Y Ogura

Nagoya University, Nagoya, Aichi, Japan

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Publications (206)477.57 Total impact

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    ABSTRACT: A 39-year-old man was diagnosed with allopurinol-induced hepatic injury. He did not show any sign of hepatic encephalopathy, but his serum total bilirubin level was >40 mg/dL when he visited the local hospital. The therapeutic effects of initial medical treatments were transient, and both renal function and coagulation ability were gradually deteriorated. Four months after the onset of hepatic injury, he was referred to our hospital for the purpose of liver transplantation (LT). Although he was wasting and severely jaundiced, his consciousness level was not disturbed at all, with normal serum ammonia blood concentration before LT. Owing to allopurinol-induced severe cholestatic liver failure, living-donor LT (LDLT) was performed with the use of a right lobe graft from his younger brother. The explanted liver was extremely enlarged, with a weight of 2,480 g, and severely cholestatic. Microscopic findings were also compatible with drug-induced cholestatic liver injury. He was discharged from hospital 55 days after LDLT, whereas his renal dysfunction remained at 6 months after LT. There are 3 types of pathophysiology of drug-induced hepatotoxicity: hepatocellular, cholestatic, and mixed liver injury. Although allopurinol hepatotoxicity is rare, it can be severe and even fatal. This is the 1st case report of successful LDLT for a patient who had developed allopurinol-induced cholestatic liver failure.
    No preview · Article · Nov 2015 · Transplantation Proceedings
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    ABSTRACT: There are few reports on the short- and long-term follow-up of endoscopic retrograde cholangiography (ERC) in adult patients with hepaticojejunostomy (HJS) stricture after living-donor liver transplantation (LDLT).
    No preview · Article · Oct 2015 · Transplantation Proceedings
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    ABSTRACT: To understand the impact of psychologic variables on donor quality of life, we studied long-term data on postoperative psychiatric complications in living liver donors. This study is a focused psychological investigation of diagnoses, treatments, and long-term clinical courses of living liver donors with psychiatric complications. Of the 142 donors who underwent live-donor liver transplantation at Nagoya University Hospital between April 2004 and July 2014, we investigated those without a history of mental illness who had developed such illness after transplantation and required psychiatric treatment. A total of 6 (4.2%) donors developed the following psychiatric complications after transplantation: major depressive disorder (n = 2), panic disorder (n = 2), conversion disorder (n = 1), and substance use disorder (n = 1). Concerning psychiatric treatment, all donors received antianxiety drugs, 3 took antidepressants, and supportive psychiatric therapy was concomitantly provided to all subjects. The average treatment period was 53.3 months. Regarding subject outcomes, 3 donors achieved remission, and the other 3 continued treatment. All subjects showed improvement in Global Assessment of Functioning Scale. It is important to accurately diagnose postoperative psychiatric complications and provide long-term treatment in close coordination with transplant surgeons. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Jul 2015 · Transplantation Proceedings
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    ABSTRACT: The authors present the case of a patient with normal-tension glaucoma and pit-like maculopathy observed by high-definition optical coherence tomography. Surgical management of macular retinoschisis was associated with improved vision and full resolution of intraretinal fluid and macular detachment. The patient had progressive vision loss over 6 months preoperatively; best corrected visual acuity and high-definition optical coherence tomography changes improved postoperatively. Optic disc pit-like maculopathy can occur in patients with normal-tension glaucoma in the absence of obvious congenital anomalies of the disc. The intraretinal fluid might have migrated from the vitreous cavity through a microhole at the optic disc margin or in the area with the nerve fiber defect. Vitrectomy without gas tamponade might lead to anatomic and functional recovery. Further studies are needed to better understand the pathogenesis of this disease. [Ophthalmic Surg Lasers Imaging Retina. 2015;46:107-110.]. Copyright 2015, SLACK Incorporated.
    Full-text · Article · Jan 2015 · Ophthalmic Surgery Lasers and Imaging Retina
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    ABSTRACT: Age-related macular degeneration (AMD) is a vision-threatening disease characterized by choroidal fibrovascular membrane (FVM) formation, choroidal neovascularization (CNV) and choroidal fibrosis. No safe and effective therapeutic method has been developed for the choroidal fibrosis, although anti-vascular endothelial growth factor therapy can partially shrink the CNV. We recently reported that periostin (POSTN), which is produced by retinal pigment epithelial cells, has an important role in the formation of preretinal FVMs, but its role in choroidal FVMs has not been determined. In this study, we used Postn knockout mice to investigate the role played by POSTN in choroidal FVM formation. In addition, we used a new class of RNA interference (RNAi) agent (NK0144) that targets POSTN and determined its effect on choroidal FVM development. Genetic ablation of Postn had an inhibitory effect not only on CNV formation but also on choroidal fibrosis in a mouse CNV model. NK0144 also had a greater inhibitory effect on both the CNV and choroidal fibrosis than control RNAi with no apparent adverse effects. These findings suggest a causal relationship between POSTN and choroidal FVM formation, and also a potential therapeutic role of intravitreal NK0144 for AMD.Gene Therapy advance online publication, 11 December 2014; doi:10.1038/gt.2014.112.
