Kohei Ogawa

Publications (65)176.34 Total impact

• Article: Key techniques for orthotopic liver transplantation model with a 30 % graft in swine.

  Tomohide Hori, Shintaro Yagi, Taku Iida, Kentaro Taniguchi, Chiduru Yamamoto, Yusuke Okamura, Kohei Ogawa, Shinji Uemto
  Surgery Today 04/2013; · 1.22 Impact Factor
• Article: Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation.

  Yoshihide Ueda, Toshimi Kaido, Yasuhiro Ogura, Kohei Ogawa, Atsushi Yoshizawa, Koichiro Hata, Yasuhiro Fujimoto, Aya Miyagawa-Hayashino, Hironori Haga, Hiroyuki Marusawa, Satoshi Teramukai, Shinji Uemoto, Tsutomu Chiba
  [show abstract] [hide abstract]
  ABSTRACT: Given the limited efficacy and high adverse event rate associated with treatment of recurrent hepatitis C after liver transplantation, an individualized treatment strategy should be considered. The aim of this study was to identify predictors of response to antiviral therapy for hepatitis C after living donor liver transplantation (LDLT) and to study the associated adverse events. A retrospective chart review was performed on 125 hepatitis C virus (HCV)-positive LDLT recipients who received interferon plus ribavirin and/or peginterferon plus ribavirin therapy at Kyoto University between January 2001 and June 2011. Serum HCV RNA reached undetectable levels within 48 weeks in 77 (62%) of 125 patients, and these patients were defined as showing virological response (VR). Of 117 patients, 50 (43%) achieved sustained VR (SVR). Predictive factors associated with both VR and SVR by univariate analysis included low pretransplant serum HCV RNA levels, a non-1 HCV genotype, and low pretreatment serum HCV RNA levels. In addition, LDLT from ABO-mismatched donors was significantly associated with VR, and white cell and neutrophil counts before interferon therapy were associated with SVR. Multivariate analysis showed that 2 variables-pretransplant serum HCV RNA level less than 500 kIU/mL and a non-1 HCV genotype-remained in models of both VR and SVR and that an ABO mismatch was associated with VR. No variables with a significant effect on treatment withdrawal were found. Virological response to antiviral therapy in patients with hepatitis C recurring after LDLT can be predicted prior to transplant, based on pretransplant serum HCV-RNA levels and HCV genotype. LDLT from ABO-mismatched donors may contribute to more efficacious interferon therapy. UMIN-CTR UMIN000003286.
  PLoS ONE 01/2013; 8(3):e58380. · 4.09 Impact Factor
• Article: Liver Transplantation for Primary Hyperoxaluria Type 1: A Single-center Experience during Two Decades in Japan.

  Tomohide Hori, Hiroto Egawa, Toshimi Kaido, Kohei Ogawa, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND: Primary hyperoxaluria type-1 (PH1) is an autosomal recessive disorder caused by impaired activity of hepatic peroxisomal alanine-glyoxylate aminotransferase that leads to end-stage renal disease (ESRD). A definitive diagnosis is often delayed until ESRD appears. Based on the etiology, liver transplantation (LT) seems to be the definitive treatment. PATIENTS AND METHODS: Three PH1 patients underwent LT at our institution during two decades. RESULTS: Two of the patients had family histories of cryptogenic ESRD. All three showed disease onset in childhood, but the definitive diagnosis was delayed in two cases (17 and 37 years of age). These delayed cases resulted in ESRD, and hemodialysis (HD) had been introduced before LT. One patient received domino LT, and the other two underwent living-donor LT (LDLT). One patient finally died of sepsis, and was unable to receive a kidney transplantation (KT) after the domino LT. One patient did not show ESRD, and did not have to undergo KT after LDLT, although extracorporeal shock wave lithotripsy was required for residual ureterolithiasis (8 years after LDLT). The third patient had an uneventful course after LDLT and received living-donor KT from the same donor 8 months after LDLT. Subsequently, HD was successfully withdrawn. CONCLUSIONS: Establishment of a definitive diagnosis of PH1 is essential. If a methodology for early diagnosis and an intensive care strategy for neonates and infants during the waiting time become well-established, a timely and preemptive LT alone can provide a good chance of cure for PH1 patients.
  World Journal of Surgery 11/2012; · 2.36 Impact Factor
• Article: An adult with primary hyperoxaluria type 1 regrets not receiving preemptive liver transplantation during childhood: report of a case.

