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Kawagishi N, Suda G, Onozawa M, Kimura M, Maehara O, Ohara M, Izumi T, Umemura M, Ito J, Nakai M, Sho T, Natsuizaka M, Morikawa K, Ogawa K, Sakamoto N. Comparing the risk of hepatitis B virus reactivation between direct-acting antiviral therapies and interferon-based therapies for hepatitis C. J Viral Hepat 2017. [PMID: 28632923 DOI: 10.1111/jvh.12737] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hepatitis B virus (HBV) reactivation has been reported during antihepatitis C treatment in patients with hepatitis C virus (HCV) and HBV co-infection. We aimed to evaluate the frequency and risk factors of HBV reactivation during anti-HCV therapy and compared those between interferon (IFN)-free direct-acting antiviral (DAA) therapies and IFN-based therapies. Three hundred and twenty-two patients with HCV infection receiving anti-HCV therapy were retrospectively screened. The baseline HBV infection statuses of all eligible patients and the HBV-DNA level of all patients with current or previous HBV infection were examined at the end of treatment. In patients with baseline anti-HBs positivity, changes in anti-HBs titre were evaluated. Of 287 patients who met the inclusion criteria, 157 had current (n=4) or previous (n=153) HBV infection; 85 were treated with IFN-free DAA therapies and 72 were treated with IFN-based therapies. Six patients experienced HBV reactivation (n=2) or HBV reappearance (n=4) after IFN-free DAA therapies, while no patient developed HBV reactivation after IFN-based therapies. The risk factors of HBV reactivation or reappearance were DAA therapies and a reduction in anti-HBs titre to <12 mIU mL-1 by the end of treatment. The decline changes of anti-HBs titre were significantly higher in patients treated with DAA therapies. Although HBV reactivation hepatitis was not observed, three of four patients with HBV reactivation or reappearance after achieving HCV eradication had viremia 8 weeks after completion of therapy. A significant proportion of patients develop HBV reactivation or reappearance without hepatitis after IFN-free DAA therapies. Low levels of anti-HBs and their decrease to <12 mIU mL-1 after treatment are significant risk factors for HBV reactivation or reappearance.
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Affiliation(s)
- N Kawagishi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - G Suda
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Onozawa
- Department of Hematology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Kimura
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - O Maehara
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Ohara
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - T Izumi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Umemura
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - J Ito
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Nakai
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - T Sho
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Natsuizaka
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - K Morikawa
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - K Ogawa
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
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Tokodai K, Kawagishi N, Miyagi S, Nakanishi C, Hara Y, Nakanishi W, Kamei T, Ohuchi N. Splenectomy for Severe Intestinal Bleeding Caused by Portal Hypertensive Enteropathy After Pediatric Living-Donor Liver Transplantation: A Report of Three Cases. Transplant Proc 2017; 49:1129-1132. [DOI: 10.1016/j.transproceed.2017.03.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Miyagi S, Kawagishi N, Kashiwadate T, Fujio A, Tokodai K, Hara Y, Nakanishi C, Kamei T, Ohuchi N, Satomi S. Relationship Between Bile Duct Reconstruction and Complications in Living Donor Liver Transplantation. Transplant Proc 2017; 48:1166-9. [PMID: 27320579 DOI: 10.1016/j.transproceed.2015.10.073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 10/03/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVES In living donor liver transplantation (LDLT), the recipient bile duct is thin and short. Bile duct complications often occur in LDLT, with persistent long-term adverse effects. Recently, we began to perform microsurgical reconstruction of the bile duct. The purpose of this study was to investigate the relationship between bile duct reconstruction methods and complications in LDLT. METHODS From 1991 to 2014, we performed 161 LDLTs (pediatric:adult = 90:71; left lobe:right lobe = 95:66). In this study, we retrospectively investigated the initial bile duct complications in LDLT and performed univariate and multivariate analyses to identify the independent risk factors for complications. RESULTS The most frequent complication was biliary stricture (9.9%), followed by biliary leakage (6.8%). On univariate and multiple logistic regression analysis, the independent risk factors for biliary stricture were bile leakage (P = .0103) and recurrent cholangitis (P = .0077). However, there were no risk factors for biliary leakage on univariate analysis in our study. The reconstruction methods (hepaticojejunostomy or duct-to-duct anastomosis) and reconstruction technique (with or without microsurgery) were not risk factors for biliary stricture and leakage. CONCLUSION In this study, the most frequent complication of LDLT was biliary stricture. The independent risk factors for biliary stricture were biliary leakage and recurrent cholangitis. Duct-to-duct anastomosis and microsurgical reconstruction of the bile duct were not risk factors for biliary stricture and leakage.
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Affiliation(s)
- S Miyagi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan.
| | - N Kawagishi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - T Kashiwadate
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - A Fujio
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - K Tokodai
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - Y Hara
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - C Nakanishi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - T Kamei
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - N Ohuchi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - S Satomi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
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Tokodai K, Kawagishi N, Miyagi S, Nakanishi C, Hara Y, Fujio A, Kashiwadate T, Maida K, Goto H, Kamei T, Ohuchi N. The Significance of Screening for HLA Antibodies in the Long-Term Follow-up of Pediatric Liver Transplant Recipients. Transplant Proc 2017; 48:1139-41. [PMID: 27320574 DOI: 10.1016/j.transproceed.2015.12.081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 12/07/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Post-transplant donor-specific anti-HLA antibodies (DSA) reportedly have detrimental effects on the outcomes of organ transplantation. However, the prevalence of post-transplant DSA in the long term after pediatric liver transplantation remains unclear, and the significance of post-transplant DSA is unknown. The aim of this cross-sectional study was to determine the prevalence of and characteristics of patients with post-transplant DSA. MATERIALS AND METHODS Of the 84 pediatric liver transplant recipients who were followed up in the outpatient department of our institution, 34 patients with available HLA typing data were included after they or their parent(s) provided informed consent for DSA evaluations. Luminex single-antigen bead assays were performed, and a mean fluorescence intensity of ≥1000 was used as the cut-off for a positive reaction. RESULTS No class I DSA were detected, whereas class II DSA were detected in 11 patients (32%). There were no differences in age at transplantation, immunosuppressive drugs, or follow-up period between the DSA-positive and DSA-negative patients. The rate of positive pre-transplant complement-dependent cytotoxicity crossmatch was higher with class II DSA than without, although the difference was not statistically significant. CONCLUSIONS The utility of screening for class I DSA was insignificant in the long-term follow-up of pediatric liver transplant recipients. The prevalence of class II DSA was relatively high; therefore, screening for class II DSA might be justified, although a follow-up survey of the association between post-transplant class II DSA and the long-term clinical course needs to be conducted.
