著者

大岡 啓二 寺本 好告 菅原 毅正 越智 達正 清水 公治 竹内 賢 杉浦 啓介 佐藤 武司 伊勢田 徳宏 岩田 英信 竹内 正文 土居 靖和 羽藤 高明

雑誌

移植 (ISSN:05787947)

巻号頁・発行日

vol.30, no.6, pp.583-588, 1995-12-10

参考文献数

7

被引用文献数

2

著者

瓜生原 葉子

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.006-012, 2013-03-10 (Released:2014-10-03)

参考文献数

24

著者

上本 伸二 門田 守人 市田 隆文 後藤 正治 田中 紘一 土肥 雪彦

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.55, no.1, pp.1-12, 2020 (Released:2020-04-25)

著者

富丸 慶人 後藤 邦仁 小林 省吾 永野 浩昭 森 正樹 土岐 祐一郎 江口 英利 伊藤 壽記 野口 洋文 宮下 和幸 川本 弘一 岩上 佳史 秋田 裕史 野田 剛広

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.54, no.4, pp.217-222, 2019

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<p>Total pancreatectomy with islet autotransplantation is an ideal surgical procedure used to relieve chronic pain derived from the pancreatitis, while insulin-dependent diabetes is inevitably induced after the surgery. Islet autotransplantation combined with a total pancreatectomy can reduce the risk of severe diabetes by preserving available islet cells. We experienced a case with hereditary pancreatitis, which is a rare inherited condition characterized by recurrent acute pancreatitis and/or chronic pancreatitis. The case was that of a female in her thirties who was introduced to our hospital due to treatment-refractory abdominal pain derived from repeated pancreatitis even after surgical treatments. At the introduction, the pain was uncontrollable even by opioid use, and oral intake was impossible due to increase of the pain after the intake. She was genetically diagnosed with hereditary pancreatitis. For relieving the pancreatitis-derived pain, total remnant pancreatectomy with islet autotransplantation was planned. After the pancreatectomy, islet cells were extracted from the excised remnant pancreas, and injected into the portal vein for liver autotransplantation. The pain was completely relieved for her after the surgery, suggesting improvement of her quality-of-life. A glucose tolerance test and glucagon loading test performed one month after the surgery showed C-peptide secretion as the blood glucose rose. However, the serum c-peptide level and SUIT index had been gradually decreased after the surgery, and she is now treated with insulin. The case suggested that total pancreatectomy with islet autotransplantation is useful for improvement of the patient's quality of life by controlling the pain in cases with hereditary pancreatitis.</p>

著者

笠原 群生 内田 孟 佐々木 健吾 平田 義弘 武田 昌寛 上遠野 雅美 久保田 智美 中里 弥生 福田 晃也 阪本 靖介

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.53, no.2-3, pp.197-208, 2018 (Released:2018-11-07)

参考文献数

33

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【Purpose】 We reviewed our experience of liver transplantation in the National Center for Child Health and Development and report the results herein.【Subjects and methods】 We have handled 500 cases of liver transplantation from November 2005 through March 2018 in the National Center for Child Health and Development. Variables including indication of liver transplantation and immunological outcome were reviewed.【Results】 There were 469 living donor, 27 deceased and 4 domino liver transplantations in the study period. The indication for liver transplantation was cholestatic liver disease in 48.0%, followed by metabolic liver disease in 22.0% and acute liver failure in 12.6%. The mean age of recipients was 4.0±5.5 years and body weight was 14.9±13.3 kg. Immunosuppression consisted of tacrolimus and low-dose steroids. The incidence of acute cellular rejection was 42.0%. The 10-year patient survival was 90.2%.【Conclusion】 Satisfactory results can be achieved in the liver transplantation program in the National Center for Child Health and Development. Deceased donor liver transplantation, patients with acute liver failure and re-transplantation shows significantly lower patient survival. We conclude that liver transplantation is a safe and effective treatment modality together with proper indication and excellent management strategy. The significant factors affecting survival may be overcome by the technical and immunological refinements that have occurred in recent years.

著者

伊藤 壽記

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.4-5, pp.378-386, 2015-09-10 (Released:2015-10-30)

参考文献数

13

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In terms of absolute shortages of donors, organ transplantation in Japan is in a more serious position than in Europe or the United States. In Japan, a law allowing organ transplantation from brain-dead donors finally came into force in October 1997. The first pancreas transplantation (PTx) was successfully performed at Osaka University Hospital in April 2000. Since then, however, only 86 cases of procurement have occurred over the approximately 13 years after introduction of the law; it was very strict and limited to organ procurement from donors who had provided prior written consent. The law was eventually revised in July 2010 to more closely resemble laws in Europe and the U. S.After this revision, the number of donations has increased approximately seven-fold. The number of such procedures totaled 146 (33.0/year, as of December 31, 2014) after the revision, compared to 64 (4.9/year) before the revision. However, the rate of marginal donors is 67.1%, which is still high.Although the number of donors increased, donor shortages and severe environment surrounding donors still exist in our country. Transplant outcomes, however, are comparable to those in Europe and the U. S.This report examines the present status and problems of PTx in Japan from the perspective of “marginal donors.”