  Tomohide Hori, Toshimi Kaido, Nobuyuki Tamaki, Yasuko Toshimitsu, Kohei Ogawa, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: A 32-year-old male was suspected to have primary hyperoxaluria type 1 (PH1) and eventually underwent liver transplantation (LT). He was diagnosed with nephrolithiasis at 9 years of age. Right heminephrectomy was performed for a staghorn calculus. He underwent urethrotomy for urinary retention at 12 years of age. Percutaneous nephrolithotomy was performed for nephrolithiasis when he was 16 years of age. He underwent frequent extracorporeal shock wave lithotripsy for recurrent nephrolithiasis from 18 to 24 years of age. PH1 was suspected at 32 years of age, and pharmacological therapy was also initiated. He developed renal failure at 36 years of age, which was treated with intensive hemodialysis. A definitive diagnosis of PH1 was made based on a liver needle biopsy 1 month later. He received a living-donor LT at 38 years of age, and a living-donor kidney transplant from the same donor 8 months later. Though he made a good recovery, an early diagnosis and preemptive LT are important for PH1 patients.
  Surgery Today 08/2012; · 1.22 Impact Factor
• Article: How transplant surgeons can overcome the inevitable insufficiency of allograft size during adult living-donor liver transplantation: strategy for donor safety with a smaller-size graft and excellent recipient results.

  Tomohide Hori, Yasuhiro Ogura, Kohei Ogawa, Toshimi Kaido, Hajime Segawa, Hideaki Okajima, Takayuki Kogure, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: Small-for-size grafts are an issue in liver transplantation. Portal venous pressure (PVP) was monitored and intentionally controlled during living-donor liver transplantation (LDLT) in 155 adult recipients. The indocyanine green elimination rate (kICG) was simultaneously measured in 16 recipients and divided by the graft weight (g) to reflect portal venous flow (PVF). The target PVP was <20 mmHg. Patients were divided by the final PVP (mmHg): Group A, PVP < 12; Group B, 12 ≤ PVP < 15; Group C, 15 ≤ PVP < 20; and Group D, PVP ≥ 20. With intentional PVP control, we performed splenectomy and collateral ligation in 80 cases, splenectomy in 39 cases, and splenectomy, collateral ligation, and additional creation in five cases. Thirty-one cases received no modulation. Groups A and B showed good LDLT results, while Groups C and D did not. Final PVP was the most important factor for the LDLT results, and the PVP cutoffs for good outcomes and clinical courses were both 15.5 mmHg. The respective kICG/graft weight cutoffs were 3.5580 × 10(-4) /g and 4.0015 × 10(-4) /g. Intentional PVP modulation at <15 mmHg is a sure surgical strategy for small-for-size grafts, to establish greater donor safety with good LDLT results. The kICG/graft weight value may have potential as a parameter for optimal PVF and a predictor for LDLT results.
  Clinical Transplantation 05/2012; 26(3):E324-34. · 1.67 Impact Factor
• Article: Efficacy and safety of prophylaxis with entecavir and hepatitis B immunoglobulin in preventing hepatitis B recurrence after living-donor liver transplantation.