    No preview · Article · Dec 2014 · Gene Therapy
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    ABSTRACT: Purpose: To report the 1-year results of intravitreal ranibizumab (IVR) injections for neovascular age-related macular degeneration (nAMD) in patients with good baseline visual acuity (VA). Methods: Thirty-six eyes of 36 patients with nAMD with best-corrected VAs (BCVAs) >0.6 (equal to 0.22 in the logarithm of the minimum angle of resolution unit) were enrolled. IVR was the primary treatment; additional treatment was administered as needed. BCVAs and central retinal thickness (CRT) were measured periodically. Results: The mean number of injections at month 12 was 3.3. The mean BCVAs were 0.11 ± 0.02 at baseline and 0.12 ± 0.03 at month 12, which did not significantly differ. The mean CRT significantly improved from 320 ± 15 to 254 ± 12 μm at month 12 (p < 0.01). Photodynamic therapy was applied in 2 cases because of frequent recurrences. Conclusions: IVR maintained VA and improved morphological changes in wet AMD with good baseline VA.
    Full-text · Article · Nov 2014 · Ophthalmologica
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    ABSTRACT: Purpose Tissue plasminogen activator (tPA) is a fibrinolytic compound, utilized originally to treat embolic or thrombotic stroke and as an adjuvant for displacement of submacular hemorrhage. The purpose of this study is to investigate anti-angiogenic effects of tPA on experimental laser-induced choroidal neovascularization (CNV) in mice.Methods CNV was induced by laser injury in C57BL/6J mice, and intravitreal injection of tPA (4 or 40 IU/µl) or PBS was performed immediately after laser injury. Fluorescein angiography was performed 7 days after laser treatment to grade fluorescein leakage. And CNV volumes were measured by confocal evaluation of Isolectin B4 staining of RPE-choroid flatmounts. The expression of fibrin on day 3 was observed by immunostaining.Results Fluorescein leakage was inhibited by tPA in a dose-dependent manner, and a significant difference was found with tPA (40 IU/ µl) compared with PBS (p=0.02). A dose-dependent suppression of CNV volume was also observed by tPA, and there was a significant differences between tPA (40 IU/µl) (208988  52456 µm3) and PBS (386902  103060 µm3, p<0.01). The expression of fibrin was reduced in eyes treated with tPA.Conclusion Intravitreal injection of tPA reduced the expression of fibrin and significantly suppressed laser-induced CNV in mice. These findings suggested that tPA might be anti-angiogenic and have a potential as an adjuvant to anti-vascular endothelial growth factor therapy.
    No preview · Article · Sep 2014 · Acta ophthalmologica
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    ABSTRACT: Purpose: The purpose of this study is to evaluate the effectiveness of intravitreal injection of aflibercept (IVA) for neovascular age-related macular degeneration (AMD). Cases and Method: Sixty-four eyes of 64 patients with neovascular AMD (16 eyes of typical AMD, 44 eyes of polypoidal choroidal vasculopathy and 4 eyes of retinal angiomatous proliferation) who underwent IVA and could be followed up for 6 months or longer, were enrolled. Averaged age was 75.0 ±8.3 years. All eyes underwent IVA in the PRN regimen, BCVA and central retinal thickness (CRT) on optical coherence tomography were measured periodically. Results: The mean BCVA at baseline was 0.44±0.41 and the BCVA at month 6 was 0.38±0.38. significantly improved compared with baseline (p<0.01). BCVA was improved by 0.3 or more logMAR units in 4 eyes (6%), in 59 eyes (92%) BCVA was unchanged and one eye deteriorated. Mean CRT significantly decreased from 298±83μm at baseline to 244 ±59 μ at month 6 (p<0.01). The mean number of IVA was 2.4 times. Conclusion: IVA in patients with neovascular AMD improved visual acuity and CRT.
    No preview · Article · Sep 2014
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    ABSTRACT: Background Hepatic arterial reconstruction during living donor liver transplantation (LDLT) is a very delicate and technically complicated procedure. Post-LDLT hepatic arterial complications are associated with significant morbidity and mortality. Methods We retrospectively analyzed the details of post-operative hepatic arterial complications in 673 consecutive adult LDLT recipients between January 1996 and September 2009. ResultsHepatic arterial complications occurred in 43 of 673 adult recipients (6.4%) within a median of 13 post-transplant days (range, 1-63). These included hepatic artery thrombosis (including anastomotic stenosis) in 33 cases, anastomotic bleeding in seven cases, and rupture of anastomotic aneurysm in three cases. To treat these complications, surgical re-anastomosis was performed in 26 cases, while the other 17 cases underwent conservative therapies, including four angioplasties by interventional radiology. Biliary complications after hepatic arterial complications occurred in 17 cases. The overall survival rate after LDLT was significantly lower in the hepatic arterial complication group compared with that in the non-complication group (60.7% vs. 80.1% at oneyr, 44.3% vs. 74.2% at fiveyr, respectively; p<0.001). Multivariate analysis showed that the extra-anatomical anastomosis (p=0.011) was the only independent risk factor for hepatic arterial complications. Conclusion Because hepatic arterial complications after LDLT are associated with poor patient survival, early diagnosis and immediate treatment are crucial. The anatomical anastomosis may be the first choice for the hepatic arterial reconstruction to the extent possible.