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Affiliation(s)
- K Tokodai
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
| | - N Kawagishi
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - S Miyagi
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - C Nakanishi
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - Y Hara
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - A Fujio
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - T Kashiwadate
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - K Maida
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - H Goto
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - T Kamei
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - N Ohuchi
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
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Miyagi S, Fujio A, Tokodai K, Hara Y, Nakanishi C, Goto H, Kamei T, Kawagishi N, Ohuchi N, Satomi S. Successful Case of Somatostatin Analog Stopping Gastrointestinal Bleeding, One of the Most Frequent Complications After Simultaneous Pancreas-kidney Transplantation: A Case Report. Transplant Proc 2016; 48:985-7. [PMID: 27234785 DOI: 10.1016/j.transproceed.2015.10.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 10/03/2015] [Indexed: 10/21/2022]
Abstract
OBJECT Pancreas transplantation has the highest surgical complication rate of all routinely performed organ transplantation procedures. The complications are not only caused by the pancreas itself but also occur due to issues with the transplant recipient. We report the case of a patient who experienced massive gastrointestinal bleeding after simultaneous pancreas-kidney transplantation (SPK), which was stopped successfully using somatostatin analog. PATIENTS AND METHODS The patient was a 45-year-old woman with diabetes mellitus type 1 who underwent SPK with enteric drainage. She had melena 5 days after SPK. RESULTS At first, we suspected that the melena was caused by the transplanted duodenum because of rejection and ischemic changes. The patient experienced severe bleeding 9 days after SPK. We quickly performed open surgery and inserted an endoscope from the recipient's ileum to investigate the transplanted duodenum. However, no bleeding source was found, including in the transplanted duodenum and the recipient's ileum end. We determined that the bleeding source was the recipient's ascending colon. We attempted to perform endovascular treatment but could not detect the source of the bleeding; therefore, we used somatostatin analog to let the blood vessels shrink and reduce pancreatic output. Thereafter, the function of the transplanted pancreas and kidney gradually recovered, and the recipient was discharged 154 days after SPK. CONCLUSION Gastrointestinal bleeding is a lethal complication and has several different causes, such as mucosal rejection, ischemic changes, and exocrine output of the pancreas graft. Somatostatin analog is one of the most acceptable treatments for patients who have gastrointestinal bleeding after SPK.
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Affiliation(s)
- S Miyagi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan.
| | - A Fujio
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - K Tokodai
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - Y Hara
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - C Nakanishi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - H Goto
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - T Kamei
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - N Kawagishi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - N Ohuchi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - S Satomi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
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Shimizu K, Miyagi S, Miyazawa K, Maida K, Kashiwadate T, Hara Y, Goto M, Kawagishi N, Ohuchi N. Resveratrol Prevents Warm Ischemia–Reperfusion Injury in Liver Grafts From Non–Heart-Beating Donor Rats. Transplant Proc 2016; 48:1221-5. [DOI: 10.1016/j.transproceed.2015.11.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 11/11/2015] [Indexed: 01/03/2023]
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Tokodai K, Kawagishi N, Miyagi S, Nakanishi C, Hara Y, Fujio A, Kashiwadate T, Maida K, Goto H, Kamei T, Ohuchi N. Poor Long-Term Outcomes of Adult Liver Transplantation Involving Elderly Living Donors. Transplant Proc 2016; 48:1130-3. [DOI: 10.1016/j.transproceed.2016.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/05/2016] [Accepted: 01/21/2016] [Indexed: 12/21/2022]
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Kawagishi N, Takeda I, Miyagi S, Sato K, Ohuchi N. Donors' quality of life evaluated by short form-36 analysis after living donor liver transplantation in a single-center experience. Transplant Proc 2015; 46:675-7. [PMID: 24767321 DOI: 10.1016/j.transproceed.2013.11.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/07/2013] [Accepted: 11/27/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to compare the quality of life of donors using the Short Form 36 (SF-36) analysis between the left and right graft periods of living donor liver transplantation. PATIENTS AND METHODS In the left graft period (July 1991 to July 2003), 68 donors were eligible for analysis and 76 were eligible in the right graft period (August 2003 to October 2010). Nine right lobe grafts were included in the left graft period, and 52 right lobe grafts were included in the right graft period. We investigated the risks of donation and evaluated the following: blood loss, operation time, postoperative liver function, and duration of hospitalization. We also assessed quality of life in donors, who were mailed a structured questionnaire and the SF-36. RESULTS Ten of the 68 donors in the left graft period and 12 of the 76 in the right graft period had postoperative complications. Most postoperative complications were treated without surgical procedures. There was no donor death in our series. Forty-eight donors in the left graft period and 36 in the right graft period responded to our investigation. Compared with published Japanese norms in SF-36, our donors scored similar or higher than the general population in both groups. Two donors in the left graft period and one in the right graft period regretted their decisions to donate. All donors returned to normalcy. CONCLUSIONS These results suggested that the donors' quality of life was guaranteed in terms of the SF-36 investigation regardless of the donation period in our series.
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Affiliation(s)
- N Kawagishi
- Division of Transplantation, Reconstruction, and Endoscopic Surgery, Tohoku University Hospital, Sendai, Japan; Division of Organ Transplantation, Tohoku University Hospital, Sendai, Japan.
| | - I Takeda
- Division of Transplantation, Reconstruction, and Endoscopic Surgery, Tohoku University Hospital, Sendai, Japan
| | - S Miyagi
- Division of Transplantation, Reconstruction, and Endoscopic Surgery, Tohoku University Hospital, Sendai, Japan
| | - K Sato
- Division of Transplantation, Reconstruction, and Endoscopic Surgery, Tohoku University Hospital, Sendai, Japan
| | - N Ohuchi
- Division of Transplantation, Reconstruction, and Endoscopic Surgery, Tohoku University Hospital, Sendai, Japan
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Murakami K, Kawagishi N, Ishida K, Sekiguchi S, Fujishima F, Sasano H, Ohuchi N. Fibrosing cholestatic hepatitis developing within one month after living donor liver transplantation for chronic hepatitis C-related cirrhosis: a case report. Transplant Proc 2015; 46:995-8. [PMID: 24767401 DOI: 10.1016/j.transproceed.2013.09.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 09/26/2013] [Indexed: 01/01/2023]
Abstract
Fibrosing cholestatic hepatitis (FCH) is a life-threatening consequence of hepatitis C virus (HCV) infection occurring in a small minority of liver transplantation (LT) recipients. We herein report a case of early-onset FCH after living donor LT in a 47-year-old woman with HCV-related cirrhosis. The patient underwent balloon-occluded retrograde transvenous obliteration of a splenorenal shunt to treat an impaired portal flow on the sixth postoperative day (POD 6) and a bypass operation for hepatic artery thrombosis on POD 12. Thereafter, the serum bilirubin levels increased gradually; however, computed tomography revealed no evidence of biliary stricture. The serum HCV-RNA level on POD 27 was >7.8 log IU/mL. Histopathology of a needle graft biopsy performed on POD 28 revealed FCH with extensive portal fibrosis accompanied by mild inflammation, hepatocyte ballooning, and ductular proliferation with cholestasis. The patient received combination therapy with pegylated interferon, ribavirin, and double-filtration plasmapheresis for the treatment of early-onset FCH. Both the recipient and the donor carried the major genotype single nucleotide polymorphism (TT) at rs8099917 near the interleukin-28B gene. Furthermore, the HCV genotype was treatment-sensitive 2a. Nonetheless, the recipient died of hepatic failure on POD 211. Thus far, few cases of FCH occurring within 1 month after LT have been reported. In addition, the early onset of FCH may be an adverse prognostic factor.
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Affiliation(s)
- K Murakami
- Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, Sendai, Japan.
| | - N Kawagishi
- Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, Sendai, Japan
| | - K Ishida
- Department of Diagnostic Pathology, Iwate Medical School of Medicine, Morioka, Japan
| | - S Sekiguchi
- Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, Sendai, Japan
| | - F Fujishima
- Department of Pathology, Tohoku University Hospital, Sendai, Japan
| | - H Sasano
- Department of Pathology, Tohoku University Hospital, Sendai, Japan
| | - N Ohuchi
- Division of Surgical Oncology, Tohoku University Hospital, Sendai, Japan
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Matsumura M, Mizuno Y, Okamoto M, Sawa N, Katayama Y, Shimoyama N, Kawagishi N, Miura K. Long-term complete remission of multiple extranodal natural killer/T-cell-type posttransplant lymphoproliferative disorder after surgical resection: a case report. Transplant Proc 2014; 46:2373-6. [PMID: 25011572 DOI: 10.1016/j.transproceed.2014.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 02/05/2014] [Accepted: 02/27/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Posttransplant lymphoproliferative disorder (PTLD) is a life-threatening complication of organ transplantation that results from immunosuppression therapy. Most cases of PTLD derive from the B-cell lineage. T-cell PTLD, particularly natural killer (NK)/T-cell PTLD, is quite rare; only a few cases have been described. CASE REPORT A 42-year-old woman received a living-related renal allograft from her father. Sixteen years after transplantation, the patient presented with a 1-week history of low-grade fever and epigastralgia. Computed tomography revealed intestinal masses and a right upper lung lobe mass. Gallium scintigraphy showed uptake in the abdominal mass. Epstein-Barr virus-related antibody was not detected in the patient's serum sample. We performed extirpation of the jejunum and ileum tumors. The pathologic findings showed that these 2 tumors were NK/T-cell lymphoma. After the operation, the lung mass rapidly enlarged, and right upper lobectomy was performed. The right upper lung lobe tumor showed the same histopathologic findings as the small bowel tumor. The final histologic diagnosis was established as multiple extranodal NK/T cell type PTLD of the small bowel and right upper lung lobe. CONCLUSIONS After reduction of the immunosuppressive agent, no recurrence of PTLD has been observed for the past 9 years.
