Hiroshi Date

Kyoto University, Kioto, Kyōto, Japan

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Publications (568)1640.79 Total impact

  • Hiroshi Date · A. Aoyama · T. Yamada · M. Sato · F. Chen
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    ABSTRACT: Attenuation of ischemia reperfusion injury (IRI) is important in lung transplantation. Our group previously reported that β2-adrenoreceptor agonist inhalation during the period before procurement successfully attenuated IRI in donated lungs after cardiac death. We therefore hypothesized that β2-adrenoreceptor agonist inhalation during ex vivo lung perfusion (EVLP) after procurement might also have a protective effect. Cardiac-dead beagles were left at room temperature for 210 minutes, and all lungs were subsequently procured and subjected to EVLP for 240 minutes. The beagles were allocated to 2 groups: the β2 group (receiving an aerosolized β2-adrenoreceptor agonist 20 minutes after initiation of EVLP; n = 7) and the control group (receiving an aerosolized control solvent at the same time point; n = 6). Physiologic data, including lung function, were evaluated during EVLP. The β2 group showed significantly lower peak airway pressure and pulmonary artery pressure than the control group. Dynamic pulmonary compliance was higher, pulmonary vascular resistance (PVR) was lower, and the wet-to-dry lung weight ratio was lower in the β2 group than in the control group. Cyclic adenosine monophosphate (cAMP) and total adenosine nucleotide (TAN) levels in lung tissue after EVLP were higher in the β2 group than in the control group. The β2 group also showed more cystic fibrosis transmembrane conductance regulator (CFTR) gene expression. After procurement, β2-adrenoreceptor agonist inhalation during EVLP attenuates lung injury in a canine model of organ donation after cardiac death. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
    The Annals of thoracic surgery 07/2015; DOI:10.1016/j.athoracsur.2015.02.136 · 3.65 Impact Factor
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    ABSTRACT: A subset of non-small-cell lung cancer (NSCLC) patients with malignant pleural effusion and/or malignant pleural nodules is now classified as stage IV and is generally considered a contraindication to surgery. However, several reports have demonstrated that the prognosis of patients with pleural carcinomatosis first detected at thoracotomy is relatively favorable. The aim of this study was to describe the results of surgical intervention in NSCLC patients with pleural carcinomatosis in Japan. In 2010, the Japanese Joint Committee of Lung Cancer Registry conducted a nationwide registration of lung cancer patients who underwent surgery in 2004. Using this database, we performed a retrospective study focused on pleural carcinomatosis. We examined the clinicopathological features, the current status of therapy, and surgical outcomes in patients with pleural carcinomatosis. Among the 11,420 registered NSCLC patients, 329 (2.9%) patients had pleural carcinomatosis. The median survival time and 5-year survival rate of 313 patients without other metastatic disease were 34.0 months and 29.3%, respectively. Primary tumor resection was performed in 256 (81.8%) patients, and macroscopic complete resection was achieved in 152 (48.6%) patients, with 5-year survival rates of 33.1% and 37.1%, respectively. Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status (p < 0.001), best stage nodal status (p = 0.002), and the presence or absence of gross residual tumor (p = 0.013) were independent predictors of survival. In our surgical registry for NSCLC, patients with pleural carcinomatosis accounted for 2.9%, and macroscopic complete resection for them was associated with better survival.
