| 1. |
Kitada H, Sugitani A, Yamamoto H, Otomo N, Okabe Y, Inoue S, Nishiyama K, Morisaki T, Tanaka M, Attenuation of renal ischemia-reperfusion injury by FR167653 in dogs, Surgery, 131, 6, 654-662, 2002.04, BACKGROUND: Inflammatory cytokines are known to contribute to ischemia-reperfusion injury. We investigated the effect of FR167653 (FR), a suppressor of interleukin-1beta and tumor necrosis factor-alpha, on ischemia-reperfusion injury of the kidney in dogs. METHODS: The left kidney was subjected to ischemia for 60 minutes followed by removal of the right kidney. A control group (n = 10) and an FR group (n = 8) were evaluated for tissue blood flow; resistive index, pulsatility index, arterial oxygen pressure, serum creatinine, blood urea nitrogen, aspartate transaminase, and alanine transaminase levels; interleukin-1beta messenger RNA expression in the peripheral blood; apoptotic index; and histopathology. RESULTS: The FR group showed lower creatinine, serum urea nitrogen, aspartate transaminase, and alanine transaminase levels (P <.038 each and lower interleukin-1beta mrna expression apoptotic index than did the control group. arterial oxygen pressure during minutes after reperfusion in fr group decreased but recovered quickly renal tissue damage was less that conclusions: ameliorates ischemia-reperfusion injury of kidney potentially by reduced production inflammatory cytokines may contribute to ischemic distant organs.>. |
| 2. |
Inoue S, Sugitani A, Yamamoto H, Kitada H, Motoyama K, Okabe Y, Ohta M, Yoshida J, Nishiyama K, Tanaka M, Effect of synthetic protease inhibitor gabexate mesilate on the attenuation of ischemia/reperfusion injury in canine kidney autotransplantation, Surgery, 137, 2, 216-224, 2005.04, BACKGROUND: Kidneys from non-heart-beating donors are associated with delayed graft function and a high rejection rate due to the long period of warm ischemia. Gabexate mesilate (GM), a synthetic serine protease inhibitor, has been shown to improve organ function by suppressing cytokine activity and neutrophil function after ischemia/reperfusion. In this study, we evaluated the effect of GM on renal function after warm ischemia in a canine kidney autotransplantation model. METHODS: After 60 minutes of warm ischemia, the left kidney was transplanted into the iliac fossa, and the right kidney was removed. The control group (n = 7) and GM group (n = 7) were evaluated for serum creatinine and blood urea nitrogen (BUN) concentrations, renal tissue blood flow, resistive index, pulsatility index, interleukin (IL)-1beta and tumor necrosis factor (TNF)-alpha mRNA expression levels in peripheral blood mononuclear cells, apoptotic index, CD10 immunolabeling as an indicator of brush border injury, and standard histopathology. RESULTS: Compared with controls, administration of GM resulted in lower serum creatinine concentrations (11.3 +/- 2.4 vs 5.2 +/- 3.3 mg/dL at 72 hours; P = .04) and BUN concentrations (188 +/- 26 mg/dL vs 98 +/- 41 mg/dL at 72 hours; P = .04), as well as better tissue blood flow, improvement of brush border injury and apoptotic index (each P . |
| 3. |
Kitada H, Sugitani A, Okabe Y, Doi A, Nishioka Y, Nishiki T, Kayashima T, Tanabe R, Tanaka M, Treatment of Arteriovenous Shunts After Renal Transplantation, Surgery Today, 39, 4, 310-313, 2009.04, PURPOSE: Immunosuppressive drugs have improved the results of renal transplantation dramatically in recent years; however, there is still no consensus on the treatment of arteriovenous (A-V) shunts after successful transplantation. We evaluated the treatment of A-V shunts after transplantation. METHODS: We reviewed all patients who underwent shunt closure at our hospital between 2005 and 2007 assessing surgical methods, operative time, blood loss, and complications. RESULTS: Fifty-two patients underwent shunt closure, as a simple transection in 5 patients, resection of the anastomotic site in 16, resection and reconstruction of the artery in 26, and graftectomy in 5. Graftectomy was associated with copious blood loss and a long operative time. The most frequent complication was phlebitis, but there were no nerve complications. CONCLUSIONS: An A-V shunt after renal transplantation may result in an aneurysm, severe venous dilatation, pain, bloating of the arm, infection, and cardiac problems. Thus, after successful transplantation, shunt closure should be performed to prevent these complications and to improve quality of life.. |
| 4. |
Kitada H, Sugitani A, Okabe Y, Doi A, Nishiki T, Miura Y, Kurihara K, Tanaka M, Availability of pancreatic Allograft Biopsies Via a Laparotomy, Transplantation Proceedings, 41, 10, 4274-4276, 2009.04, OBJECTIVE: The aim of this study was to evaluate the availability of a pancreatic allograft biopsy via a laparotpmy. PATIENTS AND METHODS: From September 2004 to November 2007, 17 pancreas transplantations were performed: 15 simultaneous pancreas and kidney transplantations (SPK), 1 pancreas transplant alone (PTA), and one pancreas after kidney transplantation (PAK). Thirteen pancreatic allograft biopsies were obtained via an open laparotomy. This study evaluated the complications associated with this procedure, the rate of obtaining an adequate sample, and the relationship between biopsy-proven rejections and laboratory markers. In SPK cases we evaluated the synchronization between pancreas and kidney rejection. The pancreatic samples were diagnosed according to the Drachenberg classification. RESULTS: No complications resulted from the procedure. The rate of obtaining adequate samples was 84.6%. Pancreas rejection correlated with elevation of the laboratory markers in 71.4%. Simultaneous pancreas and kidney rejection occurred in 62.5%, only kidney in 25%, and only pancreas in 12.5%. CONCLUSION: A pancreas graft biopsy was absolutely imperative to improve the outcome in PTA, and even in SPK cases. A pancreatic allograft biopsy via a laparotomy was a safe, necessary and easy procedure to obtain an accurate diagnosis of rejection among pancreas transplantation patients.
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| 5. |
Nishiki K, Kitada H, Okabe Y, Miura Y, Kurihara K, Kawanami S, Tanaka M, Effect of milrinone on ischemia-reperfusion injury in the rat kidney.
, Transplant Proc, 43, 5, 1489-1494, 2011.04, Abstract
BACKGROUND: Milrinone (MIL), a phosphodiesterase (PDE) 3 inhibitor, exhibits cardiotonic and angioectatic effects. Various PDE inhibitors have been shown to suppress inflammatory cytokines. In this study, we evaluated the angioectatic and anti-inflammatory cytokine effects of MIL on renal function after warm ischemia in a rat ischemia-reperfusion (I-R) injury model.