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Affiliation(s)
- M Matsumura
- Division of Surgery, Hachinohe City Hospital, Japan.
| | - Y Mizuno
- Division of Surgery, Hachinohe City Hospital, Japan
| | - M Okamoto
- Division of Surgery, Hachinohe City Hospital, Japan
| | - N Sawa
- Division of Surgery, Hachinohe City Hospital, Japan
| | - Y Katayama
- Division of Pathology, Hachinohe City Hospital, Japan
| | - N Shimoyama
- Division of Pathology, Hakodate Municipal Hospital, Japan
| | - N Kawagishi
- Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - K Miura
- Division of Surgery, Hachinohe City Hospital, Japan
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Miyagi S, Kawagishi N, Maida K, Nakanishi W, Hara Y, Nakanishi C, Takeda I, Satoh K, Ohuchi N, Satomi S. Risk Factors for Portal Vein Stenosis in Living-Donor Liver Transplantation. Transplant Proc 2014; 46:689-91. [DOI: 10.1016/j.transproceed.2013.09.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 09/26/2013] [Indexed: 11/27/2022]
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Egawa H, Teramukai S, Haga H, Tanabe M, Mori A, Ikegami T, Kawagishi N, Ohdan H, Kasahara M, Umeshita K. Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation: a Japanese multicenter study. Am J Transplant 2014; 14:102-14. [PMID: 24279828 DOI: 10.1111/ajt.12520] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/24/2013] [Accepted: 09/24/2013] [Indexed: 01/25/2023]
Abstract
We evaluated the effects of rituximab prophylaxis on outcomes of ABO-blood-type-incompatible living donor liver transplantation (ABO-I LDLT) in 381 adult patients in the Japanese registry of ABO-I LDLT. Patients underwent dual or triple immunosuppression with or without B cell desensitization therapies such as plasmapheresis, splenectomy, local infusion, intravenous immunoglobulin and rituximab. Era before 2005, intensive care unit-bound status, high Model for End-Stage Liver Disease score and absence of rituximab prophylaxis were significant risk factors for overall survival and antibody-mediated rejection (AMR) in the univariate analysis. After adjustment for era effects in the multivariate analysis, only absence of rituximab prophylaxis was a significant risk factor for AMR, and there were no significant risk factors for survival. Rituximab prophylaxis significantly decreased the incidence of AMR, especially hepatic necrosis (p < 0.001). In the rituximab group, other B cell desensitization therapies had no add-on effects. Multiple or large rituximab doses significantly increased the incidence of infection, and early administration had no advantage. In conclusion, outcomes in adult ABO-I LDLT have significantly improved in the latest era coincident with the introduction of rituximab.
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Affiliation(s)
- H Egawa
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
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Sato K, Sekiguchi S, Kawagishi N, Miyagi S, Fujimori K, Sato A, Satomi S. The optimal timing for preparation of recipient superficial femoral veins to minimize intraoperative blood loss in living donor liver transplantation. Transplant Proc 2013; 45:1934-6. [PMID: 23769077 DOI: 10.1016/j.transproceed.2012.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 10/15/2012] [Accepted: 11/20/2012] [Indexed: 11/25/2022]
Abstract
AIMS Intraoperative blood loss (IBL) usually predominates during the dissection of the native liver. A right-lobe living donor liver transplantation (LDLT) sometimes requires an additional procedure to obtain an autologous vein from the recipient for the vascular reconstruction. These procedure can sometime contribute to progressive coagulopathy causing unexpected bleeding. Therefore, we analyzed our cases to determine the optimal timing for vascular preparation from the patient in terms of IBL. METHODS Among 67 patients included in the study, 30 did not require an additional procedure to obtain the venous graft (group A), and 37 LDLT employed a superficial femoral vein (SFV). Of these, 13 had undergone removal of SFV after the hilar dissection and liver mobilization from retrohepatic area while preserving the inferior vena cava (group B), and 24 removal of the SFV immediately after hilar dissection without liver mobilization from the retrohepatic space (group C). RESULTS A significant difference existed only in the scores of the Model for End-stage Liver Disease. Although the median IBL for group C was similar to that for group A, the median IBL for group B was significantly higher than that for other 2 groups. The median duration from skin incision to graft implantation for group B was significantly longer than that for groups A and group C, because of the additional hemostatic procedures in the retrohepatic space including the leg site. CONCLUSIONS The timing for removal of SFV in LDLT patients affects IBL associated with consumptive coagulopathy and prolongs operative time. Based on our experience, we concluded that SFV preparation should be performed before liver mobilization from the retrohepatic area to minimize IBL.
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Affiliation(s)
- K Sato
- Advanced Surgical Science and Technology Division, Department of Surgery, Graduate School of Medicine, University of Tohoku, Sendai, Japan.
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Miyagi S, Kawagishi N, Satoh K, Sekiguchi S, Ohuchi N, Satomi S. A patient with hepatic artery thrombosis after living-donor liver transplantation survived the great East Japan earthquake 3 days after reoperation: a case report. Transplant Proc 2013; 45:2066-8. [PMID: 23769110 DOI: 10.1016/j.transproceed.2012.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2012] [Accepted: 11/20/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND On March 11, 2011, our hospital was severely damaged by the Great East Japan Earthquake. We report the rare case of a 5-month-old patient with hepatic artery thrombosis (HAT) after living donor liver transplantation (LDLT), who survived the earthquake that occurred 3 days after the reoperation; we were able to save this patient without abilities to perform blood tests or computed tomography (CT) for 4 days. METHODS This female infant with biliary atresia underwent LDLT 5 months after birth and developed peritonitis owing to perforation of the small intestine 7 days later. Her blood pressure decreased and she developed HAT. We performed emergency reconstruction of the hepatic artery and repair of the small intestine, and 3 days after surgery, the Great East Japan Earthquake occurred. RESULTS We could not perform blood tests or CT scans because the water supply was damaged. Gas supply lines were also damaged and sterilization was not possible; surgical tools were limited. However, emergency power was available, so we performed ultrasonography every 6 hours and predicted liver function from intrahepatic blood flow and monitored for Glisson's capsule edema. The blood examination system recovered 14 days after LDLT, and we confirmed improvement of liver function. The patient was extubated 37 days after LDLT and discharged on postoperative day 67. CONCLUSIONS Portable ultrasonography was useful in evaluating intrahepatic blood flow and Glisson's capsule edema. Furthermore, it was effective during a disaster because it required no water or gas.
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Affiliation(s)
- S Miyagi
- Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University, Sendai, Japan.
