Factors associated with changes in the 12-m stair-climbing time after lung lobectomy

Ozeki N.

General Thoracic and Cardiovascular Surgery Vol. 69 ( 2 ) page： 282 - 289 2021.2

Thymic lipofibroadenoma accompanied with largish calcifications

Hakiri S.

General Thoracic and Cardiovascular Surgery Vol. 69 ( 2 ) page： 394 - 397 2021.2

生体肺移植周術期における脊柱起立筋CT値の低下は予後不良因子である

大島洋平, 佐藤晋, 吉岡佑二, 濱田涼太, 佐藤達也, 太田垣あゆみ, 芳川豊史, 伊達洋至, 南角学, 松田秀一

日本呼吸ケア・リハビリテーション学会誌 Vol. 30 ( Suppl. ) page： 154s - 154s 2021.2

肺移植待機中の間質性肺疾患患者における運動耐容能に影響を及ぼす因子の検討

佐藤達也, 佐藤晋, 大島洋平, 吉岡佑二, 濱田涼太, 田平一行, 芳川豊史, 半田知宏, 伊達洋至, 松田秀一

日本呼吸ケア・リハビリテーション学会誌 Vol. 30 ( Suppl. ) page： 154s - 154s 2021.2

脳死肺移植における術前の脊柱起立筋CT値の低下は予後不良因子である

大島洋平, 佐藤晋, 吉岡佑二, 濱田涼太, 佐藤達也, 太田垣あゆみ, 芳川豊史, 伊達洋至, 南角学, 松田秀一

日本呼吸ケア・リハビリテーション学会誌 Vol. 30 ( Suppl. ) page： 154s - 154s 2021.2

Protective Effects of a Hydrogen-Rich Preservation Solution in a Canine Lung Transplantation Model

Kayawake H., Chen-Yoshikawa T.F., Saito M., Yamagishi H., Yoshizawa A., Hirano S.i., Kurokawa R., Date H.

Annals of Thoracic Surgery Vol. 111 ( 1 ) page： 246 - 252 2021.1

Language：Japanese Publisher：Annals of Thoracic Surgery

Background: Molecular hydrogen (H2) has protective effects against ischemia-reperfusion injury in various organs. Because they are easier to transport and safer to use than inhaled H2, H2-rich solutions are suitable for organ preservation. In this study, we examined the protective effects of an H2-rich solution for lung preservation in a canine left lung transplantation (LTx) model. Methods: Ten beagles underwent orthotopic left LTx after 23 hours of cold ischemia followed by reperfusion for 4 hours. Forty-five minutes after reperfusion, the right main pulmonary artery was clamped to evaluate the function of the implanted graft. The beagles were divided into two groups: control group (n = 5), and H2 group (n = 5). In the control group, the donor lungs were flushed and immersed during cold preservation at 4°C using ET-Kyoto solution, and in the H2 group, these were flushed and immersed using H2-rich ET-Kyoto solution. Physiologic assessments were performed during reperfusion. After reperfusion, the wet-to-dry ratios were determined, and histology examinations were performed. Results: Significantly higher partial pressure of arterial oxygen and significantly lower partial pressure of carbon dioxide were observed in the H2 group than in the control group (P =.045 and P <.001, respectively). The wet-to-dry ratio was significantly lower in the H2 group than in the control group (P =.032). Moreover, in histology examination, less lung injury and fewer apoptotic cells were observed in the H2 group (P <.001 and P <.001, respectively). Conclusions: Our results demonstrated that the H2-rich preservation solution attenuated ischemia-reperfusion injury in a canine left LTx model.

DOI： 10.1016/j.athoracsur.2020.05.076

Scopus

Kernel-based framework to estimate deformations of pneumothorax lung using anatomical landmarks

Yamamoto Utako, Nakao Megumi, Ohzeki Masayuki, Tokuno Junko, Yoshikawa Toyofumi, Matsuda Tetsuya

Transactions of Japanese Society for Medical and Biological Engineering Vol. Annual59 ( Abstract ) page： 515 - 515 2021

Language：Japanese Publisher：Japanese Society for Medical and Biological Engineering

In video-assisted thoracoscopic surgeries, the precise estimation of lung deformation between the inflated lung in the computed tomography (CT) images during preoperative planning and the deflated lung in the treatment views during surgery is expected. The purpose of this study is to develop a deformation estimation method of the 3D surface of a deflated lung from a few partial observations. To estimate deformations for a largely deformed lung, a kernel regression-based solution was introduced. The proposed method used a few landmarks to capture the partial deformation between the 3D surface mesh obtained from preoperative CT and the intraoperative anatomical positions. The method was applied on nine datasets of the left lungs of live Beagle dogs. Contrast-enhanced CT images of the lungs were acquired. The proposed method achieved a local positional error of vertices of 2.74 mm, Hausdorff distance of 6.11 mm, and Dice similarity coefficient of 0.94.

DOI： 10.11239/jsmbe.annual59.515

CiNii Research

Rituximab for antibody-mediated rejection after lung transplantation

CHEN-YOSHIKAWA Toyofumi F., DATE Hiroshi, SUGIMOTO Seiichiro, SHIRAISHI Takeshi, NAKAGAWA Ken, EGAWA Hiroto

Japanese Journal of Transplantation Vol. 56 ( 1 ) page： 53 - 68 2021

Language：Japanese Publisher：The Japan Society for Transplantation

【Objective】 We retrospectively surveyed the details of treatment with rituximab for antibody-mediated rejection (AMR) after lung transplantation.【Design】 Case series.【Methods】 This study was conducted to assess outcomes in patients who underwent lung transplantation in Japan from August 2001 to December 2016 and were treated with rituximab for AMR. A questionnaire was sent to medical institutions that had used rituximab for such treatment, and information on AMR treatment, including rituximab dosage, efficacy, and safety, was collected.【Results】 Among the 525 patients undergoing lung transplantation during the study period in Japan, fourteen patients (2.7%; 1 child and 13 adults) were enrolled. Records showed definite clinical AMR in 3 patients, probable clinical AMR in 2 patients, possible clinical AMR in 8 patients and suspected AMR in 1 patient. All patients had allograft dysfunction, and 13 adult patients were positive for donor-specific antibodies (DSA). Two patients experienced rejection more than twice. Rituximab was administered to all patients. In one patient who experienced AMR twice, rituximab was administered for each AMR. The rituximab dose was 375 mg/m2 in all but one patient, who received 348 mg/m2. Eight patients recovered from AMR. AMR treatments, including rituximab, were well tolerated. However, 11 patients developed graft loss due to rejection, and 10 patients died from chronic lung allograft syndrome or sepsis.【Conclusion】 Based on these findings, treatment containing rituximab was considered effective for AMR, but careful monitoring is needed to prevent or reduce the number of adverse events such as infection.

DOI： 10.11386/jst.56.1_53

CiNii Research

Commentary: Change the temperature before we have to

Kadomatsu Y., Chen-Yoshikawa T.F.

Journal of Thoracic and Cardiovascular Surgery 2021

Commentary: To know yourself is to know your neighbor

Nakanishi K., Chen-Yoshikawa T.F.

Journal of Thoracic and Cardiovascular Surgery 2021

Commentary: Look Before You Leap

Fukumoto K., Chen-Yoshikawa T.F.

Seminars in Thoracic and Cardiovascular Surgery 2021

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Papers - CHEN-YOSHIKAWA Toyofumi