Abstract:
:The early results of liver transplantations (OLT) in patients with advanced hepatocellular carcinoma (HCC) were poor because of frequent tumor recurrence. However, OLT has significant, theoretical advantage that it removes both the tumor and the organ that is at a risk of malignancy. The Japanese law on organ transplantation limited the availability of cadaveric liver donors until its revision on July 17, 2011. ABO-incompatible OLT was formerly contraindicated because performed anti-A/B antibodies on recipient endothelial cells raised the risk of antibody-mediated humoral graft rejection. We have herein described four successful cases of steroid withdrawal among adult patients who underwent living donor OLT from ABO-incompatible donors. In addition, we transplanted a liver from a living donor into an ABO-incompatible recipient on August 9, 2004. The 55-year-old man with HCC due to hepatitis B virus (HBV) a cirrhosis had a Child-Pugh score of C, and Model for End-stage Liver Disease score of 22. Two tumors greater than 5 cm, exceeded the Milan criteria. His des-gamma-carboxy prothrombin level was 6 mAu/mL, and alpha-fetoprotein, 18.78 ng/mL. Antirejection therapy included multiple perioperative plasmaphereses and splenectomy; with an immunosuppressive regimen consisting of tacrolimus, methylprednisolone, and mycophenolate mofetil. The maintenance dose of immunosuppression did not differ from that of ABO-identical cases. After transplantation, we used intrahepatic arterial infusion therapy with prostaglandin E1 (PG E1). The patient had complications of portal vein thrombosis, hepatic artery thrombosis, and acute myocardial infarction, which were treated by interventional radiology in the posttransplantation period. We controlled the HBsAb titer by administering hepatitis B immunoglobulin and lamivudine (200 IU/L doses) for 1 year after OLT and 100 IU/L doses thereafter. As a result, the patient achieved long-term, disease-free graft survival without steroids. He currently has good liver function and leads a normal lifestyle. Our results suggested the feasibility of controlling antibody-mediated humoral rejection and other complications in living donor liver transplantations into ABO-incompatible adults via intrahepatic arterial PG E1 infusion splenectomy, and plasmapheresis with regular immunosuppression. Withdrawal of steroids, HBV vaccination, and lamivudine, an nucleoside analog reverse transcriptase inhibitor, have achieved long-term (7 years) survival without recurrent HBV infection or tumor.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
Nakamura Y,Hama K,Iwamoto H,Yokoyama T,Kihara Y,Konno O,Jojima Y,Shimazu Mdoi
10.1016/j.transproceed.2012.01.029subject
Has Abstractpub_date
2012-03-01 00:00:00pages
565-9issue
2eissn
0041-1345issn
1873-2623pii
S0041-1345(12)00063-2journal_volume
44pub_type
杂志文章abstract:BACKGROUND:Organ transplantation is the preferred treatment for end-stage renal disease. Renal transplant recipients are surviving longer with a better quality of life. Although many hospitals have transplant education programs in place, transplant patients indicate that there is a need for additional information. Tran...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2003.08.010
更新日期:2003-11-01 00:00:00
abstract::Rates of overall graft survival after liver retransplantation (RETX) are still 20% lower than those after primary liver transplantation (TX). On the basis of previous mathematical approaches from other authors who tried to identify prognostic variables for survival and prognostic risk scores for liver RETX, we studied...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.05.057
更新日期:2008-07-01 00:00:00
abstract::Several groups have performed graft biopsies at set times posttransplant ("protocol biopsies") and found unequivocal histologic criteria for acute rejection in a high proportion of patients with stable graft function. The significance of "subclinical" rejection remains controversial. Our group and others have shown th...