  Yoshihide Ueda, Hiroyuki Marusawa, Toshimi Kaido, Yasuhiro Ogura, Kohei Ogawa, Atsushi Yoshizawa, Koichiro Hata, Yasuhiro Fujimoto, Norihiro Nishijima, Tsutomu Chiba, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: Aim:  Hepatitis B recurrence after liver transplantation can be reduced to less than 10% by combination therapy with lamivudine (LAM) and hepatitis B immunoglobulin (HBIG). The aim of this study was to evaluate the efficacy and safety of prophylaxis with entecavir (ETV), which has higher efficacy and lower resistance rates than LAM, combined with HBIG in preventing hepatitis B recurrence after living-donor liver transplantation (LDLT). Methods:  Twenty-six patients who received ETV plus HBIG (ETV group) after LDLT for hepatitis B virus (HBV)-related end-stage liver disease were analyzed by comparing with 63 control patients who had received LAM plus HBIG (LAM group). Results:  The survival rates of the patients treated with ETV plus HBIG was 73% after both 1 and 3 years, and there was no statistical difference between the patients in the ETV group and LAM group. No HBV recurrence was detected during the median follow-up period of 25.1 months in the ETV group, whereas the HBV recurrence rate was 4% at 3 years and 6% at 5 years in the LAM group. No patients had adverse effects related to ETV administration. Conclusion:  ETV combined with HBIG provides effective and safe prophylaxis in preventing hepatitis B recurrence after LDLT.
  Hepatology Research 04/2012; · 2.20 Impact Factor
• Article: Use of recipient's left colic artery for arterial reconstruction during liver transplantation in Alagille syndrome with vasculopathy: a case report.

  Mahmoud Refaat Shehata, Shintaro Yagi, Yasuhiro Ogura, Kohei Ogawa, Taku Iida, Akira Mori, Shinji Sumiyoshi, Hironori Haga, Shinji Uemoto
  Transplantation 03/2012; 93(6):e20-1. · 4.00 Impact Factor
• Article: Non-inflammatory centrilobular sinusoidal fibrosis in pediatric liver transplant recipients under tacrolimus withdrawal.

  Hiroto Egawa, Aya Miyagawa-Hayashino, Hironori Haga, Satoshi Teramukai, Atsushi Yoshizawa, Kohei Ogawa, Yasuhiro Ogura, Shinya Okamoto, Toshimi Kaido, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: Aim:  We hypothesized that non-inflammatory central sinusoidal fibrosis (NICSF) is a sign of inadequate immunosuppression in children after living-donor liver transplantation. Methods:  In study 1, liver biopsy specimens of 158 patients who had undergone liver transplantation 10 years before or earlier were examined to study the relationship between NICSF and tacrolimus withdrawal. In study 2, tacrolimus was resumed in 18 patients with NICSF in follow-up biopsies after tacrolimus withdrawal and the subsequent histological changes were analyzed. Results:  In study 1, after excluding 95 patients with ongoing vascular, biliary and immunological complications, 47 of 63 patients (75%) had NICSF and significant (P = 0.0285) contributing factors were found to be episodes of tacrolimus withdrawal. In study 2, during withdrawal, tacrolimus administration had been discontinued in nine, reduced to once per month in three, twice per month in two, once a week in two and twice a week in two patients, and then finally resumed to daily administration in all. NICSF was scored as 4 in one, 3 in seven, 2 in four and 1 in six patients using modified Dixon's criteria (score, 0-4). After resumption, NICSF was improved in six, unchanged in 11 and aggravated in one patient. C4d deposition was improved in all NICSF-improved patients. Incidence of positive C4d prior to resumption was significantly greater in improved patients than non-improved patients (P = 0.0245). Conclusion:  NICSF might be an indicator of inadequate immunosuppression in long-term followed recipients and its mechanism may be due to immune reactions including humoral immunity.
  Hepatology Research 03/2012; 42(9):895-903. · 2.20 Impact Factor
• Article: Significance of trough monitoring for tacrolimus blood concentration and calcineurin activity in adult patients undergoing primary living-donor liver transplantation.