MATERIALS AND METHODS: MIL or control solution was perfused from the left renal artery to the right kidney, and the left kidney was excised. The right renal artery, vein, and ureter were clamped and then released after 50 minutes to produce warm ischemia. We evaluated control (n = 7), MIL (n = 7), and sham operation (n = 7) groups for serum creatinine, blood urea nitrogen (BUN), blood flow, expression of tumor necrosis factor (TNF)-α mRNA, apoptosis index, and histological evidence of acute tubular necrosis.
RESULTS: Serum creatinine and BUN concentrations peaked at 24 hours after reperfusion. MIL treatment significantly reduced serum creatinine (control group 1.27 ± 0.45 mg/dL vs MIL group 0.77 ± 0.19 mg/dL, P
CONCLUSIONS: MIL maintained renal tissue blood flow by its vasodilatory effect, suppressed expression of TNF-α mRNA by increasing intracellular cyclic adenosine monophosphate, and ultimately decreased tubular cell apoptosis, thus protecting renal function after warm I-R injury.
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| 6. |
Kitada H, Okabe Y, Nishiki T, Miura Y, Kurihara K, Terasaka S, Kawanami S, Tuchimoto A, Masutani K, Tanaka M, One-year follow-up of treatment with once-daily tacrolimus in de novo renal transplant., Exp Clin Transplant, 10, 6, 561-567, 2012.04, OBJECTIVES:
The once-daily prolonged-release formulation of tacrolimus (tacrolimus QD) is expected to demonstrate equivalent efficacy and safety to the twice-daily formulation (tacrolimus BID). We reviewed the 1-year outcomes of tacrolimus QD in de novo renal transplant.
MATERIALS AND METHODS:
We reviewed 50 de novo renal transplant patients assigned in a nonrandomized fashion to either tacrolimus QD (n=23, historic control group) or tacrolimus BID (n=27). Other immunosuppressive drugs used in both groups included mycophenolate mofetil, basiliximab, and steroids. We evaluated trough levels, required dosages, renal function, rejection rates, and episodes of infection within 1 year after transplant.
RESULTS:
Trough levels of both drugs varied during the perioperative periods, but subsequently stabilized in both groups. There was a tendency toward a slow elevation and a higher dosage requirement in the tacrolimus QD group, compared with the tacrolimus BID group in the early stages, though the required dosages decreased steadily. The rejection rate in the tacrolimus QD group was low, and only 1 patient experienced subclinical rejection. No severe infectious adverse events were observed.
CONCLUSIONS:
Patients taking tacrolimus QD tended to have lower trough levels and require higher dosages than those taking tacrolimus BID during the early posttransplant period, though the differences decreased with increasing time after transplant. Tacrolimus QD can be administered with excellent efficacy and safety in de novo renal transplant recipients.
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| 7. |
Doi A, Kitada H, Ota M, Kawanami S, Kurihara K, Miura Y, Nishiki T, Okabe Y, Inoue S, Tanaka M, Effect of cell permeable peptide of c-Jun NH2-terminal kinase inhibitor on the attenuation of renal ischemia-reperfusion injury in pigs., Transplant Proc, 45, 6, 2469-2475, 2013.04, The outcomes of organ transplantation have improved due to better immunosuppressive drugs, surgical techniques, and management of complications. However, ischemia-reperfusion injury remains a challenge affecting graft survival. In this study, we employed injection of a protein transduction domain (PTD) to inhibit the c-Jun NH2-terminal kinase (JNK) pathway thereby attenuating ischemia-reperfusion injury in a porcine model. The PTD-JNK inhibitor (JNKI) was administered into the renal artery, allowing it to be taken into various elements including vascular endothelial cells by endocytosis via the PTD. Serum creatinine and blood urea nitrogen concentrations were lower among PTD-JNKI than controls. In addition, renal tissue blood flow was maintained in the PTD-JNKI group, resulting in less tissue injury and fewer apoptotic cells. These results suggested that the PTD technique improved renal transplantation outcomes. . |
| 8. |
Masutani K, Tsuchimoto A, Haruyama N, Kitada H, Okabe Y, Noguchi H, Tanaka M, Tsuruya K, Kitazono T, Protocol biopsy findings in living donor kidney transplant patients treated with once-daily or twice-daily tacrolimus formulation., Transplant Proc, 46, 2, 395-399, 2014.04, BACKGROUND:
Once-daily extended-release tacrolimus (Tac-QD) has been shown to have equivalent efficacy and safety to the twice-daily formulation (Tac-BID) in kidney transplant patients. However, detailed comparison of allograft pathology found on a protocol biopsy (PB) in Tac-QD- versus Tac-BID-based regimens has not been described.
METHODS:
We retrospectively investigated 119 de novo living donor kidney transplant patients treated with Tac-QD (n = 90) or Tac-BID (n = 29) and their 3- and 12-month PB results. Other immunosuppressive drugs administered included basiliximab, mycophenolate mofetil, and methylprednisolone. We evaluated daily doses and trough levels of Tac and serum creatinine levels, and compared pathologic findings.
RESULTS:
Daily doses were higher in the Tac-QD group, but trough levels and serum creatinine levels were comparable. On 3- and 12-month PB, the frequency of subclinical rejection was similar between the groups, whereas interstitial fibrosis and tubular atrophy (IF/TA) were less common in the Tac-QD group at 12 months (42.2% vs 20.6%, P = .04). Univariate and multivariate logistic regression analyses revealed that allograft rejection (borderline changes or higher) was associated with IF/TA (odds ratio 4.09, 95% confidence interval 1.76-10.10, P = .001). The Tac-QD-based regimen showed a trend toward the absence of IF/TA but it did not reach statistical significance. Tubular vacuolization and arteriolar hyaline changes were also comparable in the two groups.
CONCLUSIONS:
We found a trend toward milder IF/TA, but no significant differences in kidney allograft pathology in patients who were administered Tac-QD- versus Tac-BID-based regimens at 12 months. The effects of Tac-QD on chronic allograft injury must be studied by longer observation.
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| 9. |
Terasaka S, Kitada H, Okabe Y, Kawanami S, Noguchi H, Miyamoto K, Tsuchimoto A, Masutani K, Tanaka M, Living-Donor Kidney Transplantation in T-cell and B-cell Flow Cytometry Crossmatch-Positive Patients, Exp Clin Transplant, 12, 3, 227-232, 2014.04, Abstract
OBJECTIVES:
Complement-dependent cytotoxic crossmatch is an important indicator for kidney transplant. However, there is controversy about treatment for flow cytometry crossmatch-positive cases.
