JaLCDOI 10.18926/AMO/32683
フルテキストURL fulltext.pdf
著者 Sakagami, Kenichi| Saito, Shinya| Shiozaki, Shigehiro| Takasu, Shinji| Matsuno, Tsuyoshi| Fujiwara, Takuzo| Kusaka, Satoshi| Uda, Masashi| Matsuoka, Junji| Naomoto, Yoshio| Gouchi, Akira| Hamazaki, Keisuke| Tanaka, Shinichiro| Orita, Kunzo|
抄録 <p>A retrospective study was carried out in 110 cadaveric kidney transplant recipients to compare the effects of low doses of cyclosporine (CsA), azathioprine (AZP) and steroids (triple-drug therapy) with those of higher doses of steroids plus AZP (conventional immunosuppression). Graft survival rate in the triple-drug therapy was 77%, 69%, and 69% at 1, 3, and 5 years, respectively. This was significantly better than 48%, 34%, and 29% in conventional immunosuppression. The incidence of acute rejection episodes was significantly lower in the triple-drug therapy than in conventional immunosuppression (25% vs 58%). In conclusion, our study shows that triple-drug therapy using low-dose cyclosporine is the safest of the immunosuppressive regimens and provides a beneficial effect on the long-term survival of cadaveric kidney transplants.</p>
キーワード cadaveric kindney transplantation cyclosporine triple-drug therapy
Amo Type Article
発行日 1992-02
出版物タイトル Acta Medica Okayama
46巻
1号
出版者 Okayama University Medical School
開始ページ 53
終了ページ 56
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 1561907
Web of Science KeyUT A1992HH01700010
JaLCDOI 10.18926/AMO/32678
フルテキストURL fulltext.pdf
著者 Sakagami, Kenichi| Saito, Shinya| Shiozaki, Shigehiro| Fujiwara, Takuzo| Haisa, Minoru| Niguma, Takefumi| Kusaka, Satoshi| Uda, Masashi| Matsuno, Tsuyoshi| Takasu, Shinji| Yerdel, Mehmet Ali| Matsuoka, Junji| Tanaka, Shinichiro| Orita, Kunzo|
抄録 <p>One-hundred-nine HLA-haploidentical living related renal transplants have been retrospectively analysed to compare the effect of donor-specific blood transfusion (DST) and different immunosuppressive regimens on graft survival and acute rejection. The recipients were divided into four groups according to the immunosuppressive therapy. Group 1 (n = 44): conventional therapy with posttransplant azathioprine (AZP) + methylprednisolone (MP). Group 2 (n = 25): pretransplant DST + posttransplant AZP + MP. Group 3 (n = 12): triple-drug therapy with posttransplant AZP + MP + cyclosporine (CS). Group 4 (n = 25): pretransplant DST + posttransplant AZP + MP + CS. The five-year actuarial survival rates for groups 1, 2, 3 and 4 were 48%, 73%, 79%, and 89%, respectively. The graft survival rate in group 3 was significantly (p less than 0.01) better than that in group 1. The transfusion effect was reduced, and appears as a 10% improvement in the graft survival in the cyclosporin era compared with a 25% improvement at pre-cyclosporin era. Furthermore, the incidence of the first rejection episode was decreased in recipients that received DST. The present study revealed that DST, as pretransplant conditioning has a definite impact on rejection-free long-term graft survival in HLA-haploidentical living-related kidney recipients and the most favorable outcome in such patients could be achieved by DST pretreatment in conjunction with posttransplant triple-drug therapy including cyclosporine.</p>
キーワード living-related kindney transplantation donor-specific blood transfusion (DST) cyclosporine
Amo Type Article
発行日 1992-02
出版物タイトル Acta Medica Okayama
46巻
1号
出版者 Okayama University Medical School
開始ページ 1
終了ページ 5
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 1561899
Web of Science KeyUT A1992HH01700001
JaLCDOI 10.18926/AMO/32027
フルテキストURL fulltext.pdf
著者 Nakagawa, Kazuhiko| Matsuno, Tsuyoshi| Iwagaki, Hiromi| Fujiwara, Takuzo| Tanaka, Noriaki|
