JaLCDOI 10.18926/AMO/56457
フルテキストURL 73_1_43.pdf
著者 Ikeda, Ailee| Takaki, Akinobu| Yasunaka, Tetsuya| Oyama, Atsushi| Adachi, Takuya| Wada, Nozomu| Onishi, Hideki| Ikeda, Fusao| Shiraha, Hidenori| Yoshida, Kazuhiro| Kuise, Takashi| Nobuoka, Daisuke| Yoshida, Ryuichi| Umeda, Yuzo| Yagi, Takahito| Fujiwara, Toshiyoshi| Okada, Hiroyuki|
抄録 Post-orthotopic liver transplantation (OLT) hepatitis B recurrence is well-controlled with a nucleos(t)ide analogue and hepatitis B immunoglobulin (HBIG) combination, but the high cost and the potential risk of unknown infection associated with HBIG remain unresolved issues. Low-cost recombinant hepatitis B virus (HBV) vaccine administration is a potential solution to these problems. We retrospectively analyzed the rate and predictive factors of HBV vaccine success in 49 post-OLT patients: liver cirrhosis-type B (LC-B), n=28 patients; acute liver failure-type B (ALF-B), n=8; and non-HBV-related end-stage liver disease (non-B ESLD) who received a liver from anti-hepatitis B core antibody-positive donors, n=13. A positive anti-hepatitis B surface antibody response was achieved in 29% (8/28) of the LC-B group, 88% (7/8) of the ALF-B group, and 44% (4/9) of the adult non-B ESLD group. All four non-B ESLD infants showed vaccine success. The predictive factors for a good response in LC-B were young age, marital donor, and high donor age. ALF-B and non-B ESLD infants are thus good vaccination candidates. LC-B patients with marital donors are also good candidates, perhaps because the donated liver maintains an efficient immune memory to HBV, as the donors had already been infected in adulthood and showed adequate anti-HBV immune responses.
キーワード acute liver failure hepatitis B hepatitis B vaccine liver cirrhosis liver transplantation
Amo Type Original Article
発行日 2019-02
出版物タイトル Acta Medica Okayama
73巻
1号
出版者 Okayama University Medical School
開始ページ 41
終了ページ 50
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 30820053
JaLCDOI 10.18926/AMO/56374
フルテキストURL 72_6_567.pdf
著者 Yagi, Takahito| Takagi, Kosei| Umeda, Yuzo| Yoshida, Ryuichi| Nobuoka, Daisuke| Kuise, Takashi| Fujiwara, Toshiyoshi|
抄録 Living donor liver transplantation (LDLT) is the final therapeutic arm for pediatric end-stage liver diseases. Toward the goal of achieving further improvement in LDLT survival, we investigated factors affecting recipient survival. We evaluated the prognostic factors of 60 pediatric recipients (< 16 years old) who underwent LDLT between 1997 and 2015. In a univariate analysis, non-cholestatic (NCS) disease, graft/recipient body weight ratio, cold and warm ischemic times, and intraoperative blood loss were significant factors impacting survival. In a multivariate analysis, NCS disease was the only significant factor worsening survival (p=0.0021). One-and 5-year survival rates for the cholestatic disease (CS, n=43) and NCS (n=17) groups were 100% vs. 70.6% and 97.4% vs. 58.8% (p=0.004, log-rank). Intergroup comparisons revealed that CS was significantly associated with operation time, cold ischemia, hepatomegaly of the native liver, and portal plasty. These data suggest that a cirrhotic, swollen, artery-dominant liver did not increase graft size-related risks despite the surgical complexity of preceding operations. The NCS group’s poorer survival originated from recurrence of the primary disease and liver manifestation of systemic disease untreatable by transplantation. Improving the survival of pediatric recipients requires intensive efforts to prevent primary disease relapse and more rapid diagnoses to exclude contraindications from NCS disease.