MATERIALS AND METHODS:
This was a retrospective study of 127 living-donor kidney transplant recipients from May 2007 to July 2011. We divided patients into 115 flow cytometry crossmatch T-cell and B-cell-negative cases, and 12 T-cell and B-cell-positive cases. Both groups were given 20 mg basiliximab the day of surgery and 4 days after surgery. Common oral immunosuppressive agents used were tacrolimus, mycophenolate mofetil, and methylprednisolone. Flow cytometry crossmatch T-cell and B-cell-negative recipients started immunosuppression 7 days before surgery, T-cell and B-cell-positive recipients started immunosuppression 14 days before surgery. T-cell and B-cell-positive patients also received 200 mg rituximab 1 week before surgery, had 3 plasma exchange sessions before transplant, and received intravenous immunoglobulin 20 g/day during surgery and after surgery for 5 days. We measured flow-panel reactive antibodies of T-cell and B-cell-positive patients just before surgery to check desensitization efficiency. We evaluated patient survival, graft survival, graft function, and frequency of rejection and infectious diseases.
RESULTS:
Patient survival and graft survival were 100% in both groups. Flow cytometry crossmatch T-cell and B-cell-positive cases had no rejection events, but T-cell and B-cell-negative groups developed rejection. There was no statistical difference in the incidence of infection and graft function. Flow-panel reactive antibody demonstrated improvement in all T-cell and B-cell-positive cases.
CONCLUSIONS:
In living-donor kidney transplant, flow cytometry crossmatch T-cell and B-cell-positive patients are still considered to be at high risk. Although this is a short-term outcome, all T-cell and B-cell-positive patients in this study achieved excellent results with appropriate preoperative and postoperative treatment.. |
| 10. |
Matsukuma Y, Masutani K, Tsuchimoto A, Okabe Y, Kitada H, Noguchi H, Tanaka M, Tsuruya K, Kitazono T, Early disappearance of urinary decoy cells in successfully treated polyomavirus BK nephropathy, Transplant Proc, 46, 2, 560-563, 2014.04, BACKGROUND:
Polyomavirus BK nephropathy (BKVN) is an important infectious complication in kidney transplant patients. Regular screening using polymerase chain reaction for BK virus DNA in plasma and urinary cytology is effective for early diagnosis of BKVN. However, methods of follow-up and therapeutic targets are not well described.
METHODS:
Ten patients with BKVN who received biweekly urinary cytology and repeat biopsies after diagnosis were retrospectively studied. Histological remission of BKVN was determined when biopsy revealed negative SV40 large T-antigen (TAg) staining. Results of urinary cytology and repeat biopsy findings were compared.
RESULTS:
Urinary decoy cells disappeared in 8 of 10 patients 55 ± 25 (range 13-79) days after index biopsies. In those cases, allograft function was preserved and the final serum creatinine level was 2.14 ± 1.19 (0.80-4.55) mg/dL after 962 ± 393 (325-1563) days of follow-up. Two cases with persistent urinary decoy cells shedding lost their graft 195 and 362 days later. Amongst 29 repeat biopsies, there were 13 TAg-positive and 16 negative biopsies. In 12 of 13 TAg-positive biopsies (92%), urinary decoy cells were still positive, whereas at the same time in 15 TAg-negative biopsies, decoy cells had already disappeared (94%).
CONCLUSIONS:
Cytology testing is advantageous because of its cost effectiveness. Clearance of decoy cells from urine was closely related to histological remission of BKVN, and may possibly be a therapeutic target in BKVN.
Copyright © 2014 Elsevier Inc. All rights reserved.
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| 11. |
Toma H, Eguchi T, Toyoda S, Okabe Y, Kobarai T, Naritomi G, Ogawa T, Hirota I, A 10-year experience of totally extraperitoneal endoscopic repair for adult inguinal hernia, Surgery Today, 45, 11, 1417-1420, 2015.04, PURPOSE:
Laparoscopic surgery is fast becoming the treatment of choice for inguinal hernia. By reviewing our 10-year experience of performing totally extraperitoneal repair (TEP), we sought to establish its clinical significance in the treatment of adult inguinal hernia.
METHODS:
We reviewed retrospectively the clinical records of patients who underwent TEP for adult inguinal hernia between January 2003 and December 2012.
RESULTS:
None of the 303 patients with adult primary or recurrent inguinal hernia in our study needed TEP converted to other procedures or suffered serious complications during the procedure. A significant difference was noted in the operation time between direct (n = 32) vs indirect (n = 128) hernias in the primary unilateral inguinal hernia group (91 ± 27 vs 80 ± 32 min, p = 0.033) and between direct/direct (n = 31) vs indirect/indirect (n = 24) hernias (136 ± 58 vs 89 ± 24 min, p = 0.01) in the primary bilateral inguinal hernia group. The only postoperative complications recorded were four cases of hernia recurrence (1.3 %) and one case of chronic pain (0.3 %).
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| 12. |
Date S, Noguchi H, Kaku K, Kurihara K, Miyasaka Y, Okabe Y, Nakamura U, Ohtsuka T, Nakamura M, Laparoscopy-Assisted Spleen-Preserving Distal Pancreatectomy for Living-Donor Pancreas Transplantation, Transplant Proc, 10.1016/j.transproceed.2017.03.037, 49, 5, 1133-1137, 2017.04, BACKGROUND:Living pancreas transplantation plays an important role in the treatment of patients with severe type 1 diabetes. However, pancreatectomy is very invasive for the donor, and less-invasive surgical procedures are needed. Although some reports have described hand-assisted laparoscopic surgery for distal pancreatectomy in living-donor operations, less-invasive laparoscopy-assisted (LA) procedures are expected to increase the donor pool. We herein report the outcomes of four cases of LA spleen-preserving distal pancreatectomy (Warshaw technique [WT]) in living pancreas donors.PATIENTS AND METHODS:Four living pancreas donors underwent LA-WT at our institution from September 2010 to January 2013. All donors fulfilled the donor criteria established by the Japan Society for Pancreas and Islet Transplantation.RESULTS:The median donor age was 54 years. Two donors underwent left nephrectomy in addition to LA-WT for simultaneous pancreas-kidney transpl
antation. The median donor operation time for pancreatectomy was 340.5 minutes. The median pancreas warm ischemic time was 3 minutes. The median donor blood loss was 246 g. All recipients immediately achieved insulin independence. One donor required reoperation because of obstructive ileus resulting from a port-site hernia. Another donor developed a pancreatic fistula (International Study Group of Pancreatic Fistula grade B), which was controlled with conservative management. After a maximum follow-up of 73 months, no clinically relevant adverse events had occurred. These results were comparable with those of previous studies concerning living-donor pancreas transplantation.CONCLUSION:The LA-WT is a safe and acceptable operation for living-donor pancreas transplantation.. |
| 13. |
Noguchi H, Miyasaka Y, Kaku K, Nakamura U, Okabe Y, Ohtsuka T, Ishigami K, Nakamura M, Preoperative Muscle Volume Predicts Graft Survival after Pancreas Transplantation: A Retrospective Observational Cohort Study, Transplant Proc, 10.1016/j.transproceed.2018.03.018, 50, 5, 1482-1488, 2018.04, Abstract
Background
Several studies have suggested that decreased muscle volume is associated with attenuation of immune function. The recipient’s immune system is responsible for rejection of transplanted organs, which is a major cause of graft loss after transplantation. We aimed to determine whether muscle volume is correlated with graft survival after pancreas transplantation (PT).