  Ikuko Yano, Satohiro Masuda, Hiroto Egawa, Mitsuhiro Sugimoto, Masahide Fukudo, Yuko Yoshida, Sachiyo Hashi, Atsushi Yoshizawa, Yasuhiro Ogura, Kohei Ogawa, Akira Mori, Toshimi Kaido, Shinji Uemoto, Ken-Ichi Inui
  [show abstract] [hide abstract]
  ABSTRACT: Tacrolimus pharmacokinetics and calcineurin activity in peripheral blood mononuclear cells (PBMCs) were investigated in adult patients undergoing primary living-donor liver transplantation (LDLT) in order to clarify the significance of monitoring the tacrolimus blood trough concentration during the early post-transplantation period. Fourteen patients were enrolled in this study, and time-course data following the oral administration of a conventional tacrolimus formulation twice daily were obtained at 1 and 3 weeks post-transplantation. The concentration of tacrolimus in whole blood and calcineurin activity in PBMCs were measured. The apparent clearance of tacrolimus significantly increased at 3 weeks versus 1 week post-transplantation, although the trough concentration did not significantly differ at these time points. The concentration at each sampling time, except at 1 h post-dose, correlated well with the area under the concentration-time curve from 0 to 12 h (AUC(0-12)). Neither the concentration at the trough time point nor AUC(0-12) was correlated with the area under the calcineurin activity-time curve from 0 to 12 h; however, calcineurin activity at the trough time point was strongly correlated with the latter (r (2) > 0.92). Based on these results, trough concentration monitoring can be considered an appropriate procedure for routine tacrolimus dosage adjustment in adult LDLT patients. Monitoring of calcineurin activity at the trough time point was also found to be potentially useful for predicting the immunological status of the patient during the tacrolimus dosing interval.
  European Journal of Clinical Pharmacology 03/2012; 68(3):259-66. · 2.85 Impact Factor
• Article: Effects of post-transplant enteral nutrition with an immunomodulating diet containing hydrolyzed whey peptide after liver transplantation.

  Toshimi Kaido, Yasuhiro Ogura, Kohei Ogawa, Koichiro Hata, Atsushi Yoshizawa, Shintaro Yagi, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: Complications due to infections, including bacteremia, often arise after liver transplantation (LT) and are the most frequent causes of in-hospital death. Hydrolyzed whey peptide (HWP), a protein complex derived from milk, has anti-inflammatory effects. The present study retrospectively analyzes the effects of early enteral nutrition with a new immunomodulating diet (IMD) enriched with HWP in patients after living-donor LT (LDLT). Data from 76 consecutive adult patients who underwent LDLT at our institute between September 2009 and March 2011 were retrospectively analyzed. The new IMD enriched with HWP and a conventional elemental diet were administered enterally to 40 (HWP group) and 36 (control group) patients, respectively, within the first 24 h after surgery. The characteristics of patients and surgical parameters did not differ between the two groups. The incidence of bacteremia was significantly lower in the HWP (15%) than in the control group (47%) (p = 0.002). The in-hospital mortality due to infection was a little lower in the HWP group than in the control group, although there was no statistical difference (p = 0.145). The fasting blood glucose level at postoperative day 7 was significantly lower in the HWP group than in the control group (p = 0.005). The incidence of acute cellular rejection was similar between the two groups (p = 0.858). Early enteral nutrition with the new IMD enriched with HWP can prevent post-transplant bacteremia and post-transplant hyperglycemia without increasing the incidence of acute cellular rejection.
  World Journal of Surgery 02/2012; 36(7):1666-71. · 2.36 Impact Factor
• Article: Standard hepatic vein reconstruction with patch plasty using the native portal vein in adult living donor liver transplantation.