    No preview · Article · Jun 2014 · Clinical Transplantation
  • H. Kamei · Y. Onishi · K. Ogawa · S. Uemoto · Y. Ogura
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    ABSTRACT: Living donor liver transplantation (LDLT) using a right liver graft with additional vein reconstructions has not been previously reported in a situs inversus (SI) patient. A 60-year-old man with SI was referred for LDLT for end-stage cirrhosis secondary to hepatitis B. The calculated regional volumes of the individual hepatic vein territories in the right liver graft suggested that the middle hepatic vein (MHV) tributaries and the inferior right hepatic veins (IRHVs) should be reconstructed in addition to the right hepatic vein (RHV). On the back-table, the recipient's recanalized umbilical vein graft was anastomosed to the V5 opening, and the other side of vein graft was anastomosed to the RHV and V8 opening to create a large single orifice. After total hepatectomy, the right liver graft was placed in the left subphrenic space at the reversed position. The common orifice of hepatic venous drainage from RHV, V8 and V5 was anastomosed to the anatomical RHV conduit of the recipient, followed by IRHV anastomosis to the inferior vena cava. Postoperative course was almost uneventful, and no vascular complications were experienced. Even for SI patients, LDLT using a right liver graft with reconstructions of the MHV tributaries and the IRHVs is feasible.
    No preview · Article · Apr 2014 · American Journal of Transplantation
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    ABSTRACT: Skeletal muscle depletion, referred to as sarcopenia, predicts morbidity and mortality in patients undergoing digestive surgery. However, the impact on liver transplantation is unclear. The present study investigated the impact of sarcopenia on patients undergoing living donor liver transplantation (LDLT). Sarcopenia was assessed by a body composition analyzer in 124 adult patients undergoing LDLT between February 2008 and April 2012. The correlation of sarcopenia with other patient factors and the impact of sarcopenia on survival after LDLT were analyzed. The median ratio of preoperative skeletal muscle mass was 92% (range, 67-130%) of the standard mass. Preoperative skeletal muscle mass was significantly correlated with the branched-chain amino acids to tyrosine ratio (r = -0.254, p = 0.005) and body cell mass (r = 0.636, p < 0.001). The overall survival rate in patients with low skeletal muscle mass was significantly lower than in patients with normal/high skeletal muscle mass (p < 0.001). Perioperative nutritional therapy significantly increased overall survival in patients with low skeletal muscle mass (p = 0.009). Multivariate analysis showed that low skeletal muscle mass was an independent risk factor for death after transplantation. In conclusion, sarcopenia was closely involved with posttransplant mortality in patients undergoing LDLT. Perioperative nutritional therapy significantly improved overall survival in patients with sarcopenia.
    Full-text · Article · Apr 2013 · American Journal of Transplantation
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    ABSTRACT: Few studies have examined the long-term outcomes and prognostic factors associated with pediatric living living-donor liver transplantation (LDLT) using reduced and hyper-reduced left lateral segment grafts. We conducted a retrospective, single-center assessment of the outcomes of this procedure, as well as clinical factors that influenced graft and patient survival. Between September 2000 and December 2009, 49 patients (median age: 7 months, weight: 5.45 kg) underwent LDLT using reduced (partial left lateral segment; n = 5, monosegment; n = 26), or hyper-reduced (reduced monosegment grafts; n = 18) left lateral segment grafts. In all cases, the estimated graft-to-recipient body weight ratio of the left lateral segment was more than 4%, as assessed by preoperative computed tomography volumetry, and therefore further reduction was required. A hepatic artery thrombosis occurred in two patients (4.1%). Portal venous complications occurred in eight patients (16.3%). The overall patient survival rate at 1, 3 and 10 years after LDLT were 83.7%, 81.4% and 78.9%, respectively. Multivariate analysis revealed that recipient age of less than 2 months and warm ischemic time of more than 40 min affected patient survival. Pediatric LDLT using reduced and hyper-reduced left lateral segment grafts appears to be a feasible option with acceptable graft survival and vascular complication rates.
    Full-text · Article · Sep 2012 · American Journal of Transplantation
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    ABSTRACT: To report the outcome of intravitreal injection of ranibizumab for exudative age-related macular degeneration (AMD). Cases and Method: This retrospective study was made on 97 eyes of 94 cases of AMD who received intravitreal injection of ranibizumab during the past 12 months. The age averaged 74.9±9.3 years. The series comprised 68 eyes of typical AMD, 21 eyes of polypoidal choroidal vasculopathy, and 8 eyes of retinal angiomatous proliferation. Visual acuity was evaluated as logMAR. Cases were followed up for 6 months or longer. Results: The mean of postoperative best collected visual acuity was 0.41 ±0.40 with statistically significant improvement as compared with preoperative values (0.68±0.40) (p<0.05). Central retina thickness was significantly decreased (p < 0.05). Photodynamic therapy was performed on 14 eyes during the follow-up period. Conclusion: Intravitreal injection of rabinizumab was followed by significantly improved visual acuity and decreased foveal thickness in eyes with AMD during the following 6 months.
    No preview · Article · Sep 2011