Methods
Forty-three patients underwent PT for type 1 diabetes mellitus at our institution from August 2001 to May 2016. The quantity of skeletal muscle was evaluated using the psoas muscle mass index (PMI). The correlation between the PMI and outcome after PT was assessed.
Results
A total of 32 and 11 recipients underwent simultaneous pancreas–kidney transplantation (SPK) and PT alone/pancreas after kidney transplantation, respectively. Patients with a surviving graft showed a significantly lower PMI than those with graft loss (P = 0.0451). We divided the recipients into two groups according to the PMI cutoff values which were established using receiver operating characteristic curves. The cumulative graft survival rate was significantly higher in patients with a low than normal PMI (P = 0.0206). A multivariate Cox regression analysis revealed that a low PMI (P= 0.0075) is an independent predictive factor for better graft survival. A low PMI was not a significant predictive factor for acute rejection, but was an independent predictive factor for graft survival after the first acute rejection (P= 0.0025).
Conclusions
Our data suggest that muscle volume could be a predictor of graft survival after PT.
Key words
pancreas transplantation; sarcopenia; graft rejection; graft survival
Abbreviations
AR, acute rejection; ATG, rabbit antithymocyte globulin; BMI, body mass index; CI, confidence interval; CT, computed tomography; DM, diabetes mellitus; HR, hazard ratio; IL, interleukin; ND, not done; PAK, pancreas-after-kidney transplantation; PMI, psoas muscle mass index; PT, pancreas transplantation; PTA, pancreas transplantation alone; SPK, simultaneous pancreas–kidney transplantation; TNF-α, tumor necrosis factor-alpha; Tregs, regulatory T cells. |
| 14. |
Okabe Y, Noguchi H, Miyamoto K, Kaku K, Tsuchimoto A, Masutani K, Nakamura M, Preformed C1q-binding Donor-specific Anti-HLA Antibodies and Graft Function After Kidney Transplantation, Transplantation Proceedings, 10.1016/j.transproceed.2018.07.033, 50, 10, 3460-3466, 2018.04, Abstract
Background: De novo complement-binding donor-specific anti-human leukocyte antigen antibodies (DSAs) are reportedly associated with an increased risk of kidney graft failure, but there is little information on preformed complement-binding DSAs. This study investigated the correlation between preformed C1q-binding DSAs and medium-term outcomes in kidney transplantation (KT).
Methods: We retrospectively studied 44 pretransplant DSA-positive patients, including 36 patients who underwent KT between April 2010 and October 2016. There were 17 patients with C1q-binding DSAs and 27 patients without C1q-binding DSAs. Clinical variables were examined in the 2 groups.
Results: Patients with C1q-binding DSAs had significantly higher blood transfusion history (53.0% vs 18.6%; P = .0174), complement-dependent cytotoxicity crossmatch (CDC-XM)-positivity (29.4% vs 0%; P = .0012), and DSA median fluorescence intensity (MFI) (10,974 vs 2764; P = .0009). Among patients who were not excluded for CDC-XM-positivity and underwent KT, there was no significant difference in cumulative biopsy-proven acute rejection rate (32.5% vs 33.5%; P = .8354), cumulative graft survival, and 3-month and 12-month protocol biopsy results between patients with and without C1q-binding DSAs. Although patients with C1q-binding DSAs showed a higher incidence of delayed graft function (54.6% vs 20.0%; P = .0419), multivariate logistic regression showed that DSA MFI (P = .0124), but not C1q-binding DSAs (P = .2377), was an independent risk factor for delayed graft function.
Conclusions: In patients with CDC-XM-negativity, preformed C1q-binding DSAs were not associated with incidence of antibody-mediated rejection and medium-term graft survival after KT. C1q-binding DSAs were highly correlated with DSA MFI and CDC-XM-positivity.. |
| 15. |
Yamada S, Arase H, Tachibana S, Tomita K, Eriguchi M, Fujisaki K, Okabe Y, Nakamura M, Nakano T, Tsuruya K, Kitazono T, Immobilization-induced severe hypercalcaemia successfully treated with reduced dose of zoledronate in a maintenance haemodialysis patient, Nephrology, 10.1111/nep.13246 , 23, 10, 963-964, 2018.04. |
| 16. |
Noguchi H, Kakuta Y, Okumi M, Omoto K, Okabe Y, Ishida H, Nakamura M, TanabeK, Pure versus hand-assisted retroperitoneoscopic live donor nephrectomy: a retrospective cohort study of 1508 transplants from two centers, Surg Endosc, doi: 10.1007/s00464-019-06697-y, 33, 12, 4038-4047, 2019.04. |
| 17. |
Noguchi H, Tsuchimoto A, Ueki K, Kaku K, Okabe Y, Nakamura M, One-year Outcome of Everolimus With Standard doseTacrolimus Immunosuppression in De Novo ABO-incompatible Living Donor Kidney Transplantation: A Retrospective, Single-center, Propensity Score Matching Comparison With Mycophenolate in 42 Transplants, TrDirectansplant , 10.1097/TXD.0000000000000962, 6, 1, e514, 2019.04. |
| 18. |
Miura Y, Noguchi H, Okabe Y, Masutani K, Tokunaga S, Nakamura M, Effects of Telmisartan and Candesartan on the Metabolism of Lipids and Glucose in Kidney Transplantat Patients: A prospective, Randomized Crossover Study, Transplantation Direct, 10.1097/TXD.000000000000861, 5, 2, e423, 2019.04, Background. The risk of cardiovascular events remains after kidney transplantation (KT). Abnormal glucose metabolism and
hyperlipidemia contribute partly to this risk. Among angiotensin II type-1 receptor blockers, telmisartan alone has been shown
to ameliorate these effects on glucose and lipid metabolism (GLM). We investigated the effects of telmisartan on GLM in KT patients.