  Akira Mori, Toshimi Kaido, Yasuhiro Ogura, Kohei Ogawa, Koichiro Hata, Shintaro Yagi, Atsushi Yoshizawa, Hiroyoshi Isoda, Toshiya Shibata, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: An outflow obstruction of the hepatic vein is a critical complication after living donor liver transplantation (LDLT) and occasionally leads to hepatic failure. Here we introduce a simple method for preventing outflow obstructions by patch plasty in adult LDLT. Between September 2001 and May 2010, 468 adult LDLT procedures were performed at Kyoto University Hospital. We harvested each recipient's portal vein (PV) from the extirpated liver for a patch. We intended to re-form several orifices of the hepatic veins into a single, large orifice. The patch was attached to the anterior wall of the re-formed orifice on the bench. After we put in the liver graft, the procedure for the hepatic vein anastomosis to the inferior vena cava was simple enough that the warm ischemia time was reduced. Three of the 468 cases were diagnosed with an outflow obstruction. All 3 cases underwent hepatic vein reconstruction without patch plasty. In contrast, none of the 159 cases that underwent LDLT with patch plasty suffered from an outflow obstruction, regardless of the liver graft type. The procedure for hepatic vein plasty using a patch from the native PV is simple and elegant and results in excellent outcomes. We propose this as the standard procedure for hepatic vein reconstruction in adult LDLT.
  Liver Transplantation 01/2012; 18(5):602-7. · 3.39 Impact Factor
• Article: Thrombotic microangiopathy-like disorder after living-donor liver transplantation: a single-center experience in Japan.

  Tomohide Hori, Toshimi Kaido, Fumitaka Oike, Yasuhiro Ogura, Kohei Ogawa, Yukihide Yonekawa, Koichiro Hata, Yoshiya Kawaguchi, Mikiko Ueda, Akira Mori, [......], Hiroto Egawa, Atsushi Yoshizawa, Takuma Kato, Kanako Saito, Linan Wang, Mie Torii, Feng Chen, Ann-Marie T Baine, Lindsay B Gardner, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: To investigate thrombotic microangiopathy (TMA) in liver transplantion, because TMA is an infrequent but life-threatening complication in the transplantation field. A total of 206 patients who underwent living-donor liver transplantation (LDLT) were evaluated, and the TMA-like disorder (TMALD) occurred in seven recipients. These TMALD recipients showed poor outcomes in comparison with other 199 recipients. Although two TMALD recipients successfully recovered, the other five recipients finally died despite intensive treatments including repeated plasma exchange (PE) and re-transplantation. Histopathological analysis of liver biopsies after LDLT revealed obvious differences according to the outcomes. Qualitative analysis of antibodies against a disintegrin-like domain and metalloproteinase with thrombospondin type 1 motifs (ADAMTS-13) were negative in all patients. The fragmentation of red cells, the microhemorrhagic macules and the platelet counts were early markers for the suspicion of TMALD after LDLT. Although the absolute values of von Willebrand factor (vWF) and ADAMTS-13 did not necessarily reflect TMALD, the vWF/ADAMTS-13 ratio had a clear diagnostic value in all cases. The establishment of adequate treatments for TMALD, such as PE for ADAMTS-13 replenishment or treatments against inhibitory antibodies, must be decided according to each case. The optimal induction of adequate therapies based on early recognition of TMALD by the reliable markers may confer a large advantage for TMALD after LDLT.
  World Journal of Gastroenterology 04/2011; 17(14):1848-57. · 2.47 Impact Factor
• Article: Progressive familial intrahepatic cholestasis: a single-center experience of living-donor liver transplantation during two decades in Japan.