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15
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Miyagi S, Kawagishi N, Nakanishi W, Fujio A, Miyazawa K, Maida K, Kashiwadate T, Hara Y, Sekiguchi S, Ohuchi N, Satomi S. Risk Factors for Hepatic Artery Thrombosis After Microsurgical Vascular Reconstruction in Liver Transplantation. Transplant Proc 2013; 45:1994-6. [DOI: 10.1016/j.transproceed.2012.12.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 11/22/2012] [Accepted: 12/31/2012] [Indexed: 01/27/2023]
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16
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Miyagi S, Kawagishi N, Sekiguchi S, Akamatsu Y, Sato K, Takeda I, Kobayashi Y, Tokodai K, Fujimori K, Satomi S. The relationship between recurrences and immunosuppression on living donor liver transplantation for hepatocellular carcinoma. Transplant Proc 2012; 44:797-801. [PMID: 22483499 DOI: 10.1016/j.transproceed.2012.01.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Living donor liver transplantation (LDLT) offers timely transplantation for patients with hepatocellular carcinoma (HCC). If ABO-incompatible LDLT is feasible, the needs for pretransplantation treatments may be eliminated. It is known that negative impacts of immunosuppression are limited among LDLT for HCC, however, we believe that excessive immunosuppression is one of the risk factors for recurrence. We compared the impacts of immunosuppression for LDLT with hepatectomy outcomes for HCC. METHODS From 1991 to 2010, we performed 144 LDLTs including 14 patients with HCC. Seven met the Milan criteria. Immunosuppressive therapies were based on tacrolimus plus methylprednisolone plus CD25 antibody. For ABO-incompatible cases, we also used mycophenolate mofetil and rituximab. Five cases underwent strong imunosuppressive therapy (steroid pulse or rituximab) within 180 days. In addition, we performed hepatectomy for 180 HCC cases from 1997 to 2010. RESULTS Overall survival rates of the LDLT cohort and hepatectomy groups were similar, but disease-free 5-year survival rates (DFS) of the LDLT cohort were significantly better than those of the hepatectomy group (total = 54.4% versus 27.4%, within the Milan criteria cases, 71.4% versus 33.8%). Thus, the negative impact of immunosuppression on recurrence was less than the benefit of a whole liver resection. Among strongly immunosuppressed cases, 5-years DFS rates were significantly worse than among other immunosuppressed cases (20.0% versus 76.2%). Upon univariate analysis, the factors associated with HCC recurrence were alpha-fetoprotein levels and steroid doses within 180 days, but multivariate analysis did not show a predictor for recurrence. CONCLUSION Patients who are strongly immunosuppressed may have several negative impacts for recurrences. More careful indications must be selected for ABO-incompatible cases.
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Affiliation(s)
- S Miyagi
- Department of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University, Aoba-ku, Sendai, Japan.
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17
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Kashiwadate T, Miyagi S, Hara Y, Akamatsu Y, Kawagishi N, Sekiguchi S, Satomi S. Recombinant Human Soluble Thrombomodulin (ART-123) Prevents Warm Ischemia-Reperfusion Injury in Liver Grafts from Non–Heart-Beating Donors. Transplant Proc 2012; 44:369-72. [DOI: 10.1016/j.transproceed.2012.01.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Miyagi S, Sekiguchi S, Kawagishi N, Akamatsu Y, Satoh K, Takeda I, Fujimori K, Satomi S. Nonmarginal-Donor Duodenal Ulcers Caused by Rejection After Simultaneous Pancreas and Kidney Transplantation: A Case Report. Transplant Proc 2011; 43:3292-5. [DOI: 10.1016/j.transproceed.2011.09.094] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Kawagishi N, Takeda I, Miyagi S, Satoh K, Akamatsu Y, Sekiguchi S, Satomi S. Quality of life and problems affecting recipients more than 10 years after living donor liver transplantation. Transplant Proc 2009; 41:236-7. [PMID: 19249523 DOI: 10.1016/j.transproceed.2008.08.139] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Accepted: 08/14/2008] [Indexed: 01/06/2023]
Abstract
BACKGROUND We initiated living donor liver transplantation (LDLT) in 1991, allowing us to examine issues related to long-term survival. The aim of this study was to review the long-term outcomes of LDLT in children. PATIENTS AND METHODS We performed 116 LDLT from 1991 to present, including 17 recipients who survived >10 years. They were evaluated for growth, immunosuppressive therapy, complications, and quality of life (QOL). RESULTS The average age at LDLT was 5.4 years (range, 6 months to 17 years), with a present average age of 17.2 years (range, 11-28 years). At the time of LDLT, 6 recipients had growth retardation with body weights low for age by 2 standard deviations (SD). However, 4 of 6 recipients who underwent LDLT before age of 2 years caught up, reaching average heights and body weights for their ages. Among 6 recipients who were diagnosed with acute rejections by biopsy >5 years after LDLT, 5 improved after steroid pulse therapy. One recipient with a steroid-resistant acute rejection was administered deoxyspergualin after steroids. Chronic rejection was not observed in this series. One recipient has not required immunosuppressive therapy for >4 years with a good present condition. CONCLUSION The majority of LDLT recipients achieved a good QOL during long-term survival; they are pursuing normal studies.
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Affiliation(s)
- N Kawagishi
- Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan.
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20
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Sato K, Sekiguchi S, Watanabe T, Enomoto Y, Akamastu Y, Kawagishi N, Miyagi S, Takeda I, Sato A, Fujimori K, Satomi S. The use of recipient superficial femoral vein as a venous graft for portal vein reconstruction in right lobe living donor liver transplantation. Transplant Proc 2009; 41:195-7. [PMID: 19249512 DOI: 10.1016/j.transproceed.2008.08.157] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2008] [Accepted: 08/14/2008] [Indexed: 10/21/2022]
Abstract
In living donor liver transplantation (LDLT), portal vein thrombosis (PVT) in the recipient is frequently regarded as a contraindication. To reconstruct the PV of a right-lobe liver graft (RLG) using an interposition or jump graft from the splenomesenteric junction, various vein grafts and technical modifications have been introduced. The internal jugular, external iliac, or great saphenous veins have been utilized in such reconstructive procedures. However, the superficial femoral vein (SFV) is preferable to the autologous vein grafts in terms of caliber, wall thickness, and length. We employed the recipient SFV to reconstruct PVT among 40 adult LDLT using RLG. Thirty-three were reconstructed by single end-to-end anastomosis with the right or left recipient PV. Three patients were transplanted with a RLG using 2 separated PVs reconstructed by double anastomoses with both the right and left PVs of the recipient. The remaining 4 patients required venous grafting for portal reconstruction. We used the recipient SFV as an interposition or jump graft from the splenomesenteric junction to the graft PV. There were 2 cases of anastomotic PV stenosis; 1 in portal reconstruction without a venous graft and the other with a SFV graft. Both were treated successfully by balloon angioplasty. The recipient SFV is an excellent size match for the PV reconstruction as a long interposition or jump conduit when the venous system from the deceased donor is not available. The indication for LDLT in patients with complete PVT should be carefully decided before transplantation in terms of portal reconstruction.