journal_title:Transplantation proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.transproceed.2003.12.051
更新日期:2004-03-01 00:00:00
abstract::The purpose of this research was to determine the levels of anxiety and depression and the need for training of patients who had undergone liver transplantation. This descriptive research included patients who had undergone liver transplantation at least 1 month prior and had follow-up between June and November 2006. ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.11.012
更新日期:2009-06-01 00:00:00
abstract::A national database for orthotopic liver transplantation (OLT) among biliary atresia (BA) cases in Taiwan has not been reported. Using the National Health Insurance (NHI) database to investigate the prognostic features of patients with BA receiving OLT, we studied the prognosis of this procedure for BA. The NHI in Tai...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.07.136
更新日期:2008-12-01 00:00:00
abstract::Recipients of allotransplants are more susceptible to viral infections, among which the human papilloma virus infection is an independent factor inducing precancerous lesions and cancers of both the anogenital and the cervicocephalic region. MATERIALS AND METHODS:The study included a group of 69 allogenic kidney tran...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2018.05.008
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The rising demand for living renal donors has led to the recruitment of older donors. Findings vary, but these grafts appear to survive as long as grafts from standard criteria deceased and expanded criteria deceased donors. We investigated the effects of donor age ≥65 years and the presence or absence of do...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2018.08.046
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Estimation of glomerular filtration rate (eGFR) after renal transplantation is performed with the use of methods that are standardized for a population of nontransplantation patients with chronic kidney disease. The aim of the study was to compare the performance of GFR estimation formulas in renal transplan...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2014.09.009
更新日期:2014-10-01 00:00:00
abstract::The hallmark of endothelial activation, an early and critical step in many alloimmune and inflammatory responses, is the transcriptional induction and expression of endothelial adhesion molecules (eg, vascular cell adhesion molecule-1 [VCAM-1]). We assessed the feasibility of VCAM-1-targeted in vivo detection of endot...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.05.060
更新日期:2004-06-01 00:00:00
abstract::We looked at mycobacterial infections occurring after a kidney transplant to determine incidence, risk factors, and outcomes. Of 3921 kidney transplants performed between 1984 and 2002, 18 (0.45%) (10 men, eight women; 11 cadaveric donor, seven living donor graft) were identified as having mycobacterial infection at s...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.12.167
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:It is unclear whether both Kidney Donor Profile Index (KDPI) and Kidney Donor Risk Index (KDRI) scores can be applied to elderly deceased donors (DDs). This study aimed to compare the predictive values of KDRI and KDPI for the occurrence of delayed graft function (DGF) in kidney transplantation (KT) from eld...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.03.005
更新日期:2020-01-01 00:00:00
abstract::The presence of IgG antibodies in the pretransplant cross-match (XM) test results in hyperacute rejection, but IgM antibodies are inconsequential. The XM should be able to differentiate between IgG and IgM antibodies. This study evaluated 3 methods. This study was based on 500 patients for whom XM were performed betwe...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.07.045
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:The risk of the development of renal cell cancer (RCC) in renal transplant recipients is several times higher than the general population. There can often be a delay between initial radiological imaging and patients undergoing renal transplantation. We present and evaluate the prevalence and clinical charact...
journal_title:Transplantation proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.transproceed.2015.06.009
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:A positive crossmatch indicates the presence of donor-specific alloantibodies and is associated with a graft loss rate of >80%; anti-ABO blood group antibodies develop in response to exposure to foreign blood groups, resulting in immediate graft loss. However, a desensitization protocol for highly HLA-sensit...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2010.09.043
更新日期:2010-12-01 00:00:00
abstract::A high degree of macrovesicular steatosis is associated with a significant risk of graft dysfunction. Most centers, including ours, consider 60% the limit value for transplantability, while others have adopted 30% as a cutoff. Pretransplant frozen-section (PFS) evaluation is used for reliable quantification of steatos...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2010.05.033
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:The aim of this paper was to describe differences between levels of endothelial nitric oxide synthase (NOS-3) and endothelin-1 (ET-1) in swine kidneys removed from living donors (group I) and after inducing brain death by brain herniation (group II) and cardiac arrest (group III). METHODS:Each group consist...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2014.09.036
更新日期:2014-10-01 00:00:00