キーワード liver transplantation living donor pediatrics prognostic factor cholestatic disease
Amo Type Original Article
発行日 2018-12
出版物タイトル Acta Medica Okayama
72巻
6号
出版者 Okayama University Medical School
開始ページ 567
終了ページ 576
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 30573911
NAID 120006545159
JaLCDOI 10.18926/AMO/56250
フルテキストURL 72_5_515.pdf
著者 Kanamitsu, Kiichiro| Chayama, Kousuke| Washio, Kana| Yoshida, Ryuichi| Umeda, Yuzo| Yagi, Takahito| Shimada, Akira|
抄録 Hepatitis-associated aplastic anemia (HAAA) is an acquired bone marrow failure syndrome that develops after seronegative fulminant hepatitis. Abnormal cytotoxic T-cell activation with cytokine release is a possible pathophysiology. We present the case of a 16-month-old Japanese male who developed HAAA following living-donor liver transplantation for fulminant hepatitis. His aplastic anemia was successfully treated with immunosuppressive therapy. He had been administered tacrolimus for prophylaxis against hepatic allograft rejection. Ten years after the HAAA onset, the patient’s bone marrow was found to be slightly hypoplastic. Tacrolimus may be effective in controlling abnormal immune reactions that can cause recurrent impaired hematopoiesis.
キーワード hepatitis-associated aplastic anemia impaired hematopoiesis liver transplantation immunosuppressive therapy abnormal immune reaction
Amo Type Case Report
発行日 2018-10
出版物タイトル Acta Medica Okayama
72巻
5号
出版者 Okayama University Medical School
開始ページ 515
終了ページ 518
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 30369609
JaLCDOI 0
フルテキストURL J_Gastroenterol_Hepatol_62_4_925.pdf
著者 Horiguchi, higeru| Kato, Hironari| Shiraha, Hidenori| Tsutsumi, Koichiro| Yamamoto, Naoki| Matsumoto, Kazuyuki| Tomoda, Takeshi| Uchida, Daisuke| Akimoto, Yutaka| Mizukawa, Syou| Tanaka, Takehiro| Ichimura, Koichi| Takaki, Akinobu| Yagi, Takahito| Okada, Hiroyuki|
キーワード WHO2010 dynamic CT microvessel density pancreatic neuroendocrine neoplasm pathological grade
備考 This is an Accepted Manuscript of an article published by John Wiley & Sons
発行日 2017-04
出版物タイトル Journal of Gastroenterology and Hepatology
32巻
4号
出版者 John Wiley & Sons
開始ページ 925
終了ページ 931
ISSN 0815-9319
NCID AA10727383
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja
論文のバージョン author
PubMed ID 27637470
DOI 10.1111/jgh.13594
Web of Sience KeyUT 000398534100030
関連URL isVersionOf https://doi.org/10.1111/jgh.13594
JaLCDOI 10.18926/AMO/55435
フルテキストURL 71_5_381.pdf
著者 Yoshida, Kazuhiro| Umeda, Yuzo| Takaki, Akinobu| Nagasaka, Takeshi| Yoshida, Ryuichi| Nobuoka, Daisuke| Kuise, Takashi| Takagi, Kosei| Yasunaka, Tetsuya| Okada, Hiroyuki| Yagi, Takahito| Fujiwara, Toshiyoshi|
抄録 Determining the indications for and timing of liver transplantation (LT) for acute liver failure (ALF) is essential. The King’s College Hospital (KCH) guidelines and Japanese guidelines are used to predict the need for LT and the outcomes in ALF. These guidelines’ accuracy when applied to ALF in different regional and etiological backgrounds may differ. Here we compared the accuracy of new (2010) Japanese guidelines that use a simple scoring system with the 1996 Japanese guidelines and the KCH criteria for living donor liver transplantation (LDLT). We retrospectively analyzed 24 adult ALF patients (18 acute type, 6 sub-acute type) who underwent LDLT in 1998-2009 at our institution. We assessed the accuracies of the 3 guidelines’ criteria for ALF. The overall 1-year survival rate was 87.5%. The new and previous Japanese guidelines were superior to the KCH criteria for accurately predicting LT for acute-type ALF (72% vs. 17%). The new Japanese guidelines could identify 13 acute-type ALF patients for LT, based on the timing of encephalopathy onset. Using the previous Japanese guidelines, although the same 13 acute-type ALF patients (72%) had indications for LT, only 4 patients were indicated at the 1st step, and it took an additional 5 days to decide the indication at the 2nd step in the other 9 cases. Our findings showed that the new Japanese guidelines can predict the indications for LT and provide a reliable alternative to the previous Japanese and KCH guidelines.
キーワード living donor liver transplantation acute liver failure fulminant hepatic failure
Amo Type Original Article
発行日 2017-10
出版物タイトル Acta Medica Okayama
71巻
5号
出版者 Okayama University Medical School
開始ページ 381
終了ページ 390
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29042695