  Tomohide Hori, Hiroto Egawa, Yasutsugu Takada, Mikiko Ueda, Fumitaka Oike, Yasuhiro Ogura, Seisuke Sakamoto, Mureo Kasahara, Kohei Ogawa, Aya Miyagawa-Hayashino, Yukihide Yonekawa, Tohru Yorifuji, Ken-Ichiro Watanabe, Hiraku Doi, Justin H Nguyen, Feng Chen, Ann-Marie T Baine, Lindsay B Gardner, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: Progressive familial intrahepatic cholestasis (PFIC) results in liver cirrhosis. Therefore, some PFIC patients require liver transplantation (LT). Although three types of PFIC have been identified, their etiologies include unknown mechanisms. A total of 717 recipients who underwent living-donor LT (LDLT) at <20 yr old were enrolled in this study. Among these recipients, 14 PFIC recipients comprising 11 PFIC type 1 (PFIC1) and three PFIC type 2 (PFIC2) were evaluated. Three of 11 PFIC1 recipients died, while all three PFIC2 recipients survived. Eight of 11 PFIC1 recipients showed steatosis after LDLT. Among the eight steatosis-positive PFIC1 recipients, seven showed severe steatosis and seven were complicated with steatohepatitis. Nine of 11 PFIC1 recipients showed fibrosis after LDLT, and eight of the nine fibrosis-positive PFIC1 recipients showed severe fibrosis. In contrast to the PFIC1 recipients, the PFIC2 recipients did not show any steatosis or fibrosis after LDLT. The clinical courses and outcomes of PFIC1 recipients after LDLT are still not sufficient owing to steatosis/fibrosis, unlike the case for PFIC2 recipients. As PFIC1 patients will require LT during the long-term progression of the disease, further strategy improvements are required for PFIC1 patients.
  Clinical Transplantation 12/2010; 25(5):776-85. · 1.67 Impact Factor
• Article: Liver transplantation for congenital biliary dilatation: a single-center experience.

  Tomohide Hori, Fumitaka Oike, Yasuhiro Ogura, Kohei Ogawa, Koichiro Hata, Yukihide Yonekawa, Mikiko Ueda, Seisuke Sakamoto, Mureo Kasahara, Hiroto Egawa, Yasutsugu Takada, Toshimi Kaido, Etsuro Hatano, Justin H Nguyen, Feng Chen, Ann-Marie T Baine, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: Congenital biliary dilatation is a rare disease. Although the possibility of refractory cholangitis and/or the frequency of malignant tumors legitimize hepatobiliary surgery, repeated cholangitis and biliary obstruction result in secondary liver cirrhosis even after polysurgery. There are no definitive guidelines on liver transplantation for congenital biliary dilatation. A total of 1,101 liver transplantation recipients were enrolled in this study. Eleven patients with congenital biliary dilatation including 5 patients with Caroli's disease were retrospectively analyzed in detail. Nine of 11 patients underwent initial operations before liver transplantation while 2 patients with Caroli's disease received liver transplantation as initial surgery, with good outcomes. All patients had intractable symptoms caused by liver cirrhosis, and growth delay was considerable in patients aged <20 years. Histopathological analysis of the native liver revealed hepatic fibrosis (≥F2). One patient with ABO incompatibility died. One patient with Caroli's disease accompanied with intrahepatic carcinoma survives 11.8 years after liver transplantation without any recurrences. Patients with congenital biliary dilatation with refractory symptoms and complications secondary to liver failure are appropriate candidates for liver transplantation. We suggest that liver transplantation is an effective therapeutic option for patients with congenital biliary dilatation with due consideration to many accompanying factors, such as clinical course, growth delay, image findings and histopathological analysis.
  Digestive surgery 11/2010; 27(6):492-501. · 1.37 Impact Factor
• Article: Initial burst of viremia related to CD8 effector memory T cells after living donor liver transplantation in hepatitis C virus-infected recipients.