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 07/2015; 10(7):1076-82. DOI:10.1097/JTO.0000000000000554 · 5.80 Impact Factor
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    ABSTRACT: A number of studies have shown that KRAS mutations in colorectal cancer (CRC) result in the lack of response to anti-epidermal growth factor receptor (EGFR)-based therapy; thus, KRAS mutational testing has been incorporated into routine clinical practice. However, one limitation of this test is the heterogeneity of KRAS status, which can either be intratumoral heterogeneity within an individual primary CRC, or discordant KRAS status between a primary CRC and its corresponding metastases. We previously reported that fluorodeoxyglucose (FDG) accumulation was significantly higher in primary CRCs with mutated KRAS than in those with wild-type KRAS. However, the clinical utility of the previous report has been limited because endoscopic biopsy for testing KRAS status is safe and feasible only in primary CRC. The purpose of this study was to investigate whether KRAS status is associated with FDG accumulation in metastatic CRC, and whether FDG-Positron emission tomography/computed tomography (PET/CT) scans can be used to predict the KRAS status of metastatic CRC. A retrospective analysis was performed on 55 metastatic CRC tumors that were identified by FDG-PET/CT before surgical resection. Maximum standardized uptake value (SUVmax) of the respective metastatic tumor was calculated from FDG accumulation. From the analysis with the 55 tumors, no significant correlation was found between SUVmax and KRAS status. We next analyzed only tumors larger than 10mm to minimize the bias of partial volume effect, and found that SUVmax was significantly higher in the KRAS mutated group than in the wild-type group (8.3 ± 4.1 vs. 5.7 ± 2.4, respectively; P = 0.03). Multivariate analysis indicated that SUVmax remained significantly associated with KRAS mutations (P = 0.04). KRAS status could be predicted with an accuracy of 71.4% when SUVmax cutoff value of 6.0 was used. FDG accumulation into metastatic CRC was associated with KRAS status. FDG-PET/CT scans may be useful for predicting the KRAS status of metastatic CRC, and help in determining the therapeutic strategies against metastatic CRC. Copyright © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
    Journal of Nuclear Medicine 07/2015; DOI:10.2967/jnumed.115.160614 · 5.56 Impact Factor
  • The Journal of thoracic and cardiovascular surgery 06/2015; DOI:10.1016/j.jtcvs.2015.06.048 · 3.99 Impact Factor
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    ABSTRACT: Thymic carcinoma is a rare thymic malignancy. The purpose of this study was to evaluate the prognostic impact of clinicopathological variables and perioperative therapy for surgically treated thymic carcinoma using a nationwide database. Of 2835 patients with surgically treated thymic epithelial tumours collected from 32 Japanese institutions, a total of 306 patients with thymic carcinomas, excluding neuroendocrine tumours, were enrolled in this retrospective study. Multivariable Cox regression analyses were performed for overall (OS) and recurrence-free survival (RFS) after R0 resection. Of 306 patients, 228 (75%) patients presented with Masaoka stage III-IV. Squamous cell carcinoma was the most common histological type (n = 216, 71%). R0 resection was performed in 181 (61%) patients, R1 in 46 (16%), R2 sub-total (≥80% tumour resection) in 43 (14%) and R2 non-resection in 27 (9%). The 5-year OS rate was 61%. Prognostic factors for OS were Masaoka stage and resection status. R0 resection was associated with most improved OS; however, both R1 and R2 sub-total resection resulted in superior OS compared with R2 non-resection [hazard ratio (95% confidence interval) for R0, R1 and R2 sub-total, 0.27 (0.15-0.48), 0.40 (0.22-0.74) and 0.38 (0.20-0.72), respectively]. Histological type and perioperative therapy did not affect OS, whereas tumour size and postoperative radiotherapy were associated with improved RFS after R0 resection. R0 resection is essential for prolonged OS for surgically treated thymic carcinoma, but maximal debulking surgery might be beneficial and worth evaluating for advanced disease deemed difficult for R0 resection. The benefit of postoperative radiotherapy after R0 resection should also be evaluated prospectively. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 06/2015; DOI:10.1093/ejcts/ezv239 · 2.81 Impact Factor
  • A Aoyama · F Chen · K Minakata · K Yamazaki · T Yamada · M Sato · H Date
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    ABSTRACT: Living-donor lobar lung transplantation (LDLLT) is indicated for rapidly deteriorating patients, and the total volume of two lower lobe grafts must be sufficient for the recipient. To rescue patients with small lobar grafts, we performed five LDLLTs sparing native upper lobes. This strategy was used when upper lobes or segments were preoperatively less impaired. There were no hospital deaths. Extracorporeal circulation time and operative time were similar to those of conventional LDLLTs. The length of intensive care unit stay was also similar. Late complications attributed to the spared lungs were airway infection in one recipient and pneumothorax in two but they were successfully managed. All recipients were discharged without supplemental oxygen. The spared lung volumes measured by volumetry did not change after LDLLT. Lung perfusion scintigraphy performed at 1 year showed remaining perfusion in the spared lungs, although much less than in the grafts. These results suggested that the spared lobes kept adequate space in the thoracic cavity and kept functioning to a limited extent. The new lobar-sparing strategy appears feasible and effective in LDLLT using small grafts for selected patients when the upper lobes or segments are less impaired. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.