著者

岡田 剛史

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.54, no.1, pp.29-35, 2019 (Released:2019-04-02)

参考文献数

34

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Although postoperative quality of life of living donors for organ transplantation has been reported to be better than that of the normal population, it is reported that they also experience various psychiatric and psychological problems. In this report, we review psychiatric and psychological problems and consider effective mental interventions for living donors. It is inferred that there is a specific psychological mechanism in the donor, such as obtrusion in donors, rebirth fantasy, rebound neglect, or ambivalent feelings about donor selection. In addition, donors sometimes exhibit physical, economic, and social anxiety and a depressive state arising from feelings of guilt towards the recipient. It is important for caregivers to recognize these mechanisms and understand the donor’s psychology. The death of the recipient, delay in returning to society, lack of family support, economic burden, and past history of mental illness are the risk factors for donors’ low psychological quality of life and require intensive support. Donors who are not fully aware of their own psychological ambivalence before donation also tend to experience decline in the psychological quality of life. In Japan, third parties evaluate the spontaneity of providing donor organs in an interview. In this interview, asking about donors’ ambivalence may contribute to donors’ mental well-being. Focusing on positive aspects of donation, such as post-traumatic growth and resilience, is also important.

著者

日本臨床腎移植学会・日本移植学会

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.52, no.2-3, pp.113-133, 2017-09-30 (Released:2017-09-30)

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A large number of 1,648 kidney transplants in Japan, including 1,471 from living donors, 61 from nonheart-beating donors, and 116 from heart-beating donors, were performed in 2016. The data obtained from the Japanese Renal Transplant Registry are shown and analyzed in this annual report. The characteristics of recipients and donors, such as relationships, original diseases, duration of dialysis therapy, blood transfusion, status of viral antigens and antibodies, pretransplant complications, causes of death of deceased donors, ischemic time, and histocompatibilities, are described. Moreover, immunosuppressants used initial and other treatments are analyzed. We also report the results of a follow-up survey for recipients and living donors.

著者

島津 元秀

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.001-005, 2015-03-10 (Released:2015-03-31)

参考文献数

5

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Even after the revision of the Organ Transplant Law, organ transplantation continues to be mired in a dire situation. The causes of this situation must be understood when taking steps to reverse it; in fact, these causes have been partially discussed in the past. Issues include both hard and soft aspects, such as institutional issues not solved by legal revision alone, prejudice, and misunderstandings of transplantation rooted in a cultural/historical background.Potential measures for improving the situation include: revision of the transplantation system (enhancement of in-hospital coordinators, simplification of transplantation suitability assessments, saving labor in organ donation verification) ; administrative reform (organ procurement organizations, brain death notification system, opting out) ; revision of the health insurance system (insurance coverage of brain death determination, various additional fees adjustment factor) ; and educational/public awareness activities (secondary education, media cooperation, participation by recipients and others).The time has come to investigate methods to increasing organ donations as a national project.

著者

奥村 明之進 澤 芳樹

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.4-5, pp.192-200, 2013-09-10 (Released:2013-11-16)

参考文献数

9

著者

市丸 直嗣

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.6, pp.312-316, 2013-12-10 (Released:2014-01-30)

参考文献数

29

著者

日本造血細胞移植データセンター・日本造血細胞移植学会

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.53, no.2-3, pp.163-172, 2018 (Released:2018-11-07)

参考文献数

3

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Hematopoietic stem cell transplantation (HSCT) offers potentially curative treatment for a wide range of otherwise fatal hematologic disorders, and the number of HSCTs has continued to increase over the last 20 years, and more than 5,000 allogeneic and autologous HSCTs have been performed annually in recent years. A constant increase of allogeneic HSCTs for older (aged over 50) patients, and an increase in the variety of donor/stem cell source such as cord blood from unrelated donors have led to this constant increase of HSCTs in Japan. The transplant survival outcome also continues to improve and the assets for the improvement include better supportive care, innovative transplant approaches, and the considerable contribution of a well-established transplant outcome registry to a variety of clinical studies.

著者

石神 修大 佐野 俊二 王 英正

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.6, pp.565-575, 2015-12-10 (Released:2015-12-20)

参考文献数

47

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In July 2010, the domestic law for organ transplants was revised to enable children under 15-year of age to donate their organs if the parents had given consent in the case of brain death. After this revision, the substantial number of pediatric heart transplantations was expected to increase; however only 7 cases were performed during these 5 years. The problems related to the shortage of organ donors and long waiting times for orthotopic heart transplantations have not yet been resolved. As a result, new treatment strategies including innovative mechanical devices and regenerative therapies for pediatric heart failure, are critically needed. Accumulated evidence of cardiac regeneration strategies using various types of somatic stem cells have revealed the efficacy of stem cell therapies for heart failure. Initial results of the Transcoronary Infusion of Cardiac Progenitor cell infusion in patients with single ventricle physiology (TICAP) phase I study (NCT01273857) conducted at Okayama University (2011-2013) have shown that intracoronary infusion of cardiosphere-derived cells (CDCs) following staged palliation was feasible and safe to treat children with hypoplastic left heart syndrome. Currently, a randomized phase II trial (Cardiac Progenitor Cell Infusion to treat Univentricular Heart Disease: PERSEUS, NCT01829750) is ongoing at our institution to verify the therapeutic efficacy of CDC infusion in patients with univentricular heart diseases. From 2016, we will conduct a countrywide sponsor-initiated multicenter clinical trial to construct this therapeutic strategy for children with heart failure as an insurance coverage treatment. In this review, we discuss the problems involved with end-stage pediatric heart failure and the current status of stem cell therapy for heart failure in children.