  Yasutsugu Takada, Kazue Ozawa, Hiroto Egawa, Satoshi Teramukai, Akira Mori, Toshimi Kaido, Mureo Kasahara, Kohei Ogawa, Masako Ono, Hiroshi Sato, Koichi Tanaka, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: The post-transplant immune responses, viremia, and allograft histology after living donor liver transplantation were studied in 39 hepatitis C virus (HCV)-infected recipients. The recipients were classified into the following groups according to a hierarchical clustering of their preoperative CD8CD45 T-cell isoforms: group I, naive-dominant; group II, effector memory-dominant; and group III, effector-dominant. Plasma HCV-RNA rapidly increased and then peaked as an initial burst around postoperative day (POD) 25 in group I, on POD 40 in group II, and on POD 55 in group III. The initial burst of viremia was suppressed by the high expression of CD8+CD28-CD27- subsets. The progression of fibrosis > or =F2 was significantly more frequent for those patients with the highest viremia levels. Moreover, the initial T-cell immune response became less important throughout time, and new immune responses emerged after 2 months that modified the host-virus interaction. It is suggested that the interferon (IFN)-alpha/ribavirin therapy starting 2 months may be an effective option and now is undertaken.
  Translational research : the journal of laboratory and clinical medicine. 08/2010; 156(2):68-79.
• Article: Comprehensive and innovative techniques for liver transplantation in rats: a surgical guide.

  Tomohide Hori, Justin H Nguyen, Xiangdong Zhao, Yasuhiro Ogura, Toshiyuki Hata, Shintaro Yagi, Feng Chen, Ann-Marie T Baine, Norifumi Ohashi, Christopher B Eckman, [......], Kagemasa Kuribayashi, Takuma Kato, Kanako Saito, Linan Wang, Mie Torii, Naruhiko Sahara, Naoko Kamo, Tomoko Sahara, Motohiko Yasutomi, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: To investigate our learning curves of orthotopic liver transplantation (OLT) in rats and the most important factor for successful surgery. We describe the surgical procedures for our rat OLT model, and determined the operator learning curves. The various factors that contributed to successful surgery were determined. The most important surgical factors were evaluated between successful and unsuccessful surgeries. Learning curve data indicated that 50 cases were required for operator training to start a study. Operative time, blood loss, warm ischemic time, anhepatic phase, unstable systemic hemodynamic state, and body temperature after surgery significantly affected surgery success by univariate analysis, while the anhepatic phase was the most critical factor for success by multivariate analysis. OLT in rats is the only liver transplantation model that provides clinically relevant and reliable results. Shortened anhepatic phase is key to success in this model.
  World Journal of Gastroenterology 07/2010; 16(25):3120-32. · 2.47 Impact Factor
• Source

  Available from: kyoto-u.ac.jp

  Article: Does a positive lymphocyte cross-match contraindicate living-donor liver transplantation?

  Tomohide Hori, Shinji Uemoto, Yasutsugu Takada, Fumitaka Oike, Yasuhiro Ogura, Kohei Ogawa, Aya Miyagawa-Hayashino, Kimiko Yurugi, Justin H Nguyen, Yukinobu Hori, Feng Chen, Hiroto Egawa
  [show abstract] [hide abstract]
  ABSTRACT: There is still no consensus on the importance of lymphocyte cross-matching (LCM) in the field of living-donor liver transplantation (LDLT). LCM examinations are routinely performed before LDLT, and the results of complement-dependent cytotoxicity were used in this study. A total of 1157 LDLT cases were evaluated. The recipients were divided into four groups based on the LCM and ABO compatibilities: (1) negative LCM and identical/compatible ABO; (2) negative LCM and incompatible ABO; (3) positive LCM and identical/compatible ABO; and (4) positive LCM and incompatible ABO. The diagnosis of antibody-mediated rejection (AMR) was made based on the clinical course, immunological assays and histopathological findings. C4d immunostaining was added if AMR was suspected. The LCM-positive LDLT recipients showed significantly poorer outcomes than the LCM-negative recipients. Among the LCM-positive recipients, 44.1% of recipients eventually died and 85.2% of recipients revealed positive C4d findings. The survival rate of LCM-positive and ABO-incompatible group was 0.50. The survival days were compared with the LCM-negative and ABO-identical/compatible group, and the LCM-positive and ABO-identical/compatible group clearly showed early death after LDLT, although the ABO-incompatible groups did not show significant. The factors of age, disease, pre-transplant scores, LCM, ABO compatibility and graft-recipient weight ratio showed statistical significance in multivariate analysis for important factors of LDLT outcomes. However, the LCM and ABO compatibilities had no synergetic effects on the LDLT survival. HLA antigens are more widely expressed than ABO antigens, and advanced immunological strategies must be established for LCM-positive LDLT as well as for ABO-incompatible LDLT.
  Surgery 06/2010; 147(6):840-4. · 3.10 Impact Factor
• Article: Pediatric orthotopic living-donor liver transplantation cures pulmonary hypertension caused by Abernethy malformation type Ib.