    American Journal of Transplantation 06/2015; DOI:10.1111/ajt.13357 · 6.19 Impact Factor
  • Ei Miyamoto · Msasaaki Sato · Tetsu Yamada · Hiroshi Date
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    ABSTRACT: Major tracheobronchial trauma may lead to underestimation of the potential for lung donation due to insufficient alveolar ventilation and resulting poor oxygenation, bronchoscopic findings and radiographic findings (e.g. atelectasis). Here, we report a case of successful bilateral lung transplantation from a deceased donor whose right bronchus was ruptured by a trauma from the main bronchus to the bronchus intermedius. Although poor oxygenation and a collapsed right lung detected by computed tomography scanning precluded the use of the donor lungs by multiple transplant centres, careful bronchoscopic evaluation and intraoperative assessment convinced us that the parenchyma of the donor lungs was preserved sufficiently well for transplantation. Upon transplantation, the donor right bronchus was anastomosed at two levels, the upper lobe bronchus and the bronchus intermedius, and the lacerated portion was removed. The recipient's postoperative course was uneventful and the bronchial anastomoses healed excellently. Careful preoperative evaluation and appropriate surgical techniques might enable successful lung transplantation, using seemingly suboptimal donor lungs with major airway trauma. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 06/2015; DOI:10.1093/icvts/ivv161 · 1.11 Impact Factor
  • 06/2015; 2:15014. DOI:10.1038/hgv.2015.14
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    ABSTRACT: Video-assisted thoracic surgery( VATS) has been utilized worldwide for treatment of thoracic disease in recent years. Then, in most VATS, the thoracoscope was handled by young surgeons consequently. In VATS, a role of the scopist is very important, because if there is no consensus of verticality and horizontality on the monitor among operator, assistant and scopist, it is difficult to perform the surgery smoothly. Therefore, it is important for young surgeons to improve their skills as scopist. However, there are few models of verticality and horizontality on the monitor and thoracoscope techniques of VATS. We present our consensus of verticality and horizontality on the monitor in the standard 3-ports VATS by right upper lobectomy and left upper lobectomy.
    Kyobu geka. The Japanese journal of thoracic surgery 06/2015; 68(6):421-425.
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  • Jitian Zhang · Fengshi Chen · Toshimitsu Ueki · Hiroshi Date
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    ABSTRACT: Imatinib has been proposed as a treatment for sclerodermatous chronic graft-versus-host disease (GVHD) due to its antifibrotic activity. Because imatinib has a potentially adverse effect on wound healing, the safety of its perioperative use in lung transplantation is unknown. Herein, we present a patient who underwent bilateral living-donor lobar lung transplantation for pulmonary complications after bone marrow transplantation, who had also received treatment with imatinib for sclerodermatous GVHD. Imatinib was discontinued 3 weeks before lung transplantation, but was resumed 1 week postoperatively for an exacerbation of sclerodermatous GVHD. Seven months after the postoperative the patient continues to do well without complications. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 05/2015; DOI:10.1093/icvts/ivv122 · 1.11 Impact Factor
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    ABSTRACT: The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor gefitinib is an effective treatment for recurrent or advanced lung cancer harboring EGFR gene mutations, and has improved progression-free survival in several clinical trials. However, the effect of gefitinib treatment for recurrent lung cancers with EGFR gene mutations after complete resection and the influence of the timing of such treatment have not been fully elucidated in a practical setting. We investigated 64 patients (median age: 68 years; men: 22; women: 42; adenocarcinoma: 61; adenosquamous cell carcinoma: 2; combined large cell neuroendocrine carcinoma: 1) with recurrent lung cancer after complete resection who received gefitinib for the recurrent lesions and in whom the tumors had EGFR gene mutations. Progression-free survival, response rate, and safety were analyzed. Complete response and partial response were achieved in 2 patients and in 42 patients, respectively (objective response rate: 69 %). Stable disease was obtained in 16 patients, the disease control rate was 94 %, and median progression-free survival was 16 months. The timing of gefitinib treatment (first line, second line, or later) and the type of EGFR gene mutation present did not influence progression-free survival. However, a smaller number of recurrent sites at the start of gefitinib treatment was linked to better progression-free survival. Hematologic and nonhematologic toxicities were generally mild, but 1 patient experienced interstitial lung disease. Our results suggest that gefitinib treatment for recurrent lung cancer with gene EGFR mutations is a useful option in a practical setting, irrespective of the timing of such treatment and the type of EGFR gene mutation present.