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Affiliation(s)
- K Sato
- Department of Advanced Surgical and Technology, Tohoku University School of Medicine, Sendai, Aobaku, Japan
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21
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Sato K, Iwane T, Sekiguchi S, Nakamura A, Akamatsu Y, Kawagishi N, Miyagi S, Takeda I, Sato A, Fujimori K, Satomi S. Management of Living Donor Liver Transplant Patients Using Twice-Daily 4-Hour Intravenous Cyclosporine Therapy. Transplant Proc 2009; 41:229-32. [DOI: 10.1016/j.transproceed.2008.08.158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Accepted: 08/14/2008] [Indexed: 11/26/2022]
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22
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Miyagi S, Sekiguchi S, Kawagishi N, Akamatsu Y, Sato A, Fujimori K, Satomi S. Parkinsonism During Cyclosporine Treatment in Liver Transplantation: An Unusual Case Report. Transplant Proc 2008; 40:2823-4. [DOI: 10.1016/j.transproceed.2008.07.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Miyagi S, Enomoto Y, Sekiguchi S, Kawagishi N, Sato A, Fujimori K, Satomi S. Microsurgical Back Wall Support Suture Technique With Double Needle Sutures on Hepatic Artery Reconstruction in Living Donor Liver Transplantation. Transplant Proc 2008; 40:2521-2. [DOI: 10.1016/j.transproceed.2008.07.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Hashimoto R, Hashimoto H, Shintani N, Chiba S, Hattori S, Okada T, Nakajima M, Tanaka K, Kawagishi N, Nemoto K, Mori T, Ohnishi T, Noguchi H, Hori H, Suzuki T, Iwata N, Ozaki N, Nakabayashi T, Saitoh O, Kosuga A, Tatsumi M, Kamijima K, Weinberger DR, Kunugi H, Baba A. Pituitary adenylate cyclase-activating polypeptide is associated with schizophrenia. Mol Psychiatry 2007; 12:1026-32. [PMID: 17387318 DOI: 10.1038/sj.mp.4001982] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Pituitary adenylate cyclase-activating polypeptide (PACAP, ADCYAP1: adenylate cyclase-activating polypeptide 1), a neuropeptide with neurotransmission modulating activity, is a promising schizophrenia candidate gene. Here, we provide evidence that genetic variants of the genes encoding PACAP and its receptor, PAC1, are associated with schizophrenia. We studied the effects of the associated polymorphism in the PACAP gene on neurobiological traits related to risk for schizophrenia. This allele of the PACAP gene, which is overrepresented in schizophrenia patients, was associated with reduced hippocampal volume and poorer memory performance. Abnormal behaviors in PACAP knockout mice, including elevated locomotor activity and deficits in prepulse inhibition of the startle response, were reversed by treatment with an atypical antipsychotic, risperidone. These convergent data suggest that alterations in PACAP signaling might contribute to the pathogenesis of schizophrenia.
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Affiliation(s)
- R Hashimoto
- The Osaka-Hamamatsu Joint Research Center for Child Mental Development, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan.
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25
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Sato K, Sekiguchi S, Kawagishi N, Akamatsu Y, Enomoto Y, Takeda I, Fukushima D, Fujimori K, Sato A, Satomi S. Continuous low-dose human atrial natriuretic peptide promotes diuresis in oliguric patients after living donor liver transplantation. Transplant Proc 2007; 38:3591-3. [PMID: 17175340 DOI: 10.1016/j.transproceed.2006.10.130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2006] [Indexed: 11/23/2022]
Abstract
Human atrial natriuretic peptide (ANP) is beneficial for the prophylaxis of acute renal failure (ARF) after liver transplantation (OLT). We evaluated renal function in OLT patients with or without ARF, describing cases unresponsive to loop diuretics successfully treated with continuous low-dose ANP infusion without hemodialysis. Twenty-seven consecutive adult-to-adult living donor liver transplantations (LDLTs) were performed in 26 patients. One case was excluded due to the need for continuous hemodialysis (HD) during the operation. Of the 26 cases, 6 (23%, group 2) developed ARF in the first 30 days after LDLT; the other 20 were ARF-free (group 1). The median follow-up was 24 months. No patient required either continuous or intermittent HD. Only one patient died due to multiple liver abscesses. Mean preoperative serum creatinine (sCr) value and intraoperative blood loss in group 2 were significantly higher than those in group 1. Three cases in group 2 failed to improve on high-dose loop diuretics with low-dose dopamine, exhibiting fluid overload. The remaining three cases in group 2 responded to conventional diuretic treatments. Continuous low-dose ANP was started 2, 4, or 5 days after LDLT, and urine output significantly increased after ANP administration. The serum creatinine values were 1.1, 1.2, and 1.1 at 1 month and 1.0, 0.9, and 0.6 mg/dL at 6 months after LDLT. Massive blood loss during the operation caused ARF, but did not affect renal function after LDLT. Continuous low-dose ANP improved renal function and diuresis for oliguric ARF patients, preventing the need for HD or continuous venovenous hemodialysis.
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Affiliation(s)
- K Sato
- Advanced Surgical Science and Technology Division, Department of Surgery, Graduate School of Medicine, University of Tohoku, Sendai, Japan.
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26
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Saiga K, Toyoda E, Tokunaka K, Masuda A, Matsumoto S, Mashiba H, Kuramochi H, Nemoto K, Abe F, Kawagishi N, Furukawa H, Ono M. NK026680, a novel compound suppressive of dendritic cell function, ameliorates mortality in acute lethal graft-versus-host reaction in mice. Bone Marrow Transplant 2006; 37:317-23. [PMID: 16299543 DOI: 10.1038/sj.bmt.1705231] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2005] [Revised: 10/04/2005] [Accepted: 10/10/2005] [Indexed: 11/09/2022]
Abstract
A role for dendritic cells (DCs) has been emphasized in the onset of acute graft-versus-host disease (GVHD). We have made efforts to develop a new strategy for suppression of DC functions with a chemical compound in the treatment of acute GVHD. We here describe the immunological characterization of the new chemical compound NK026680. It was found that NK026680 significantly suppressed (1) expression of CD83, CD86, and major histocompatibility complex (MHC) class I and II antigens on human monocyte-derived DCs, (2) excretion of interleukin-12p40 on activation of monocyte-derived DCs, (3) allogeneic responses of human and mouse T cells and (4) mortality in mice with acute GVHD evoked across MHC class I or II. The beneficial effect of NK026680 administered orally was without any recognizable adverse effects. Early intervention in acute GVHD was required for this effect, indicating that an early event in acute GVHD is a critical target of NK026680. We propose the use of NK026680 as a prophylactic for acute GVHD.
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Affiliation(s)
- K Saiga
- Pharmaceutical Group, Nippon Kayaku Co., Ltd, Tokyo, Japan
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27
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Sato K, Sekiguchi S, Fukumori T, Kawagishi N, Akamastu Y, Enomoto Y, Iwane T, Fujimori K, Sato A, Satomi S. Experience With Recipient’s Superficial Femoral Vein as Conduit for Middle Hepatic Vein Reconstruction in a Right-Lobe Living Donor Liver Transplant Procedure. Transplant Proc 2005; 37:4343-6. [PMID: 16387116 DOI: 10.1016/j.transproceed.2005.11.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Middle hepatic vein reconstruction during the right-lobe living donor liver transplant procedure has been recognized to be a significant factor. We initially reconstructed only a single middle hepatic vein orifice draining into segment 8. In cases where the right-lobe liver graft has several major middle hepatic vein tributaries, including veins draining segment 5 that are remote from the right hepatic vein orifice, a long and thick interposition conduit is necessary for reconstruction. Among 11 consecutive adult patients who received a right-lobe liver graft without a middle hepatic vein at our institution, 8 underwent reconstruction of all major middle hepatic vein tributaries using a vein graft from the recipient's superficial femoral vein. The remaining 3 patients had no major middle hepatic vein tributaries. Posttransplant-computed tomography imagings showed increased liver mass with a patent superficial femoral vein graft in 8 patients. In the absence of a venous system from a deceased donor, a recipient superficial femoral vein offers an excellent size match to maintain the venous outflow of middle hepatic vein tributaries. Reconstruction with recipient superficial femoral vein plays an important role in maximizing liver function and minimizing morbidity in the early posttransplant period.
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Affiliation(s)
- K Sato
- Department of Surgery, Graduate School of Medicine, University of Tohoku, Sendai, Japan.