abstract::Because of the serious organ shortage in Japan, the use of extended criteria (EC) donors is inevitable to increase the number of deceased donors. However, the influence of this practice on recipient outcomes has not been clarified yet. We analyzed donor and recipient factors to determine whether those factors, especia...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.01.010
更新日期:2012-03-01 00:00:00
abstract:UNLABELLED:Pancreas transplant (Ptx) is the gold standard for the treatment of type I diabetes, mainly when associated with renal failure. The number of Ptx is increasing worldwide, but in developing countries, such as Brazil, the number of centers is small and transplant surgeons need to practice the technique. METHO...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.06.056
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:To assess the effect of sodium heparin concentrations on antibody- and complement-mediated cytolysis by means of a real-time cell analyzer system (RTCA) investigating the complement regulation ability of heparin to reduce or prevent hyperacute in an in vitro model of pig-to-baboon xenotransplantation. MATERI...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.05.015
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:The limited supply of organs restricts the number of transplantations. Studying the families who refuse donation may help to increase the number of transplantations. METHODS:This descriptive cross-sectional study used a questionnaire to obtain information from 61 family members who had refused to donate org...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.07.018
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Acinetobacter baumannii has become an increasingly important nosocomial pathogen. Carbapenem is the preferred drug of choice for treatment of multidrug-resistant gram-negative bacilli, but carbapenem-resistant A baumannii (CRAB) has now emerged. The aim of this study was to determine the incidence, outcomes,...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2018.01.043
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:After renal transplantation, the prevalence of BK virus (BKV) viruria, viremia, and nephritis (BKVAN) has been estimated at 30%, 13%, and 8%, respectively. PATIENTS AND METHODS:The aim of this prospective study was to assess the occurrence of BKV DNAemia during the first year after renal transplantation and...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.11.001
更新日期:2007-01-01 00:00:00
abstract::Gingival overgrowth (GO), characterized by increased cellular and extracellular matrix components in gingival tissue, is a frequent side effect of cyclosporine (CsA). In previous studies, elevated levels of transforming growth factor-beta (TGF-beta) have been detected in GO tissue, which led to the conclusion that TGF...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.08.151
更新日期:2006-11-01 00:00:00
abstract::Heart transplantation is contraindicated in patients with acute irreversible pulmonary hypertension (PH), but new drugs are opening up therapeutic possibilities. Sildenafil citrate is a nonselective pulmonary vasodilator that is being used in our hospital to treat several patients with PH and which has allowed the inc...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2005.02.013
更新日期:2005-04-01 00:00:00
abstract:UNLABELLED:We have previously reported that tolerance to class I disparate lung allografts in miniature swine could be induced using an intensive 12-day course of tacrolimus and that pretransplant sensitization with immunogenic MHC class I allopeptides failed to block the induction of tolerance. We also have previously...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.10.064
更新日期:2006-12-01 00:00:00
abstract::We report 6-month results of renal allograft recipients enrolled in seven Australian centers as part of a worldwide, multicenter, randomized, open-label, concentration-controlled trial comparing standard tacrolimus (sTAC) with reduced tacrolimus (rTAC) both with sirolimus (SRL) and steroids. Patients were randomized 1...
journal_title:Transplantation proceedings
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0041-1345(03)00210-0
更新日期:2003-05-01 00:00:00
abstract::To assess the time-dependent changes in renal function in relation to antioxidant and lipid-lowering effects of fluvastatin in hyperlipidemic renal transplant recipients, 20 patients were treated with fluvastatin 40 mg/d for 12 months, after failure of a dietary program. Plasma malondialdehyde (MDA) levels and lipid p...
journal_title:Transplantation proceedings
pub_type: 临床试验,杂志文章
doi:10.1016/s0041-1345(03)00376-2
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Ex vivo machine perfusion (MP) has been reported as a possibly method to rescue discarded organs. The main aim of this study was to report an initial experience in Spain using MP for the rescue of severely marginal discarded liver grafts, and to, secondarily, define markers of viability to test the potential...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2018.04.092
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The ischemia/reperfusion (I/R) phenomenon can cause the dysfunction of some transplanted organs and other distant organs. Liver surgery success, including transplantations, may depend on the adverse effects of intestinal mucosa injury arising from temporary porta triad occlusion. The study objective was to e...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2016.06.003
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Conversion to belatacept at a later point after kidney transplantation (KT) as a rescue therapy has been shown to be beneficiary in an increasing number of patients, but prognostic factors for a favorable outcome have never been investigated. METHODS:The present study analyzed all KT patients after late con...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2017.05.013
更新日期:2017-10-01 00:00:00