Methods. This trial had a crossover design. Forty-six KT patients with well-controlled hypertension under angiotensin II
type-1 receptor blockers were randomized into telmisartan and candesartan groups. After a 12-week treatment, crossover was
initiated, and additional 12-week treatment was administered without a washout period. We examined the laboratory parameters
of GLM, blood pressure and graft function before and after each treatment period. Results. Forty patients completed the scheduled
treatment regimen. Serum levels of triglyceride were significantly lower (114.3 ± 50.8 mg/dL vs 136.5 ± 66.8 mg/dL;
P = 0.019), and the estimated glomerular filtration rate was significantly higher (50.4 ± 15.1 mL/min per 1.73 m2 vs
48.5 ± 12.5mL/min per 1.73m2; P = 0.038) after telmisartan treatment than after candesartan treatment. Therewere no significant
differences between the 2 treatment groups with regard to the other parameters studied (including serum adiponectin levels and
parameters of glucose metabolism). Conclusions. These data suggest that telmisartan can improve serum triglyceride levels
and graft function for KT patients better than candesartan.. |
| 19. |
Noguchi H, Tsuchimoto A, Ueki K, Kaku K, Okabe Y, Nakamura M, Reduced Recurrence of Primary IgA Nephropathy in Kidney Transplant Recipients Receiving Everolimus With Corticosteroid: A Retrospective, Single-Center Study of 135 Transplant Patients, Transplantation Proceedings, 10.1016/j.transproceed.2020.05.022, 52, 10, 3118-3124, 2020.04. |
| 20. |
Mei T, Noguchi H, Hisadome Y, Kaku K, Nishiki T, Okabe Y, Nakamura M, Hepatitis B virus reactivation in kidney transplant patients with resolved hepatitis B virus infection: Risk factors and the safety and efficacy of preemptive therapy, Transplant Infectious disease, doi.org/10.1111/tid.13234, 22, 2, e13234, 2020.04, BackgroundHepatitis B virus (HBV) reactivation is associated with complications and adverse outcomes in patients with clinically resolved HBV infection who are seronegative for hepatitis B surface antigen (HBs Ag), and seropositive for hepatitis B core antibody (HBc Ab) and/or hepatitis B surface antibody (HBs Ab) before kidney transplantation (KT).MethodsWe retrospectively analyzed 52 patients with resolved HBV infection who were HBV‐DNA negative. HBV‐DNA after KT was evaluated, and the occurrence of HBV reactivation and outcomes were monitored. We defined HBV reactivation as seropositivity for HBV‐DNA at or above the minimal detection level of 1.0 log IU/mL and treated preemptively (using entecavir) when the HBV‐DNA level was at or above 1.3 log IU/mL, in accordance with the Japanese Guidelines for HBV treatment.ResultsAmong the 52 patients, the mean age was 57.2 ± 10.8 years. The median HBc Ab titer was 12.8 (inte
rquartile range, 4.6‐42.6) cutoff index, and five (9.6%) cases of HBV reactivation occurred. No patients developed graft loss and died due to HBV reactivation. Statistical analysis showed that age and HBc Ab titer were significant risk factors for HBV reactivation (P = .037 and P = .042, respectively). No significant differences were found between graft survival and the presence or absence of HBV reactivation.ConclusionThese results suggest that HBc Ab titer and age could be significant risk factors for HBV reactivation. Resolution of HBV infection did not appear to be associated with patient or graft survival, regardless of whether HBV reactivation occurred, when following our preemptive strategy.. |
| 21. |
Araki T, Noguchi H, Kaku K, Okabe Y, Nakamura M, Hand-assisted Laparoscopic versus Hand-Assisted retroperitoneoscopic living-donor Nephrectomy: a retrospective, single-center, propensity-score analysis of 840 transplants using 2 techniques, Transplantation Proceedings, 10.1016/j.transproceed.2020.01.134, 52, 6, 1655-1660, 2020.04, ABSTRACT
Introduction. Living-donor kidney transplantation (LDKT) is the most realistic option for
patients with end-stage kidney disease because of a severe shortage of deceased donors.
Hand-assisted laparoscopic donor nephrectomy (HALDN) and hand-assisted
retroperitoneoscopic donor nephrectomy (HARDN) have been undertaken at our
institute. We compared these 2 surgical procedures with respect to donor outcome and
the graft function of recipients.
Methods. We reviewed data from 840 consecutive live-donor kidney transplants from
October 2003 to April 2019. Propensity scores were calculated for each patient using
bivariate logistic regression.
Results. After propensity-score matching, the 2 groups each contained 205 patients.
Donors in the HALDN group had a longer procedure time (217 minutes, P less estimated blood loss (51 mL, P postoperative day (POD) 1 (7.9 mg/dL, P There were 22 modified Clavien-classifiable complications among the study groups. A
significantly higher conversion to open surgery was noted in the HARDN group (P .
.0181) than in the HALDN group, but there was no significant difference in the
prevalence of complications in either group. There was no significant difference in the
estimated glomerular filtration rate of recipients at POD14 between the 2 groups.
Conclusions. Safety and early graft function of HALDN in LDKT are comparable to or
even better than that of HARDN.. |
| 22. |
Mei T, Noguchi H, Suetsugu K, Hisadome Y, Kaku K, Okabe Y, Masuda S, Nakamura M, Effects of Concomitant Administration of Vonoprazan Fumarate on the Tacrolimus Blood Concentration in Kidney Transplant Recipients, Biological and Pharmaceutical Bulletin, https://doi.org/10.1248/bpb.b20-00361, 43, 10, 1600-1603, 2020.04, Vonoprazan fumarate (vonoprazan) is a new kind of acid suppressant with potent acid inhibitoryeffects. Therefore, it has been administered to kidney transplant recipients for treatment or prophylaxis ofsteroid ulcers, refractory peptic ulcers, and gastroesophageal reflux disease. Because tacrolimus, which is awell-established immunosuppressant for kidney transplantation, and vonoprazan share the CYP3A4 systemfor metabolism, drug interactions are anticipated upon simultaneous administration. We retrospectivelyanalyzed 52 kidney transplant recipients who were converted from rabeprazole, which has a small effecton the tacrolimus trough blood concentration (C0), to vonoprazan between August 2016 and July 2019. Wecompared the tacrolimus C0/tacrolimus dose (C0/D) before and after conversion and serum liver enzymes,serum total bilirubin, and the estimated glomerular filtration rate (eGFR). As a result, mean tacrolimus C0/Dbefore and after conversion was 1.98
1.02 and 2.19 1.15 (ng/mL)/(mg/d), respectively, (p < 0.001). Additionally,mean aspartate transaminase (AST) before and after conversion was 18.6 4.2 and 19.6 5.2 IU/L,respectively, (p 0.037). Mean alanine transaminase (ALT) before and after conversion was 15.8 5.5and 17.6 7.1 IU/L, respectively, (p 0.007). Mean eGFR before and after conversion was 50.6 14.4 and51.4 14.7 mL/min/1.73 m2, respectively (p 0.021). Mean AST, ALT, and eGFR were slightly but significantlyelevated within normal ranges after conversion. In conclusion, our study suggests that the mean tacrolimusC0/D was elevated significantly by converting from rabeprazole to vonoprazan, but it had little clinicalsignificance. Vonoprazan can be administered safely to kidney transplant recipients receiving tacrolimus.. |
| 23. |
Mori Y, Nakata K, Ideno N, Ikenaga N, Okabe Y, Ishigami K, Oda Y, Nakamura M, Congenital biliary dilatation in the era of laparoscopic surgery, focusing on the high incidence of anatomical variations of the right hepatic artery, J Hepatobiliary Pancreat Sci, 10.1002/JHBP.819, 27, 11, 870-876, 2020.04, Abstract
Background: The present study aimed to evaluate anatomical variations of the right hepatic artery (RHA) in patients with congenital biliary dilatation (CBD) and the appropriate approach in laparoscopic surgery for CBD.