  • No preview · Article · Aug 2011 · Folia Japonica de Ophthalmologica Clinica
  • T Kaido · A Mori · Y Ogura · K Hata · A Yoshizawa · T Iida · S Yagi · S Uemoto
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    ABSTRACT: The goal of this study was to examine whether the lower limit of the graft-to-recipient weight ratio (GRWR) can be safely reduced to make better use of a left-lobe graft in adult-to-adult living donor liver transplantation (LDLT) in combination with portal pressure control. Beginning in December 2007, our institution actively selected left-lobe grafts for use in liver transplantation seeking to minimize the risks to healthy donors. We gradually decreased the lower limit of the GRWR to preferentially select a left-lobe over a right-lobe graft: from ≥0.7% beginning in December 2007 to ≥0.6% beginning in April 2009. A portal pressure control program, targeting final portal pressures below 15 mm Hg, was also introduced to overcome small-for-size graft problems. The ratio of left-lobe grafts among all adult-to-adult LDLT grafts and the donor complication rate (defined as Clavien grade ≥ III, excluding wound infection) were compared between two time periods: June 1999 to November 2007 (period 1, n = 541) and December 2007 to February 2010 (period 2, n = 119). Overall survival rates were also compared between those recipients of a GRWR < 0.8% and those with a GRWR ≥ 0.8% in 198 recipients who underwent LDLT at our institution between April 2006 and February 2010. Left-lobe grafts use increased from period 1 (65/541 recipients; 12.0%) to period 2 (50/119 recipients; 42.0%; P < .001). The donor complication rate tended to decrease from 13.8% in period 1 to 9.3% in period 2 (P = .115). The overall survival rate in 52 recipients with a GRWR < 0.8% did not differ from that in 146 recipients with a GRWR ≥ 0.8%. The lower limit of the GRWR can be safely reduced to 0.6% in adult-to-adult LDLT in combination with portal pressure control.
    No preview · Article · Jul 2011 · Transplantation Proceedings
  • Y Ogura · H Kanazawa · A Yoshizawa · T Nitta · T Ikeda · S Uemoto
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    ABSTRACT: Treatment of Budd-Chiari syndrome consists of medical management, surgical shunt, transjugular intrahepatic portosystemic shunt (TIPS), and liver transplantation. Liver transplantation is indicated only when other treatments have failed. A 36-year-old Japanese man underwent living-donor liver transplantation after radiologic intervention procedures. Because of the position of the TIPS stent and the damaged vascular lesion of Budd-Chiari syndrome, a supradiaphragmatic approach was employed to achieve a safe total hepatectomy. Moreover, after resection of damaged portion of the inferior vena cava (IVC), an artificial vascular graft was utilized to fill the IVC gap. The postoperative course was uneventful; no serious complications were experienced within 2 years after liver transplantation. This supradiaphragmatic IVC approach and IVC reconstruction technique emphasized the option of surgical techniques to decrease the operative risk during liver transplantation for Budd-Chiari syndrome.
    No preview · Article · Jun 2011 · Transplantation Proceedings
  • T Iida · T Kaido · A Yoshizawa · S Yagi · K Hata · Y Ogura · A Mori · H Isoda · S Uemoto

