Kyushu University Academic Staff Educational and Research Activities Database
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Noboru Harada Last modified date:2019.06.06

Lecturer / Department of Surgery and Science, Graduate School of Medical Sciences
Liver Surgery
Kyushu University Hospital


Graduate School
Undergraduate School
Other Organization
Administration Post
Other
Other


E-Mail
Homepage
http://www.kyudai2geka.com/index.html
Phone
092-642-5466
Fax
092-642-5482
Academic Degree
Doctor of Philosophy
Country of degree conferring institution (Overseas)
No
Field of Specialization
Hepatobiliary-pancreas and liver transplant surgery
Total Priod of education and research career in the foreign country
01years00months
Outline Activities
Clinical medical practice and research for hepatobiliary-pancreas cancer, living donor liver transplantation, and deceased donor liver transplantation
October 2018- Associate Professor, MD, PhD, F.A.C.S under Professor Mori, MD, PhD, F.A.C.S, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan
August 2017- Associate Professor, MD, PhD, F.A.C.S under Professor Maehara, MD, PhD, F.A.C.S, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan
April 2016- Assistant Professor, under Professor Maehara, MD, PhD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan
April 2014- March 2016 Assistant Director of the Department of General Surgery, Red Cross Hospital and Survivors Hospital
April 2012- March 2014 Department of the Department of General Surgery, Saiseikai General Hospital, Fukuoka, Japan
April 2011- March 2012 Visiting Physician, under Director Sander Florman, MD, PhD, Recanati/Miller Transplantation Institute Mount Sinai School of Medicine in New York, USA
April 2010- March 2011 Visiting Professor, under Professor Maehara, MD, PhD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan
April 2008- March 2010 Chief Attendant of hepatobiliary-pancreas Surgery and Digestive surgery, Department of Surgery, Fukuoka City Hospital, Japan
October 2005- March 2008 Visiting Professor, under Professor Maehara, MD, PhD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan
April 2005- September 2005 Clinical Fellow, under Professor Maehara, MD, PhD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, training the surgical management of hepatobiliary-pancreas surgery and liver transplantation, Japan
April 2001- March 2005 Reseach Assistant, under Professor Maehara, MD, PhD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, studying the basic science and clinical training of hepatocellular carcinoma and liver transplantation, Japan
April 2000- March 2001 Postgraduate Medical Education Program, Department of Surgery, Munakata doctor association Hospital, Fukuoka, Japan.
Residency included 12 months in general surgery.
April 1999- March 2000 Postgraduate Medical Education Program, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Residency included 6 months in general surgery, 3 months in emergency medicine, and 3 months in anesthesia.
Research
Research Interests
  • 1.Clinical outcome and indications of liver transplantation in patients with hepatocellular carcinoma(novel vascular pattern of metastasis in living donor liver transplantation)
    2.Tolerance of liver transplantation allograft
    3.Prevention of the postoperative biliary stricture and TMA
    4.Perioperative treatment of Intrahepatic cholangiocellular carcinoma including the operative indication
    5.The pancreas stiffness using Real-time Elastography is a useful index to predict the postoperative pancreatic fistula; A preliminary study
    6.Analysis of hepatic artery reconstruction in living donor liver transplantation using left lobe
    7.Analysis of hepatic artery reconstruction in living donor liver transplantation using right lobe
    8. Analysis of effect of MMF in living donor liver transplantation
    keyword : hepatocellular carcinoma, immunology
    2016.04~2021.03.
Current and Past Project
  • The vacuole called exosome which cancer associated fibroblast which is important to cancer progress secretes out of the cell contains a great variety of unknown protein and mRNA or miRNA, but is unexplained about the detailed functional significance. CAF brought EMT of the cancer cell through exosome and might take an important role of the increase permeation of cancer and thought that this mechanism elucidation was connected for the innovative cure that controlled new liver cancer increase permeation, and an original idea did this study. The purpose of this study elucidates cancer increase permeation mechanism through exsome of CAF in the liver cancer and is that an original idea does new liver cancer treatment. The role of exosome which CAF of the liver cancer which it is hard to control secretes is unexplained, and the mechanism is unreported and thinks that there are originality and originality. I analyze the influence on liver cancer strain of separation exosome and an expression of miRNA and mRNA change with the microarray and analyze liver cancer progress permeation ability by these expression control and am going to elucidate mechanism.