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28
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Koyamada N, Sato A, Takayama J, Usuda M, Kawagishi N, Doi H, Fujimori K, Satomi S. Macrophage depletion prevents anti-graft antibody production and results in long-term survival in xenotransplantation. Transplant Proc 2005; 37:514-5. [PMID: 15808694 DOI: 10.1016/j.transproceed.2005.01.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Liposome-encapsulated dichloromethylene diphosphonate (clodronate) is known to deplete macrophages. We examined the effect of clodronate on xenoreactive antibody production and xenograft rejection. Hamster cardiac grafts were transplanted into Lewis rats. Clodronate (4 mL/kg) was injected intravenously on the day before transplantation. In some groups, cyclosporine A (CsA) at a dose of 15 mg/kg was given daily intramuscularly until the end of each experiment. Untreated Lewis rats rejected the grafts at 2 and 3 days after transplantation. Neither CsA treatment alone nor clodronate treatment alone prolonged graft survival. Five of 7 Lewis recipients treated with clodronate and CsA did not reject hamster hearts for 100 days. Antibody production in the CsA plus clodronate-treated group was suppressed compared with control groups.
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Affiliation(s)
- N Koyamada
- Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Sendai City, Japan.
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29
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Kawagishi N, Satoh K, Enomoto Y, Akamatsu Y, Sekiguchi S, Fukumori T, Fujimori K, Satomi S. New strategy for ABO-incompatible living donor liver transplantation with anti-CD20 antibody (rituximab) and plasma exchange. Transplant Proc 2005; 37:1205-6. [PMID: 15848670 DOI: 10.1016/j.transproceed.2004.12.114] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
It is more difficult to control humoral rejection in living donor liver transplantations (LDLT) across the ABO blood group barrier than in matched or compatible combinations. We achieved excellent results in ABO-incompatible transplantation with novel immunosuppressive regimens and plasma exchange (PE). Among 82 LDLT were 10 cases of ABO-incompatible recipients, including three who were administered rituximab for rescue or prophylactic therapy. Pretransplantation PE was performed as necessary to maintain hemagglutinin titers below 1:16 and posttransplantation PE was performed when there were signs of hyperacute rejection associated with high titers. Induction immunosuppression consisted of FK506, steroid, mycophenolate mofetil (MMF), and rituximab. The first patient was administered rituximab with deoxyspergualin (DSG), steroid pulse therapy, and PE on postoperative day (POD) 7, because of biopsy-proven humoral acute rejection. The titers and LFTs improved drastically. The second and third patients were administered rituximab just after the operation with other routine immunosuppressants for prophylaxis of hyperacute rejection. The second patient showed a slight deterioration in LFTs with an elevated titer, which normalized after steroid pulse therapy and PE. The third patient had no episodes of rejection. At present, that is 27, 17, and 6 months after the operations respectively, the 3 transplant recipients are in stable condition.
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Affiliation(s)
- N Kawagishi
- Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Sendai, Japan.
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30
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Wang HS, Enomoto Y, Usuda M, Miyagi S, Asakura T, Masuoka H, Fukushima K, Aiso T, Narita T, Yamaya H, Sekiguchi S, Kawagishi N, Sato A, Ohkohchi N, Satomi S. Excessive portal flow causes graft nonfunction in small size liver transplantation: An experimental study in pigs. Transplant Proc 2005; 37:407-8. [PMID: 15808660 DOI: 10.1016/j.transproceed.2005.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We investigated the effects of portocaval shunt (PCS) on excessive portal flow in producing sinusoidal microcirculatory injury in small-for-size liver transplants in pigs. The posterior segment of a whole liver (25%) was transplanted orthotopically. The pigs were divided two groups: group A, graft with PCS (n = 11), and group B, graft without PCS (n = 11). The PCS was a side-to-side anastomosis of the portal vein and the inferior vena cava. In group A, eight pigs survived for more than 4 days; all pigs except for one died of graft nonfunction within 24 hours in group B. The portal flow after reperfusion decreased in group A, but increased about three times greater in group B than that before the operation (P < .01). In group B, destruction of the sinusoidal lining and bleeding in the periportal areas were observed after reperfusion, findings that were not recognized in group A. These results suggest that graft nonfunction after small-for-size liver transplantation may be attributable to excessive portal flow producing sinusoidal microcirculatory injury.
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Affiliation(s)
- H S Wang
- Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Sendai, Japan.
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Kawagishi N, Ohkohchi N, Fujimori K, Orii T, Koyamada N, Kikuchi H, Sekiguchi S, Tsukamoto S, Sato T, Satomi S. Antibody elimination by apheresis in living donor liver transplant recipients. Ther Apher 2001; 5:449-54. [PMID: 11800079 DOI: 10.1046/j.1526-0968.2001.00376.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In the present study, we investigated retrospectively the indications and the efficacy of the elimination of preexisting antiallogeneic antibodies in liver transplant recipients. Three patients who were ABO blood type incompatible were subjected to plasmapheresis and double filtration plasmapheresis before the living donor liver transplantation (LDLTx), and the titers decreased to less than 8. After transplantation, plasmapheresis was also performed in 3 cases, and continuous hemodiafiltration in 1 case, and in 2 out of these 3 patients acute rejection was recognized. Two patients who were crossmatch positive were subjected to plasmapheresis before transplantation, and the T warm titers were reduced to less than Score 2. These 2 patients had no acute rejections after transplantation. We conclude that in liver transplant patients apheresis is effective to prevent acute rejection induced by preexisting anti-A and/or anti-B antibodies and anti-donor specific antibodies before transplantation, but it is not effective in a patient with accelerated humoral rejection occurring after transplantation.
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Affiliation(s)
- N Kawagishi
- Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Sendai, Japan
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32
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Ohkohchi N, Orii T, Kawagishi N, Satomi S. Quality of life of pediatric patients receiving living donor liver transplantation in long-term follow-up period. Transplant Proc 2001; 33:3610-3. [PMID: 11750534 DOI: 10.1016/s0041-1345(01)02554-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- N Ohkohchi
- Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Aobaku, Sendai, Japan
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Yamashita A, Kawagishi N, Miyashita T, Nagatsuka T, Sugiura T, Kume K, Shimizu T, Waku K. ATP-independent fatty acyl-coenzyme A synthesis from phospholipid: coenzyme A-dependent transacylation activity toward lysophosphatidic acid catalyzed by acyl-coenzyme A:lysophosphatidic acid acyltransferase. J Biol Chem 2001; 276:26745-52. [PMID: 11352914 DOI: 10.1074/jbc.m101795200] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
CoA-dependent transacylation activity in microsomes is known to catalyze the transfer of fatty acids between phospholipids and lysophospholipids in the presence of CoA without the generation of free fatty acids. We previously found a novel acyl-CoA synthetic pathway, ATP-independent acyl-CoA synthesis from phospholipids. We proposed that: 1) the ATP-independent acyl-CoA synthesis is due to the reverse reaction of acyl-CoA:lysophospholipid acyltransferases and 2) the reverse and forward reactions of acyltransferases can combine to form a CoA-dependent transacylation system. To test these proposals, we examined whether or not recombinant mouse acyl-CoA:1-acyl-sn-glycero-3-phosphate (lysophosphatidic acid, LPA) acyltransferase (LPAAT) could catalyze ATP-independent acyl-CoA synthetic activity and CoA-dependent transacylation activity. ATP-independent acyl-CoA synthesis was indeed found in the membrane fraction from Escherichia coli cells expressing mouse LPAAT, whereas negligible activity was observed in mock-transfected cells. Phosphatidic acid (PA), but not free fatty acids, served as an acyl donor for the reaction, and LPA was formed from PA in a CoA-dependent manner during acyl-CoA synthesis. These results indicate that the ATP-independent acyl-CoA synthesis was due to the reverse reaction of LPAAT. In addition, bacterial membranes containing LPAAT catalyzed CoA-dependent acylation of LPA; PA but not free fatty acid served as an acyl donor. These results indicate that the CoA-dependent transacylation of LPA consists of 1) acyl-CoA synthesis from PA through the reverse action of LPAAT and 2) the transfer of the fatty acyl moiety of the newly formed acyl-CoA to LPA through the forward reaction of LPAAT.