著者

堤 寛

雑誌

移植 (ISSN:05787947)

巻号頁・発行日

vol.45, no.2, pp.110-115, 2010-04-10

参考文献数

14

著者

大段 秀樹

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.6, pp.333-338, 2013-12-10 (Released:2014-01-30)

参考文献数

9

著者

瀬戸 加奈子 松本 邦愛 高橋 絹代 藤田 民夫 高原 史郎 相川 厚 篠崎 尚史 長谷川 友紀

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.52, no.4-5, pp.346-351, 2017-09-30 (Released:2017-11-24)

参考文献数

10

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Although public opinion polls reported that over 40% of Japanese people want to donate their organs at death, the number of organs remains low (=< 1 donor/million population). This low donation rate is supposed to be due to the lack of an in-hospital system to confirm patient desires to donate organs to patients at hospitals. The purpose of this study is to develop and evaluate the educational program to improve the quality of terminal care at acute care hospitals in the form of a QM (quality management) seminar at emergency departments, focusing on management methods and quality management to facilitate and establish an in-hospital system. From 2013 to 2015, there were 94 participants. Pre- and post-program test showed that the improvement rate was 15.9% for transplantation medical care, 6.9% for skills, and 10.5% for the management method. By the educational method, the improvement rate was 10.1% for lecture and 10.2% for group-work exercise (+ lecture). Compared with doctors, nurses had a lower improvement rate in the domain of management methods. A questionnaire survey showed that the participants evaluated that management method was difficult and their understanding level was low, but they highly recommended participation. To improve the quality terminal care, the role of nurses is important because they are the major players in patient care, and revision to improve the educational program is necessary to provide outcomes similar to those doctors produce. Other supporting methods, such as the provision of educational tools and sharing success cases, should be considered to facilitate in-hospital system development.

著者

松村 外志張

雑誌

移植 (ISSN:05787947)

巻号頁・発行日

vol.40, no.2, pp.129-142, 2005-04-10

参考文献数

25

被引用文献数

2

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

兵頭 洋二 宍戸 清一郎 河村 毅 櫻林 啓 新津 靖雄 二瓶 大 青木 裕次郎 村松 真樹 酒井 謙 相川 厚

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.042-047, 2013-03-10 (Released:2014-10-03)

参考文献数

10

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【Objective】The purpose of this study was to evaluate pharmacokinetic (Pk) profile of newly developed modified release tacrolimus (MR-TAC) in pediatric kidney transplant recipients.【Methods】According to our current immunosuppressive protocol, tacrolimus (TAC) was initially given and converted to MR-TAC in 13 pediatric patients who received kidney transplantation from April 2010 to April 2011. The switch dose ratio was 1:1, and the 24hour full Pk study was assessed before and after the conversion from TAC to MR-TAC.【Results】The mean total daily dose at baseline upon enrollment was 5.4±3.3 mg. There was no significant correlation between the oral dose and the trough concentration (C0) of TAC/MR-TAC. The consecutive Pk studies revealed no significant difference in the mean time to maximum concentration (Tmax) / maximum concentration (Cmax) and the area under the time-concentration curve (AUC0-24) of both reagents; the mean C0 of MR-TAC was 18% lower than those of TAC. A better correlation between AUC0-24 and C0 was observed in MR-TAC compared to that in TAC (r2=0.912, for MR-TAC; r2>0.555, for TAC). 【Conclusion】In the conversion from TAC to MR-TAC, AUC0-24 was equivalent despite the 18% reduction of C0, even in the pediatric kidney transplant recipients. The trough concentration might be an excellent predictor in the therapeutic drug monitoring of MR-TAC because of its better correlation of C0 and AUC0-24.

著者

冨岡 勉 三ツ林 裕巳 赤枝 恒雄 新谷 正義 羽生田 俊 大隈 和英 田村 憲久 河野 太郎 河村 建夫

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.51, no.1, pp.001-006, 2016-03-10 (Released:2016-03-25)

参考文献数

2

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It has been five years since the revised Organ Transplant Act went into effect, but the number of organ transplants has not increased; indeed, there has been a decreasing trend in the number of cases. Because of that, we have decided to respond by establishing a Parliamentarians' League for Consideration of Organ Transplants in the parliament. Although various measures have been undertaken up to now, we express our renewed determination to execute stronger measures, in cooperation with medical societies, the Japan Organ Transplant Network, and other groups, with the aim of increasing the number of transplants to over 200 cases within five years.