Methods: The medical records of 36 patients who underwent laparoscopic or open surgery for CBD from 1996 to 2018 were retrospectively reviewed. Radiological evaluation of the origin and course of the RHA in these 36 patients were compared with 195 control patients without CBD.
Results: The incidence of the RHA crossing anterior to the common hepatic duct (CHD) was significantly higher in patients with CBD than in those without CBD (33% versus 10%, P = .0001). There was no intraoperative injury of the RHA, irrespective of the course of the RHA. The CHD was divided at the caudal side of the RHA in 11 of 12 patients (92%) with the anterior type of RHA, and in 13 of 24 patients (54%) with the posterior type of RHA (P = .03).
Conclusions: Patients with CBD had a higher incidence of the RHA crossing anterior to the CHD than patients without CBD. Preservation of the RHA in each situation is necessary during surgery for CBD in the era of laparoscopic surgery.
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| 24. |
Hisadome Y, Noguchi H, Nakafusa Y, Sakihama K, Mei T, Kaku K, Okabe Y, Masutani K, Ohara Y, Ikeda K, Oda Y, Nakamura M, Association of Pretransplant BK Polyomavirus Antibody Status with BK Polyomavirus Infection After Kidney Transplantation: A Prospective Cohort Pilot Study of 47 Transplant Recipients, Transplantation Proceedings, 10.1016/j.transproceed.2020.01.164, 52, 6, 1762-1768, 2020.04. |
| 25. |
Kaneyasu Nakagawa, Akihiro Tsuchimoto, Kenji Ueki, Yuta Matsukuma, Yasuhiro Okabe, Kosuke Masutani, Kohei Unagami, Yoichi Kakuta, Masayoshi Okumi, Masafumi Nakamura, Toshiaki Nakano, Kazunari Tanabe, Takanari Kitazono, Significance of Revised Criteria for Chronic Active T Cell-Mediated Rejection in the 2017 Banff Classification: Surveillance by 1-year Protocol Biopsies for Kidney Transplantation , American Journal of Transplantation, 10.1111/ajt.16093, 21, 1, 174-185, 2021.04, Abstract
Diagnostic criteria for chronic active T‐cell mediated rejection (CA‐TCMR) were revised in the Banff 2017 consensus, but it is unknown whether the new criteria predict graft prognosis of kidney transplantation. We enrolled 406 kidney allograft recipients who underwent a 1‐year protocol biopsy (PB) and investigated the diagnostic significance of Banff 2017. Interobserver reproducibility of the three diagnosticians showed a substantial agreement rate of 0.68 in Fleiss’s kappa coefficient. Thirty‐three patients (8%) were classified as CA‐TCMR according to Banff 2017, and 6 were previously diagnosed as normal, 12 as acute TCMR, 10 with borderline changes, and 5 as CA‐TCMR according to Banff 2015 criteria. Determinant factors of CA‐TCMR were cyclosporine use (vs. tacrolimus), previous acute rejection, and BK polyomavirus‐associated nephropathy. In survival analysis, the new diagnosis of CA‐TCMR predicted a composite graft endpoint defined as doubling serum creatinine or death‐censored graft loss (log‐rank test, P |
| 26. |
Kazuki Tomihara, Yu Hisadome, Hiroshi Noguchi, Keizo Kaku, Yasuhiro Okabe, Masafumi Nakamura, Serum pancreatic enzymes in the early postoperative period predict complications associated with pancreatic fluid after pancreas transplantation: A retrospective, single-center, observational cohort study, Journal of Hepato-biliary-Pancreatic Sciences, 10.1002/jhbp.895, 28, 4, 365-375, 2021.04, Abstract
Background: Pancreas transplantation (PT) is a radical treatment for diabetes mellitus (DM). Although the results of PT have been improving, surgical complications remain. Few reports have focused on complications associated with pancreatic fluid (CAPF) after PT. We aimed to investigate the risk factors and predictors for CAPF after PT.
Methods: Sixty-nine patients, who underwent deceased-donor PT for type 1 DM at our institution from August 2001 to May 2020, were retrospectively studied. We identified CAPF from those with Clavien-Dindo Classification ≥ grade III, and assessed risk factors by univariate and multivariate analyses using logistic regression.
Results: Twenty-one (30.4%) patients had complications with Clavien-Dindo Classification ≥ grade III. Eleven (16.0%) patients were diagnosed with CAPF. Median serum pancreatic amylase (P-AMY) levels with CAPF on postoperative day (POD)1 and POD2 were significantly higher than those without CAPF (P=0.019 and P=0.027, respectively). In multivariable analysis, serum P-AMY levels on POD1 were an independent predictive factor for CAPF (odds ratio 1.83, 95% confidence interval 1.07-3.14, P=0.008).
Conclusions: CAPF after PT is associated with high serum P-AMY in the early postoperative period. Serum pancreatic enzymes in the first few postoperative days after PT may be a significant predictive factor for CAPF.
Keywords: amylase; complications associated with pancreatic fluid; lipase; pancreas transplantation; pancreatic fistula.. |
| 27. |
Yu Hisadome, Takanori Mei, Hiroshi Noguchi, Toshiaki Ohkuma, Yu Sato, Keizo Kaku, Yasuhiro Okabe, Masafumi Nakamura, Safety and Efficacy of Sodium-glucose Cotransporter 2 Inhibitors in Kidney Transplant Recipients With Pretransplant Type 2 Diabetes Mellitus: A Retrospective, Single-center, Inverse Probability of Treatment Weighting Analysis of 85 Transplant Patients, Transplant Direct, 10.1097/TXD.0000000000001228, 7, 11, e772, 2021.04, Abstract
Whether sodium-glucose cotransporter 2 (SGLT2) inhibitors can be used effectively and safely in kidney transplant (KT) recipients with pretransplant type 2 diabetes as the primary cause of end-stage renal disease (ESRD) remains unclear. In this study, we retrospectively analyzed the efficacy and safety of SGLT2 inhibitors compared with other oral hypoglycemic agents (OHAs) in KT recipients with pretransplant type 2 diabetes as the primary cause of ESRD.