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Affiliation(s)
- A Yamashita
- Faculty of Pharmaceutical Sciences, Teikyo University, Sagamiko, Kanagawa 199-0195, Japan.
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Kawagishi N, Ohkohchi N, Fujimori K, Orii T, Koyamada N, Kikuchi H, Satomi S. Experience with artificial liver support in 16 living related liver transplant recipients. Ther Apher 2001; 5:7-11. [PMID: 11258616 DOI: 10.1046/j.1526-0968.2001.005001007.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study was a retrospective investigation about the indication and efficacy of artifical liver support for liver transplant recipients. Apheresis was performed in 16 of 41 patients subjected to living related liver transplantation (LRLTx) as articial liver support, including plasmapheresis (PP) in 13 cases, continuous hemodiafiltration (CHDF) in 7 cases, and plasma adsorption (PA) in 2 cases. One patient with cryptogenic liver cirrhosis was subjected to PP before the LRLTx, and the result was satisfactory. On the contrary, the results of PP and CHDF for graft, respiratory, or cardiac failure were not acceptable. Only 1 patient survived despite multiple organ failure. Both PP and PA for patients with hyperbilirubinemia were effective and improved their critical conditions. We conclude that apheresis for liver transplant patients is effective to treat hyperbilirubinemia, but it is not indicated for respiratory and cardiac failure nor for hepatic failure.
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Affiliation(s)
- N Kawagishi
- Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Sendai, Japan
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Koyamada N, Ohkohchi N, Doi H, Orii T, Kikuchi H, Chubachi S, Sekiguchi S, Kawagishi N, Haga I, Nakajima N, Satomi S, Oguma S. Strategy for chronic rejection in recipient of living-related liver transplantation. Transplant Proc 2000; 32:2134-6. [PMID: 11120102 DOI: 10.1016/s0041-1345(00)01603-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- N Koyamada
- 2nd Department of Surgery, Tohoku University School of Medicine, Sendai, Japan.
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Kawagishi N, Ohkohchi N, Fujimori K, Orii T, Chubachi S, Koyamada N, Watanabe M, Asakura T, Gotoh M, Satomi S. Indications and efficacy of apheresis for liver transplant recipients: experience of 16 cases in 34 living-related liver transplants. Transplant Proc 2000; 32:2111-3. [PMID: 11120092 DOI: 10.1016/s0041-1345(00)01593-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- N Kawagishi
- The 2nd Department of Surgery, Tohoku University School of Medicine, Sendai, Japan
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Orii T, Ohkohchi N, Koyamada N, Kikuchi H, Chubachi S, Kawagishi N, Satomi S. Growth of pediatric patients with biliary atresia after liver transplantation: influence of age at transplantation and steroid administration. Transplant Proc 2000; 32:2210-2. [PMID: 11120136 DOI: 10.1016/s0041-1345(00)01638-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- T Orii
- Second Department of Surgery, School of Medicine, Tohoku University, Sendai, Japan.
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Takayama J, Ohkohchi N, Gotoh M, Ogawa N, Nakasima N, Asakura T, Oikawa K, Kawagishi N, Watanabe M, Mizuno Y, Sakurai M, Kikuchi H, Koyamada N, Orii T, Doi H, Fujimori K, Katoh H, Satomi S, Shimaoka S. Treatment for strictures of hepatojejunostomy in living-related liver transplantation. Transplant Proc 2000; 32:2235-40. [PMID: 11120148 DOI: 10.1016/s0041-1345(00)01650-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- J Takayama
- Second Department of Surgery, Tohoku University, School of Medicine, Sendai, Japan
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Abstract
A-59-year-old Japanese woman presented a cellulitis-like erythematous skin rash, low-grade fever, and general fatigue, accompanied by a firm swelling of the right parotid gland. She had a history of tick bite on the right lateral neck 2 weeks before. Serum anti-Borrelia burgdorferi antibody was positive by Western blot analysis, and B. burgdorferi was isolated from the skin lesion. Serum amylase level was elevated with predominant salivary gland isozyme; the level returned to normal within 3 weeks following penicillin and tetracycline treatment. Parotitis might be included among the rare complications of Lyme disease affecting the head and neck region.
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Affiliation(s)
- N Kawagishi
- Division of Dermatology, Kitami Kobayashi Hospital, Kitami, Japan
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Kawagishi N, Ohkohchi N, Doi H, Satomi S. Human T-cell receptor variable gene analysis against porcine peripheral lymphocytes. Transplant Proc 2000; 32:950-1. [PMID: 10936291 DOI: 10.1016/s0041-1345(00)01055-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- N Kawagishi
- The 2nd Department of Surgery, Tohoku University School of Medicine, Sendai, Japan
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Abstract
We describe two cases of pleomorphic angioleiomyoma. In one case, a 46-year-old man presented with a single nodule on his scrotum of 1 year's duration, and in another, a 38-year-old woman presented with a single nodule on her right knee of 1 year's duration. In both cases, histopathologic examination showed a well-circumscribed nodule composed of smooth muscle and numerous veins and capillaries. Contrary to the ordinary angioleiomyoma, marked nuclear pleomorphism was noted. Although mitoses were rare, immunohistochemistry revealed many tumor cells that were positive for proliferating cell nuclear antigen, Ki-67, and p53, indicating that the pleomorphic appearance does not simply represent a degenerative change of some tumor cells.
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Affiliation(s)
- N Kawagishi
- Division of Dermatology, Kitami Kobayashi Hospital, Japan
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Magosaki N, Hosoda S, Kawagishi N, Yamaguchi T, Sakatani H, Haze K, Itagane H, Otsuka M, Nobuyoshi M, Yokoi H. [Efficacy of hemostatic puncture closing device for hemostasis and early ambulation after coronary angiography and angioplasty: results of a multicenter trial]. J Cardiol 1999; 34:131-8. [PMID: 10500973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
To assess the efficacy and safety of a hemostatic puncture closing device for reducing patient immobilization after cardiac catheterization from a percutaneous femoral artery approach, we conducted a prospective, randomized trial at 4 participating centers. A total of 240 patients (183 men, 57 women, mean age 61 +/- 10 yr; 157 patients underwent diagnostic angiography, 83 patients underwent coronary angioplasty) were randomized to either the device group (n = 120) or the manual compression group (n = 120). There were no statistical differences in age, gender, weight or sheath size between the 2 groups. A 7, 8F sheath was used in 53 patients of the device group and in 43 patients of the manual compression group. One hundred and two patients (85%) in the device group and 96 patients (80%) in the manual compression group received heparin. Protamine was used in one patient of the device group and 23 patients of the manual compression group. Activated clotting time just prior to sheath removal was 206 +/- 64 sec in the device group and 170 +/- 47 sec in the manual compression group (p < 0.01). Successful placement of the device was achieved in 118 of 120 patients (98%). Time to hemostasis was significantly shorter in the device group (0.8 +/- 3.2 vs 12.2 +/- 5.3 min, p < 0.01). Time to ambulation could be reduced in the device group (5.3 +/- 3.7 vs 10.9 +/- 5.1 hr, p < 0.01). The following complication rates occurred in the device group as compared with the manual compression group: hematoma, 16% vs 10%; bleeding, 8% vs 3%; pseudoaneurysm, 0% vs 1%, respectively. None of these differences was statistically significant. These results indicate that early ambulation using a hemostatic puncture closing device is feasible without significantly increasing the risk of peripheral vascular complications.