  • In a specimen to hepatectomy of hepatocellular carcinoma, is easy to have vessels permeation with HCC subtype to exist a special blood vessel pattern to be surrounded with more sinusoid-like vasculature, and a no recurrence survival rate is bad after art; this EMT (Hepatology, 2015, 62; 452-65) that were reported when caused blood circulation metastasis and remote metastasis independently. There is much metastasis remoter than the recurrence in the liver, and remote metastasis controls convalescence as a recurrence form after a live donor liver transplant for the liver cancer. I examine HCC subtype and a liver cancer recurrence form.
Academic Activities
Books
1. 原田 昇, Bacteremia; Risk Factors, Treatment and Potential Complications, 2014.08, Bacterial sepsis is frequent occurrences during the first 1 to 2 months after liver transplantation under the immunosuppressive therapy. Despite recent advances in perioperative management and surgical techniques, postoperative mortality and morbidity rates are still associated with infectious complications such as bacterial sepsis after liver transplantation. Furthermore, bacterial sepsis is the most frequent cause of in-hospital death after living donor liver transplantation (LDLT).
In this section, we discuss the etiology, outcomes, and risk factors of bacterial sepsis after LDLT, and we focus on the impact of the perioperative nutritional support in LDLT to prevent bacterial sepsis after LDLT. Compared with deceased donor liver transplantation, LDLT involves smaller graft size and scheduled nonemergent surgery. The smaller graft size is the main disadvantage of adult-to adult LDLT because it results in increased portal venous pressure, impaired bowel motility, bacterial translocation, ascites production, and hyperbilirubinemia.
In the last 2 decades, nutritional support has been recognized as a vital component for the management of critically ill patients, by delivering preoperative essential substrates, and nutrition by using enteral feeding, to aid patient recovery. In particular, preoperative branched-chain amino acid (BCAA) supplementation might reduce the incidence of postoperative bacterial sepsis after LDLT, and early enteral nutrition was associated with significantly reduced risk of developing bacterial sepsis after LDLT.
In this way, poor nutritional status of the pretransplants can be improved by using preoperative nutritional support and high infectious status of the posttransplants under immunosuppressive therapy can be improved with initiation of the early postoperative enteral nutrition. Improved nutrition supports a functional immune system and reduces septic morbidity and mortality in patients with liver transplantation. .
Papers
1. Harada N, Yoshizumi T, Uchiyama H, Soejima Y, Ikegami T, Itoh S, Maehara Y., Impact of Hepatic Artery Size Mismatch between Donor and Recipient on Outcomes after Living-donor Liver Transplantation using the Right Lobe. Clinical Transpl. , Clinical Transplantation, 2019.05.
2. Harada N, Yoshizumi T, Ikegami T, Itoh S, Furusho N, Shimoda S, Fukuhara T, Soejima Y, Maehara Y., Serum Asunaprevir and Daclatasvir Concentrations and Outcomes in Patients with Recurrent Hepatitis C who have Undergone Living Donor Liver Transplantation., Anticancer Research, 2018.10, Abstract: Background/Aim: This study’s aim was to investigate the safety and effectiveness of asunaprevir and daclatasvir treatment for recurrent hepatitis C virus (HCV) infection in transplant recipients. The study cohort comprised 14 transplant recipients with recurrent hepatitis C who were receiving asunaprevir and daclatasvir. Patients and Methods: Serum concentrations of asunaprevir and daclatasvir, their therapeutic effects, trough concentrations/dose ratios of tacrolimus, and adverse effects were evaluated. Results: Hepatitis C virus was still undetectable in 12 (85.7%) of 14 patients 12 weeks after completing treatment. One week after starting treatment, asunaprevir concentrations were significantly higher in patients with baseline albumin concentrations ≤ 3.6 g/dl than in those with baseline albumin concentrations >3.6 g/dl. No marked fluctuations were identified in tacrolimus trough concentrations/dose ratios during the 24 weeks of therapy. Conclusion: Full doses of asunaprevir and daclatasvir-based treatment can be safely and effectively administered to liver transplant recipients for recurrent HCV genotype 1b after living donor liver transplantation (LDLT) with little effect on blood concentrations of tacrolimus..