抄録 <p>The immune status of thirteen living and related kidney transplant recipients with stable allografts were examined. The immunological assays consisted of a mixed lymphocyte reaction (MLR), cell-mediated lympholysis (CML) assay, interleukin-2 (IL-2) production in mixed lymphocytes culture (MLC) and IL-2 receptor (IL-2 R) expression on MLC cells. The suppression rates of the monoclonal antibodies (mAbs) against IL-2 R were tested on MLRs. The stimulation indices (SI) of the MLR against both donor and third-party cells increased compared with those of pretransplantation. The MLC responder cells stimulated by donor cells produced detectable amounts of IL-2, these amounts were lower than those by third-party cells. The MLC cells against donor cells expressed IL-2 R alpha and beta chains to the same degree as those against third-party cells. Anti-IL-2 R mAbs equally inhibited the MLRs between recipient and donor or third-party cells. Cytotoxic T lymphocytes (CTL) against donor cells were not generated, even with the addition of recombinant IL-2 in any of recipients except one, while anti-donor CTL had been detected prior to transplantation and the CTL against third-party cells were induced in posttranspalnt CML </p> <p>assays. These results indicate that the clonal anergy phenomenon might mediate the specific CTL unresponsiveness observed in kidney transplant recipients and the anergy phenomenon might serve in the long-term acceptance of allograft.</p>
キーワード renal transplantation long-term stable recipients specific CTL nuresponsiveness interleckin-2 interleukin-2 receptors
Amo Type Article
発行日 2001-02
出版物タイトル Acta Medica Okayama
55巻
1号
出版者 Okayama University Medical School
開始ページ 31
終了ページ 39
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 11246975
Web of Sience KeyUT 000167249900005
JaLCDOI 10.18926/AMO/31581
フルテキストURL fulltext.pdf
著者 Saito, Shinya| Sakagami, Kenichi| Fujiwara, Takuzo| Matsuno, Tsuyoshi| Orita, Kunzo| Hiramatsu, Yuji| Kudo, Takafumi|
抄録 <p>Three cases of successful pregnancies in renal transplant recipients who had undergone transplantation in the Okayama University Medical School Hospital are reported. Two of the women had received an organ from a living relative and one woman received a cadaveric organ graft. These patients, aged 28-37 at the time of the delivery, had received their transplants 2-5 years prior to their conception. The periods of gestation ranged between 35 and 40 weeks. The weight of the babies at birth ranged from 2,380g to 2,500g and the apgar score at 1 min was 8 or 9. None of the infants showed any congenital abnormalities. Lower-segment cesarean section was performed in all of three cases. Serum creatinine levels, an indicator of renal graft function, did not deteriorate during the pregnancy or after delivery. Although further work is needed to solve problems regarding pregnancy in renal transplant recipients, these results encouraged us to meet their hope for a baby.</p>
キーワード pregnancy renal transplantation immunosuppression
Amo Type Article
発行日 1993-10
出版物タイトル Acta Medica Okayama
47巻
5号
出版者 Okayama University Medical School
開始ページ 347
終了ページ 349
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 8273458
Web of Science KeyUT A1993ME47100009
JaLCDOI 10.18926/AMO/31132
フルテキストURL fulltext.pdf
著者 Fujiwara, Takuzo| Sakagami, Kenichi| Saito, Shinya| Uda, Masashi| Orita, Kunzo|
抄録 <p>The antidonor immune response was examined in a one haplotype-mismatched renal transplant recipient with an allograft that had been well-functioning for more than 10 years. Although the relative response of the mixed lymphocyte reaction (MLR) was (45.8)% and the MLR responder cells stimulated by donor cells produced measurable amounts of interleukin-2 (IL-2) (11.6 U/ml), the cytotoxic T lymphocytes (CTL) could not be generated against donor cells, even with exogenous IL-2. These results indicate that antidonor CTL precursors were either deleted or inactivated in this recipient.</p>
キーワード renal transplantation long-term stable recipient cytotoxic T lymphocytes
Amo Type Article
発行日 1994-02
出版物タイトル Acta Medica Okayama
48巻
1号
出版者 Okayama University Medical School
開始ページ 63
終了ページ 65
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 8191919
Web of Sience KeyUT A1994MY85100011