Methods: In this retrospective, observational, single-center, inverse probability of treatment weighting (IPTW) analysis study, we compared the outcomes of SGLT2 inhibitors (SGLT2 group) and other OHAs (control group) following KT. A total of 85 recipients with type 2 diabetic nephropathy as the major cause of ESRD before KT who were treated at our institute between October 2003 and October 2019 were screened and included. The variables considered for IPTW were recipient age, sex, body mass index, history of cardiovascular disease, ABO incompatibility, insulin therapy, estimated glomerular filtration rate (eGFR), and hemoglobin A1c (HbA1c) at the initiation of additional OHAs. Primary endpoints were changes in HbA1c, body weight, and eGFR 1 y after the initiation of additional OHAs.
Results: After IPTW analysis, there were 26 patients in the SGLT2 group and 59 patients in the control group (n = 85 overall). The body weights were significantly reduced in the SGLT2 group. There was no statistical difference in changes in HbA1c and eGFR. Similarly, there was no significant difference in the incidence of urinary infection, acute rejection, or other side effects between the groups.
Conclusions: Our findings suggested that SGLT2 inhibitors reduced the body weight of KT recipients and were used safely without increasing side effects.. |
| 28. |
Takanori Mei, Hiroshi Noguchi, Kanae Otsu, Yuki Shimada, Yu Sato, Yu Hisadome, Keizo Kaku, Yasuhiro Okabe, Masafumi Nakamura, Risk Factors and Optimal Methods for Incisional Hernias After Kidney Transplantation: A Single-Center Experience From Asia, Transplantation Proceedings, 10.1016/j.transproceed.2021.02.012, 53, 3, 1048-1054, 2021.04. |
| 29. |
Yu Sato, Hiroshi Noguchi, Takanori Mei, Keizo Kaku, Yasuhiro Okabe, Masafumi Nakamura, Impact of the Mayo Adhesive Probability score on donor and recipient outcomes after living-donor kidney transplantation: a retrospective, single-center study of 782 transplants
, Transplant Direct, 10.1097/TXD.0000000000001185, 7, 8, e728, 2021.04, Abstract
Background: This study was performed to assess the impact of the Mayo Adhesive Probability (MAP) score on donor and recipient outcomes after living-donor kidney transplantation (LDKT).
Methods: We retrospectively analyzed 782 transplants involving LDKT between February 2008 and October 2019 to assess the correlation between the MAP score and outcome after LDKT. We divided the transplants into 2 groups according to the donor MAP score: 0 (MAP0) and 1-5 (MAP1-5).
Results: Compared with the MAP0 group, donors in the MAP1-5 group were significantly older, had higher body mass index, and were more likely to be men. The prevalences of hypertension, hyperlipidemia, and diabetes were also higher among donors in the MAP1-5 group than among donors in the MAP0 group. Operative time, estimated blood loss during donor nephrectomy, and percentage of glomerular sclerosis were significantly greater in the MAP1-5 group than in the MAP0 group. Donor and recipient perioperative complications were comparable between the 2 groups; death-censored graft survival rates also did not significantly differ between groups. Although the recipient mean estimated glomerular filtration rate (eGFR) from postoperative d 1 to 7 was significantly higher in the MAP0 group than in the MAP1-5 group (P = 0.007), eGFR reductions within 5 y after transplantation were similar between groups. There were no significant differences between groups in recipient mortality and biopsy-proven acute rejection episodes within 1 y after transplantation. Additionally, multivariate analysis showed that the only factors affecting recipient eGFR at postoperative d 7 were donor age, recipient age, and female sex (P Conclusions: The MAP score did not influence surgical complications or graft survival; therefore, it should not affect donor selection.. |
| 30. |
Hiroshi Noguchi, Yu Hisadome, Yu Sato, Takanori Mei, Keizo Kaku, Yasuhiro Okabe, Masafumi Nakamura, Impact of the introduction of pure retroperitoneoscopic living-donor nephrectomy on perioperative donor outcomes: a propensity score matching comparison with hand-assisted laparoscopic living-donor nephrectomy, Asian Journal of Endoscopic Surgery, 10.1111/ases.12922, 14, 4
, 692-699, 2021.04, Abstract
Introduction: We previously reported that the outcomes of pure retroperitoneoscopic donor nephrectomy are superior to those of hand-assisted retroperitoneoscopic donor nephrectomy. Consequently, we introduced pure retroperitoneoscopic donor nephrectomy in our hospital. Here, we compared perioperative outcomes between hand-assisted intra-abdominal laparoscopic donor nephrectomy and pure retroperitoneoscopic donor nephrectomy.
Methods: We retrospectively reviewed data from 315 living-donor kidney transplantation procedures performed between October 2015 and December 2020 (213 involving hand-assisted intra-abdominal laparoscopic donor nephrectomy, October 2015 to June 2019; 102 involving pure retroperitoneoscopic donor nephrectomy, May 2019 to December 2020). After propensity score matching, 90 transplantations were included in each group (n = 180 overall).
Results: Donors in the pure retroperitoneoscopic donor nephrectomy group had longer warm ischemia times (P Conclusion: The introduction of pure retroperitoneoscopic donor nephrectomy was safe and effective. Moreover, it was less invasive and less harmful for donors, compared with hand-assisted intra-abdominal laparoscopic donor nephrectomy; recipient outcomes were equivalent.
Keywords: kidney transplantation; living-donor nephrectomy; retroperitoneoscopic surgery.. |
| 31. |
Yu Sato, Keizo Kaku, Yu Hisadome, Takanori Mei, Hiroshi Noguchi, Yasuhiro Okabe, Masafumi Nakamura, Impact of Recipient Age on Outcomes After Pancreas Transplantation, Transplantation Proceedings, 10.1016/j.transproceed.2021.04.013, 53, 6, 2046-2051, 2021.04, Background: Few reports have provided the ages of pancreas transplant recipients. The aim of this study was to determine whether recipient age affects survival of pancreatic grafts after transplantation.
Methods: We analyzed 73 patients who had undergone pancreas transplantation at our institution from August 2001 to March 2020 and assessed the effects of recipient age on pancreas graft survival within 5 years after pancreas transplantation.
Results: The cutoff value for recipient age established by receiver operating characteristic curve was 35 years. The pancreas graft survival rate of recipients aged 35 years or younger (1, 3, and 5 years: 72.9%, 41.7%, and 41.7%, respectively) was significantly lower than that of recipients aged over 35 years (1, 3, and 5 years: 93.2%, 88.4%, and 88.4%, respectively). Multivariate Cox hazard regression analysis showed that recipient age 35 years or younger (hazard ratio = 3.60; 95% confidence interval, 1.04-12.50; P = .044) and solitary pancreas transplantation (hazard ratio = 10.72; 95% confidence interval, 2.72-42.28; P < .001) were significant risk factors for pancreas graft loss within 5 years.