    International Journal of Clinical Oncology 05/2015; DOI:10.1007/s10147-015-0838-z · 2.17 Impact Factor
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    ABSTRACT: The lung allocation score (LAS) system has been implemented to reduce waiting list time and mortality in the USA, but it remains uncertain how the LAS would reflect the impairment in health-related quality of life (HRQOL), which is another lung transplantation treatment goal to be improved in addition to survival. We thus investigated the relationships of the LAS with mortality and HRQOL in Japanese lung transplantation candidates. One hundred and two candidates for lung transplantation at Kyoto University Hospital between 2009 and 2013 were consecutively recruited to participate in this study. Their physiological measurements of pulmonary function and 6-min walking distance, as well as patient-reported measurements of HRQOL, dyspnoea and psychological status, were assessed. Among these 102 patients, 22 died during a mean follow-up of 11.6 months. The LAS was significantly correlated to mortality (P = 0.0026), although other physiological measurements were not. However, regarding its relationship with HRQOL, correlation coefficients between the LAS, Medical Outcomes Study 36-item short form and St George's Respiratory Questionnaire (SGRQ) were relatively low, with the highest at 0.31. Multivariate analyses showed that the LAS was less significantly related to the SGRQ total score than dyspnoea, and psychological status. The LAS was significantly related to mortality in lung transplant candidates in Japan, while, despite its multidimensional scoring, its relationship with health-related quality of life was only weak. Their severity assessment system may be more focused on patients' health and symptoms. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 04/2015; 21(1). DOI:10.1093/icvts/ivv101 · 1.11 Impact Factor
  • The Journal of Heart and Lung Transplantation 04/2015; 34(4):S269. DOI:10.1016/j.healun.2015.01.752 · 5.61 Impact Factor
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    ABSTRACT: Adult recipients frequently withdraw from living-donor lobar lung transplantation because of the small size of donor grafts. The right lower lobe is 120% larger than the left lower lobe. We developed a novel surgical technique in which an inverted right lower lobe graft can be transplanted into the left thorax. The first patient was a 43-year-old woman with end-stage idiopathic interstitial pneumonia. Her husband was the only eligible donor for living-donor lobar lung transplantation. His right lower lobe was estimated to provide 45% of the recipient's predicted forced vital capacity, which would provide the borderline function required for living-donor lobar lung transplantation. Since lung perfusion scintigraphy of the recipient showed a right-to-left ratio of 64:36, transplanting the right lower lobe graft into the left thorax and sparing the native right lung was considered the only treatment option. We simulated this procedure using three-dimensional models produced by a three-dimensional printer. In living-donor lobar lung transplantation, all anastomoses were performed smoothly as planned preoperatively. Because of the initial success, this procedure was performed successfully in two additional patients. This procedure enables larger grafts to be transplanted, potentially solving critical size matching problems in living-donor lobar lung transplantation. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.
    American Journal of Transplantation 04/2015; 15(6). DOI:10.1111/ajt.13148 · 6.19 Impact Factor
  • The Journal of Heart and Lung Transplantation 04/2015; 34(4):S270-S271. DOI:10.1016/j.healun.2015.01.755 · 5.61 Impact Factor
  • The Journal of Heart and Lung Transplantation 04/2015; 34(4):S259. DOI:10.1016/j.healun.2015.01.722 · 5.61 Impact Factor

Publication Stats

5k Citations
1,640.79 Total Impact Points


  • 2008–2015
    • Kyoto University
      • Department of Thoracic Surgery
      Kioto, Kyōto, Japan
  • 1988–2012
    • Okayama University
      • • Department of Cancer and Thoracic Surgery
      • • Department of Hematology, Oncology and Respiratory Medicine
      Okayama, Okayama, Japan
  • 1998–2008
    • Minami Okayama Medical Center
      Okayama, Okayama, Japan
  • 2007
    • Kagawa Prefectural Central Hospital
      Takamatu, Kagawa, Japan
  • 2006–2007
    • Osaka City University
      • Graduate School of Medicine
      Ōsaka, Ōsaka, Japan
  • 2003
    • St. Vincent's Hospital Sydney
      Sydney, New South Wales, Australia
  • 1993–1998
    • Washington University in St. Louis
      • • Division of Pulmonary and Critical Care
      • • Division of Cardiothoracic Surgery
      San Luis, Missouri, United States