著者

江川 裕人 尾形 哲 山本 雅一 高原 武志 若林 剛 藤山 泰二 高田 泰次 保田 裕子 八木 孝仁 岡島 英明 海道 利実 上本 伸二 伊藤 孝司 吉村 了勇 吉住 朋晴 調 憲 前原 喜彦 阪本 靖介 猪股 裕紀洋 篠田 昌宏 板野 理 北川 雄光 川岸 直樹 石山 宏平 井手 健太郎 大段 秀樹 水野 修吾 伊佐地 秀司 浅岡 忠史 永野 浩昭 梅下 浩司 日髙 匡章 江口 晋 小倉 靖弘

出版者

一般社団法人 日本移植学会

雑誌

移植 (ISSN:05787947)

巻号頁・発行日

vol.50, no.1, pp.062-077, 2015-03-10 (Released:2015-03-31)

参考文献数

12

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【Objective】To estimate a standard dosage of rituximab prophylaxis for ABO incompatible living donor liver transplantation (ABO-I LDLT), we retrospectively investigated rituximab dosage, efficacy and safety in 37 patients including 4 children undergoing ABO-I LDLT with rituximab prophylaxis in 15 centers in 2013.【Methods】We analyzed the data collected by questionnaire that were sent to registered surgeons or hepatologists of the Japanese Liver Transplantation Society.【Results】Doses of rituximab in adult patients were 500 mg/body in 16 cases (48%), 375 mg/m2 in 12 cases (36%) and 300 mg/body or 100 mg/body in 5 cases. The number of administration was one in 29 cases (89%). The scheduled timing of initial administration was 2 weeks of operation or earlier in 14 centers (93%), and the median of actual timing was 14 days prior to transplantation. One-year patient survival rate was 82%, and the incidence of antibody-mediated rejection (AMR) was 9%. Patients with a standard regimen consisting of 500 mg/body or 375 mg /m2 rituximab 2 weeks before operation or earlier had significantly better one-year survival rate compared to a non-standard regimen consisting of 100mg/body or 300mg/body rituximab later than 2 weeks (100% vs. 70%, p = 0.009) and a lower incidence of AMR (0% vs. 15%, p=0.074). ABO-I LDLT with rituximab prophylaxis was well tolerated.【Conclusion】The recommended regimen for rituximab prophylaxis is a single dose of 375 mg/m2 body surface area 2 weeks before transplantation or earlier. The dose should be reduced carefully according to patient condition.

著者

川岸直樹研究代表

出版者

[川岸直樹]

巻号頁・発行日

2008

著者

原 康之 川岸 直樹 中西 史 武田 郁央 宮城 重人 佐藤 和重 関口 悟 佐藤 成 大内 憲明

出版者

一般社団法人 日本移植学会

雑誌

移植 (ISSN:05787947)

巻号頁・発行日

vol.48, no.1, pp.048-052, 2013-03-10 (Released:2014-10-03)

参考文献数

12

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An indocyanine green (ICG) test is a reliable and convenient examination that has been generally used for evaluating the liver function for hepatectomy, especially in patients with hepatic cirrhosis. We routinely perform an ICG test a preoperative examination for the donor of the living donor liver transplantation (LDLT). Here we report a rare case of living donor with Gilbert's syndrome and a constitutional ICG excretory defect.A 32-year-old woman became a donor candidate of LDLT for her 7-month-old nephew with fulminant hepatic failure. Preoperative examination tests showed no abnormal values except a marked delay of ICG retention rate at 15 minutes (69.2%) and hyperbilirubinemia; total bilirubin was 2.5 mg/dl, and indirect bilirubin was 2.3 mg/dl. The patient was diagnosed as Gilbert's syndrome with constitutional ICG excretory defect but was still entitled as an appropriate living donor. Left lateral segmentectomy was performed for the donor, and there were neither perioperative nor postoperative complications. Laboratory tests of the donor showed no remarkable change during a two-year course after surgery. The recipient was discharged 87 days after the transplantation without severe complications.This case report showed that left lateral segmentectomy could safely be performed on the living donor with Gilbert's syndrome and constitutional ICG excretory defect. However, more data collections and deliberations are required to decide whether a volume extraction of grafts, i.e., right or left lobe, is applicable to this donor.

著者

佐埜 勇 川岸 直樹 阿部 道夫 土屋 誉 里見 孝弘 新井 元順 九里 孝雄 渡部 秀一 伊藤 順造 佐々木 幸則 児山 香

出版者

一般社団法人日本消化器外科学会

雑誌

日本消化器外科学会雑誌 (ISSN:03869768)

巻号頁・発行日

vol.25, no.10, pp.2530-2534, 1992-10-01

被引用文献数

1

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肝細胞癌を合併した非常にまれな抗ミトコンドリア抗体陰性の早期の無症候性の原発性胆汁性肝硬変症の1例を報告する.症例は71歳の男性で,近医で肝細胞癌を指摘され当院に手術目的で紹介入院.入院時自覚症状なく黄疽,貧血を認めず.腹部所見で心窩部に手拳大の腫瘤を触知するほか異常所見なし.血清学的検査では胆道系酵素が上昇し,HBs抗原陰性,HCV抗体陽性だった.腫瘍マーカーは正常範囲内だった.免疫学的検査ではIgMのみが軽度高値を示したほか正常であった.腹部超音波検査,コンピューター断層撮影,血管造影にて肝左葉外側区域の直径7.0cmの肝細胞癌と診断し,肝左葉外側区域切除術施行.病理学的検査では,腫瘍部は高分化型のEdmondson II型の肝細胞癌で非腫瘍部には細胆管の増殖と中等大以下の小葉間胆管に炎症像のみらねるstage 2の早期の原発性胆汁性肝硬変症と診断.経過順調で現在外来通院中である.