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Affiliation(s)
- N Magosaki
- Department of Cardiology, Heart Institute of Japan, Tokyo Women's Medical University
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Kawagishi N, Tsurumi Y, Ishii Y, Suzuki K, Kasanuki H. Clinical and angiographic outcome of stenting following suboptimal results of percutaneous transluminal coronary angioplasty in small (<2.5 mm) coronary arteries. Catheter Cardiovasc Interv 1999; 47:269-76. [PMID: 10402274 DOI: 10.1002/(sici)1522-726x(199907)47:3<269::aid-ccd1>3.0.co;2-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of the present study was to evaluate the feasibility and efficacy of stenting following suboptimal percutaneous transluminal coronary angioplasty (PTCA) in angiographically small coronary arteries. The clinical and angiographic outcome of unplanned stenting in 33 patients with coronary arteries <2.5 mm in diameter was studied. Procedural success was achieved for 97.0% with a greater initial gain (1.79 +/- 0.60 vs. 1.34 +/- 0.58 mm, P < 0.05) and larger postprocedural minimal luminal diameter (2.19 +/- 0.43 vs. 1.57 +/- 0.57 mm, P < 0.001) than that in the size-matched elective PTCA patients. Trends toward a lower restenosis rate and a significant reduction in target lesion revascularization (7.1% vs. 41.9%, P < 0.01) were observed in the stented patients, suggesting the feasibility and efficacy of stenting following suboptimal PTCA in small coronary arteries. Cathet. Cardiovasc. Intervent. 47:269-276, 1999.
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Affiliation(s)
- N Kawagishi
- Department of Cardiology, the Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan
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Oikawa K, Ohkohchi N, Kato H, Orii T, Shimaoka S, Kawagishi N, Asakura T, Takayama J, Satomi S. Graft weight/recipient body weight ratio (G/R ratio) in living-related liver transplantation for pediatric patients: abdominal wall closure in cases with a large G/R ratio. Transplant Proc 1998; 30:3209-10. [PMID: 9838419 DOI: 10.1016/s0041-1345(98)00998-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K Oikawa
- Second Department of Surgery, Tohoku University, School of Medicine, Sendai, Japan
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Asakura T, Ohkohchi N, Katoh H, Orii T, Kikuchi H, Sekiguchi S, Kawagishi N, Takayama J, Oikawa K, Satomi S. Doppler ultrasonography in living-related liver transplantation. Transplant Proc 1998; 30:3190-4. [PMID: 9838410 DOI: 10.1016/s0041-1345(98)00989-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- T Asakura
- Second Department of Surgery, Tohoku University School of Medicine, Aoba-ku Sendai, Japan
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Kawagishi N, Ohkohchi N, Fujimori K, Doi H, Sakurada M, Kikuchi H, Oikawa K, Takayama J, Satomi S. Safety of the donor operation in living-related liver transplantation: analysis of 22 donors. Transplant Proc 1998; 30:3279-80. [PMID: 9838449 DOI: 10.1016/s0041-1345(98)01028-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- N Kawagishi
- 2nd Department of Surgery, Tohoku University School of Medicine, Sendai, Japan
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47
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Takayama J, Ohkohchi N, Oikawa K, Asakura T, Kawagishi N, Kikuchi H, Koyamada N, Orii T, Sakurada M, Doi H, Fujimori K, Katoh H, Satake M, Satomi S. Living related liver transplantation in patients with ABO incompatibility. Transplant Proc 1998; 30:3504-6. [PMID: 9838537 DOI: 10.1016/s0041-1345(98)01115-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- J Takayama
- Second Department of Surgery, Tohoku University, School of Medicine, Sendai, Japan
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Kawagishi N, Hashimoto Y, Takahashi H, Ishida-Yamamoto A, Iizuka H. Epidermal cell kinetics of pig skin in vivo following UVB irradiation: apoptosis induced by UVB is enhanced in hyperproliferative skin condition. J Dermatol Sci 1998; 18:43-53. [PMID: 9747661 DOI: 10.1016/s0923-1811(98)00024-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We investigated the effects of ultraviolet B (UVB) irradiation on pig epidermal sunburn cell (apoptotic cell) formation. Expression of p53 tumor suppressor gene product, p21 (WAF1/CIP1), and proliferating cell nuclear antigen (PCNA) was also determined immunohistochemically. Apoptotic cells appeared at 12 h and reached a peak at 48 h following 2 MED-UVB irradiation. The formation of sunburn cells was confirmed by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) method. p53-positive cells, and p21-positive cells appeared at 6 h, and 12 h, respectively, following the UVB-irradiation. The peak of p53-positive cells was observed at 24 h, and that of p21-positive cells was at 48 h. No expression of TUNEL-, p53-, or p21-positive cells was detected in non-irradiated epidermis. The increase in PCNA-positive cells was observed at 24 h and reached its peak at 96 h following the UVB-irradiation. Flow cytometric analyses indicated a decrease in S-phase cells at 24 h, that was followed by their increase at 96 h. Cells in G2/M phase were also considerably decreased at 6 h and 48 h following the UVB-irradiation, and was followed by their increase thereafter. The [3H]thymidine uptake and mitotic counts remained low up until 48 h, and then both parameters increased reaching their peaks at 72 96 h. Effects of UVB irradiation were also determined in tape stripping-induced hyperproliferative epidermis. The numbers of UVB-induced apoptotic cells and PCNA positive cells were markedly enhanced in the tape stripping-treated epidermis, while the numbers of p53- and p21-positive cells were not significantly altered. No induction of apoptosis, p53, or p21 was observed by tape stripping alone. Our results indicate that UVB irradiation induces G1 arrest, prolonged S, and G2/M block of epidermal keratinocytes as well as apoptosis. These processes provide a G1 check point and the elimination of possibly hazardous cells carrying DNA damage, respectively. Our results also indicate that the UVB-induced apoptotic process is enhanced in hyperproliferative skin condition suggesting that apoptosis is closely associated with cell cycle progression.
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Affiliation(s)
- N Kawagishi
- Division of Dermatology, Kitami Kobayashi Hospital, Japan
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Satake M, Kawagishi N, Möller E. Direct activation of human responder T cells by porcine stimulator cells leads to T cell proliferation and cytotoxic T cell development. Xenotransplantation 1996. [DOI: 10.1111/j.1399-3089.1996.tb00138.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hashimoto Y, Kawagishi N, Sakai H, Takahashi H, Matsuo S, Nakao M, Miyamoto K, Iizuka H. Lyme disease in Japan. Analysis of Borrelia species using rRNA gene restriction fragment length polymorphism. Dermatology 1995; 191:193-8. [PMID: 8534936 DOI: 10.1159/000246545] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Lyme disease is sporadically observed in Japan since the first report in 1987. We have experienced 19 cases of Lyme disease. In 12 out of 13 trials we succeeded in isolating Borrelia strains (JEM1-12) from erythema migrans (EM) lesions. Recently, Borrelia burgdorferi sensu lato was classified into at least three distinct subgroups, B. burgdorferi sensu stricto, B. garinii and B. afzelii. OBJECTIVE In order to characterize Lyme disease in Japan, we summarized the clinical features of our cases and investigated the nature of the isolated Borrelia strains. METHODS The 12 Borrelia strains were analyzed by restriction fragment length polymorphism (RFLP) of ribosomal RNA gene. RESULTS Most of our 19 patients were in stage I with EM as the main clinical manifestation. RFLP analysis using 12 strains isolated from the patients indicated that 8 strains (group IV, V) were different from the three aforementioned genospecies. CONCLUSION Clinical data from the present study substantiate the view that Japanese Lyme disease has a relatively milder course. We speculate that this may be related to the specific Borrelia strains in Japan.
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Affiliation(s)
- Y Hashimoto
- Department of Dermatology, Asahikawa Medical College, Hokkaido, Japan
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