3. Noboru Harada, Surgical Resection for hepatocellular carcinoma with Concomitant Esophageal Varices., World Journal of Surgery, 10.1007/s00268-015-3110-9, 39, 10, 2510-2518, 2016.02, Background: The aim of this study was to compare the outcome of patients with hepatocellular carcinoma (HCC), Barcelona Clinic Liver Cancer (BCLC) stages 0 and A, and portal hypertension (PHT) who underwent liver resection (LR) or radiofrequency ablation (RFA).Methods: The study population consisted of 121 patients with PHT and HCC of BCLC stage 0 and A who underwent LR (n=81) or RFA (n=40). To reduce bias in patient selection, the different covariate distributions in the two groups were adjusted using inverse probability treatment weighting (IPTW). The prognostic outcomes of LR- and RFA-treated patients were then analyzed.
Results: Before IPTW adjustment, the 5-year overall survival (OS) of LR and RFA patients was comparable. Five-year recurrence-free survival (RFS) was significantly better in the LR group than in the RFA group (P < 0.0001). Multivariate analysis showed that RFA was an independent predictor of worse RFS (P = 0.0004). The RFA group had more local recurrences rates than the LR group and each group had tendency to perform the same treatment modality as the firstline one after recurrence. After IPTW adjustment, the OS of patients in the LR and RFA groups did not significantly differ, whereas the RFS of the LR group remained significantly better than that of the RFA group (P=0.00014). However, the RFA group had fewer postoperative complication rates and a shorted length of hospital stay. Conclusions: By taking care of the postoperative complications, LR may be a treatment option for patients with BCLC stage 0 or A HCC and PHT..
Presentations
1. The treatment strategy for the improvement of outcomes after hepatectomy for patients with intrahepatic cholangiocellular carcinoma.
2. Comparison of the Outcomes of Patients with Hepatocellular Carcinoma and Portal Hypertension after Liver Resection vs. Radiofrequency Ablation.
Membership in Academic Society
  • Japanese Society of Hepato-Biliary-Pancreatic Surgery
  • Japan Surgical Society
Awards
  • none
Educational
Educational Activities
I perform laboratory assignment of medical department 3 annual (medicine subject, life sciences department) in particular, study instruction in the basic placement, medical department 5 annual bedside teaching and the bedside teaching in the Clinical Clark Ship of the medical department sixth grader. In addition, it enforces an instructional activity as an examiner in the OSCE, a marking official, an instructor.
Other Educational Activities
  • 2016.08, The University of Tokyo; Health Science Bachelor, Hongo 7-3-1, Bunkyo-ku, 113-8653, Tokyo, Japan (1992)
    Kyushu University; Bachelor of Medicine, Maidashi 3-1-1, Hiugashi-ku, 812-8582, Fukuoka, Japan. (1999).
    Kyushu University; Doctor of Medicine, Maidashi 3-1-1, Hiugashi-ku, 812-8582, Fukuoka, Japan. (2005).
    April 2016- Assistant Professor, under Professor Maehara, MD, PhD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan
    April 2014- March 2016 Assistant Director of the Department of General Surgery, Red Cross Hospital and Survivors Hospital
    April 2012- March 2014 Director of the Department of General Surgery, Saiseikai General Hospital, Fukuoka, Japan
    April 2011- March 2012 Visiting Physician, under Director Sander Florman, MD, PhD, Recanati/Miller Transplantation Institute Mount Sinai School of Medicine in New York, USA
    April 2010- March 2011 Visiting Professor, under Professor Maehara, MD, PhD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan
    April 2008- March 2010 Chief Attendant of hepatobiliary-pancreas Surgery and Digestive surgery, Department of Surgery, Fukuoka City Hospital, Japan
    Octorber 2005- March 2008 Visiting Professor, under Professor Maehara, MD, PhD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan
    April 2005- September 2005 Clinical Fellow, under Professor Maehara, MD, PhD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, training the surgical management of hepatobiliary-pancreas surgery and liver transplantation, Japan
    April 2001- March 2005 Reseach Assistant, under Professor Maehara, MD, PhD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, studying the basic science and clinical training of hepatocellular carcinoma and liver transplantation, Japan
    April 2000- March 2001 Postgraduate Medical Education Program, Department of Surgery, Munakata doctor association Hospital, Fukuoka, Japan.
    Residency included 12 months in general surgery.
    April 1999- March 2000 Postgraduate Medical Education Program, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Residency included 6 months in general surgery, 3 months in emergency medicine, and 3 months in anesthesia..
Social
Professional and Outreach Activities
I work on international medical assistance from Japan by supporting activity of the authorized NPO Rosinantes.
I worked on the pediatric living donor liver transplantation in Myanmar from March 15 to18 in 2019..