    No preview · Article · Apr 2011 · American Journal of Transplantation
  • V. Raut · A. Mori · Y. Ogura · T. Kaido · I. Taku · O. Fumitaka · S. Uemoto

    No preview · Article · Mar 2011 · Journal of Hepatology
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    ABSTRACT: Background: Congenital biliary dilatation is a rare disease. Although the possibility of refractory cholangitis and/or the frequency of malignant tumours legitimize hepatobiliary surgery, repeated cholangitis and biliary obstruction result in secondary liver cirrhosis even after polysurgery. There are no definitive guidelines of liver transplantation for congenital biliary dilatation patients. Patients: A total of 1,101 liver transplantation recipients were enrolled in this study. Eleven congenital biliary dilatation patients including 5 Caroli's disease patients were retrospectively analyzed in detail. Results: Nine of eleven patients underwent initial surgeries before liver transplantation, while two Caroli's disease patients received liver transplantation as initial surgery with good outcomes. All patients had intractable symptoms caused by liver cirrhosis, and growth reduction was considerable in patients aged < 20 years. Histopathological analysis of the native liver revealed hepatic fibrosis (≥F2). One patient with ABO incompatibility finally died. Though one Caroli's disease patient accompanied with intrahepatic carcinoma, this patient survives 11.8 years after liver transplantation without any recurrences. Conclusions: The congenital biliary dilatation patients with refractory symptoms and complications secondary to liver failure are appropriate candidates for liver transplantation. We suggested that liver transplantation become an effective therapeutic option for congenital biliary dilatation patients, under the thoughtful considerations of many supportive factors, such as clinical course, growth reduction, image findings and histopathological analysis.
    No preview · Article · Jan 2011
  • T. Kaido · A. Mori · Y. Ogura · K. Hata · A. Yoshizawa · T. Lida · S. Uemoto

    No preview · Article · Dec 2010 · Clinical Nutrition Supplements

Publication Stats

4k Citations
477.57 Total Impact Points


  • 2014-2015
    • Nagoya University
      • Division of Transplantation Surgery
      Nagoya, Aichi, Japan
  • 1998-2015
    • Nagoya City University
      • • Department of Ophthalmology and Visual Science
      • • Department of Ophthalmology
      Nagoya, Aichi, Japan
  • 1987-2014
    • Kyoto University
      • • Department of Hepato-pancreato-biliary Surgery and Transplantation
      • • Graduate School of Medicine / Faculty of Medicine
      • • Department of Ophthalmology and Visual Sciences
      Kioto, Kyōto, Japan
  • 1995
    • Doheny Eye Institute
      Los Ángeles, California, United States
  • 1994-1995
    • Johns Hopkins University
      • Wilmer Eye Institute
      Baltimore, Maryland, United States
  • 1988-1994
    • University of Illinois at Chicago
      • Department of Ophthalmology and Visual Sciences (Chicago)
      Chicago, Illinois, United States