Conclusion: Our data suggest that younger recipient age is a risk factor for pancreas graft loss after transplantation.. |
| 32. |
Yasuhisa Mori, Kohei Nakata, Noboru Ideno, Naoki Ikenaga, Yasuhiro Okabe, Masafumi Nakamura, Efficacy of Distal Pancreatectomy Combined With Modified DuVal Procedure in Patients With a High Risk of Postoperative Pancreatic Fistula, The American Surgeon, 10.1177/0003134821995088, 2021.04, Abstract
Background: The incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) remains high. The present study aimed to clarify the efficacy of our modified DuVal (mDuVal) pancreatojejunostomy following DP in patients with a high risk of POPF.
Methods: The medical records of 346 consecutive patients who underwent DP between 2006 and 2016 were retrospectively reviewed. Perioperative features were compared between 24 patients undergoing mDuVal (mDuVal group) and 322 patients undergoing standard DP (standard DP group).
Results: Preoperative American Society of Anesthesiologists physical status 1 was more frequent in the standard group than in the mDuVal group (P = .02). The start of a solid diet after operation was significantly earlier in the mDuVal group than in the standard DP group (P = .01), while there were no significant differences between the groups for clinically relevant POPF, amylase concentration in the drainage fluid on postoperative day 1 and days 3-5, time to drain removal, additional intervention for POPF, overall complications, or postoperative hospital stay.
Discussion: The mDuVal procedure could be an option for patients with a high risk of POPF to improve the outcomes after DP. Further investigation involving large study populations is necessary to clarify the efficacy of this procedure.
Keywords: pancreatectomy; pancreatic fistula; postoperative complications.. |
| 33. |
Kenji Ueki, Akihiro Tsuchimoto, Yuta Matsukuma, Kaneyasu Nakagawa, Hiroaki Tsujikawa, Kosuke Masutani, Shigeru Tanaka, Keizo Kaku, Hiroshi Noguchi, Yasuhiro Okabe, Kohei Unagami, Yoichi Kakuta, Masayoshi Okumi, Masafumi Nakamura, Kazuhiko Tsuruya, Toshiaki Nakano, Kazunari Tanabe, Takanari Kitazono
, Development and validation of a risk score for the prediction of cardiovascular disease in living donor kidney transplant recipients, Nephrology, Dialysis, Transplantation, 10.1093/ndt/gfaa275 , 36, 2, 365-374, 2021.04, Abstract
Background: Cardiovascular disease (CVD) is a major cause of death in kidney transplant (KT) recipients. To improve their long-term survival, it is clinically important to estimate the risk of CVD after living donor KT via adequate pre-transplant CVD screening.
Methods: A derivation cohort containing 331 KT recipients underwent living donor KT at Kyushu University Hospital from January 2006 to December 2012. A prediction model was retrospectively developed and risk scores were investigated via a Cox proportional hazards regression model. The discrimination and calibration capacities of the prediction model were estimated via the c-statistic and the Hosmer-Lemeshow goodness of fit test. External validation was estimated via the same statistical methods by applying the model to a validation cohort of 300 KT recipients who underwent living donor KT at Tokyo Women's Medical University Hospital.
Results: In the derivation cohort, 28 patients (8.5%) had CVD events during the observation period. Recipient age, CVD history, diabetic nephropathy, dialysis vintage, serum albumin and proteinuria at 12 months after KT were significant predictors of CVD. A prediction model consisting of integer risk scores demonstrated good discrimination (c-statistic 0.88) and goodness of fit (Hosmer-Lemeshow test P = 0.18). In a validation cohort, the model demonstrated moderate discrimination (c-statistic 0.77) and goodness of fit (Hosmer-Lemeshow test P = 0.15), suggesting external validity.
Conclusions: The above-described simple model for predicting CVD after living donor KT was accurate and useful in clinical situations.
Keywords: dialysis vintage; external validation; nutritional status; proteinuria; risk score.
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| 34. |
Hiroshi Noguchi, Yuta Matsukuma, Kaneyasu Nakagawa, Kenji Ueki, Akihiro Tsuchimoto, Toshiaki Nakano, Yu Sato, Keizo Kaku, Yasuhiro Okabe, Masafumi Nakamura, Treatment of chronic active T cell-mediated rejection after kidney transplantation: A retrospective cohort study of 37 transplants, Nephrology, 10.1111/nep.14048, 27, 6, 2022.04. |
| 35. |
Yasuhiro Okabe, Hiroshi Noguchi, Yu Sato, Takanori Mei, Keizo Kaku, Kenji Ueki, Akihiro Tsuchimoto, Masafumi Nakamura, Outcomes of Everolimus Plus Standard-Dose Tacrolimus Immunosuppression in De Novo Kidney Transplant: A Retrospective, Single-Center Study of 225 Transplants, Experimental and Clinical Transplantation, DOI, 20, 4, 362-369, 2022.04. |
| 36. |
Hiroshi Noguchi, Kei Nishiyama, Keizo Kaku, Yasuhiro Okabe, Masafumi Nakamura, Factors Associated With Height Among Pediatric Kidney Transplant Recipients Aged ≤ 16 Years: A Retrospective, Single-Center Cohort Study of 60 Transplants, Experimental and Clinical Transplantation, 10.6002/ect.2021.0311, 20, 1, 35-41, 2022.04. |
| 37. |
Keizo Kaku, Yasuhiro Okabe, Yu Sato, Yu Hisadome, Takanori Mei, Hiroshi Noguchi, Masafumi Nakamura, Effective Technique for Pancreas Transplantation by Iliac Vascular Transposition, Without Heparin-Based Anticoagulation Therapy, World J Surg, 10.1007/s00268-021-06232-y, 46, 1, 215-222, 2022.04, Background: To evaluate patients undergoing a new procedure, iliac vascular transposition, in pancreas transplantation regarding the risk of thrombosis and graft survival without heparin-based anticoagulation therapy.
Methods: Iliac vascular transposition (IVT) involves changing the positions of the external iliac artery and vein relative to each other. In this study, this technique was evaluated in patients undergoing the procedure compared with patients not undergoing the procedure (iliac vascular parallel (IVP) group).
Results: No patients received prophylactic heparin therapy. Two patients in the IVP group (n = 26) developed complete thrombosis and six developed partial thrombosis, compared with no patients with complete thrombosis and one with partial thrombosis in the IVT group (n = 29). The cumulative incidence of thrombosis was significantly higher in the IVP group (p Conclusions: IVT in pancreas transplantation is a simple technique that results in a lower thrombosis risk and better graft survival rates without heparin-based anticoagulation therapy.. |