  Tomohide Hori, Yukihide Yonekawa, Shinya Okamoto, Kohei Ogawa, Yasuhiro Ogura, Fumitaka Oike, Yasutsugu Takada, Hiroto Egawa, Justin H Nguyen, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: A 3.3-yr-old boy was diagnosed with PH caused by a PSS of Abernethy malformation type Ib. After control of PH, he underwent OLDLT at 4.9 yr. His PV flowed directly into the confluence of the CCLMHV and the IVC. To shorten the anhepatic phase, hepatic arterial flow was partially maintained. Removal of the native liver began simultaneously with the graft harvest. The proximal PV was cut at the optimal point for reconstruction. The distal PV was cut at the concrescence of the PV and the CCLMHV. After IVC-plasty, the LHV of the graft was attached with an anterior patch by venous grafting and was then anastomosed to the IVC. Although the mPAP temporarily increased above the mean arterial pressure, mPAP was stable during OLDLT. FNH and steatosis were confirmed histopathologically. In summary, pediatric OLDLT was performed successfully in PH caused by PSS.
  Pediatric Transplantation 02/2010; 15(3):e47-52. · 1.48 Impact Factor
• Article: Diagnostic value of (18)F-fluorodeoxyglucose positron emission tomography for pancreatic neuroendocrine tumors with reference to the World Health Organization classification.

  Toshihiko Masui, Ryuichiro Doi, Tatsuo Ito, Kazuhiro Kami, Kohei Ogawa, Daisuke Harada, Shinji Uemoto
  [show abstract] [hide abstract]
  ABSTRACT: The 2004 classification of the World Health Organization (WHO) has demonstrated an efficacy for prediction of the prognosis of pancreatic neuroendocrine tumors. This study aimed to assess the predictive value of preoperative (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) in relation to the 2004 WHO criteria. The histology of 21 pancreatic endocrine tumors resected at our hospital was reviewed and the tumors were classified according to the 2004 WHO criteria. FDG-PET findings were analyzed by comparing the findings with CT scans. FDG uptake was positive in 10 primary endocrine tumors (47%), but no uptake was seen in 11 tumors. In relation to the 2004 WHO classification, 1 out of 8 well-differentiated tumors with benign behavior was positive by PET (12.5%), 4 out of 7 well-differentiated tumors with uncertain behavior were positive (57%) and 4 low-grade malignant tumors were positive (100%). According to the WHO criteria, the rate of positive FDG uptake increased as the malignant potential increased. The metastases of low-grade malignant tumors also showed a positive FDG uptake. In conclusion, from our limited experience, FDG-PET appears to be useful for identifying pancreatic neuroendocrine tumors with a higher malignant potential. In addition, FDG-PET can detect distant metastases and may contribute to better staging of advanced disease.
  Oncology letters 01/2010; 1(1):155-159. · 0.11 Impact Factor
• Article: Fatal impact of lymphocyte cross-matching upon humoral rejection after adult living related liver transplantation.

  Tomohide Hori, Hiroto Egawa, Yasutsugu Takada, Fumitaka Oike, Yasuhiro Ogura, Kohei Ogawa, Toshimi Kaido, Yasuko Toshimitsu, Shintaro Yagi, Taku Iida, Justin H Nguyen, Shinji Uemoto
  Transplant International 10/2009; 23(3):338-40. · 2.92 Impact Factor