Language：Japanese   Publisher：(NPO)日本肺癌学会  

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INTRODUCTION: The association of changes in skeletal muscle mass and quality during the waiting time with outcomes of lung transplantation (LT) remains unclear. We aimed to examine the association of changes in skeletal muscle mass and quality during the waiting time, as well as preoperative skeletal muscle mass and quality, with outcomes of LT. METHODS: This study included individuals who underwent LT from brain-dead donors. Skeletal muscle mass (cm2 /m2 ) and quality (mean Hounsfield units [HU]) of the erector spinae muscle at the 12th thoracic level were evaluated using computed tomography. Preoperative skeletal muscle mass and quality, and their changes during the waiting time were calculated. We evaluated the associations among mechanical ventilation (MV) duration, intensive care unit (ICU) length of stay (LOS), hospital LOS, 6-minute walk distance at discharge, and 5-year survival after LT. RESULTS: This study included 98 patients. The median waiting time was 594.5 days (interquartile range [IQR], 355.0-913.0). The median changes in skeletal muscle mass and quality were -4.4% (IQR, -13.3-3.1) and -2.9% (IQR, -16.0-4.1), respectively. Severe low skeletal muscle mass at LT was associated with prolonged ICU LOS (B = 8.46, 95% confidence interval [CI]: .51-16.42) and hospital LOS (B = 36.00, 95% CI: 3.23-68.78). Pronounced decrease in skeletal muscle mass during the waiting time was associated with prolonged MV duration (B = 7.85, 95% CI: .89-14.81) and ICU LOS (B = 7.97, 95% CI: .83-15.10). CONCLUSION: Maintaining or increasing skeletal muscle mass during the waiting time would be beneficial to improve the short-term outcomes of LT.

DOI： 10.1111/ctr.15169

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BACKGROUND: No proven treatment after the development of primary graft dysfunction (PGD) is currently available. Here we established a novel strategy of in vivo lung perfusion (IVLP) for the treatment of PGD. IVLP involves the application of an in vivo isolated perfusion circuit to an implanted lung. This study aimed to explore the effectiveness of IVLP versus conventional post-lung transplant (LTx) extracorporeal membrane oxygenation (ECMO) treatment using an experimental swine LTx PGD model. METHODS: After 1.5-h warm ischemia of the donor lungs, a left LTx was performed. Following the confirmation of PGD development, pigs were divided into three groups (n = 5 each): control (no intervention), ECMO, and IVLP. After 2 h of treatment, a 4-h functional assessment was conducted and samples obtained. RESULTS: Significantly better oxygenation were achieved in the IVLP group (p ≤ 0.001). Recovery was confirmed immediately and maintained during the following 4-h observation. The IVLP group also demonstrated better lung compliance than the control group (p = 0.045). A histological evaluation showed that the lung injury score and terminal deoxynucleotidyl transferase dUTP nick end labeling assay showed significantly fewer injuries and a better result in the wet-to-dry weight ratio in the IVLP group. CONCLUSIONS: A two-hour IVLP is technically feasible and allows for prompt recovery from PGD after LTx. The posttransplant short-duration IVLP strategy can complement or overcome the limitations of the current practice for donor assessment and PGD management.

DOI： 10.1016/j.healun.2023.10.011

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DOI： 10.1038/s41598-023-43995-x

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The long-term survival after lung transplantation (LT) is favorable in Japan. However, long-term survivors after LT are subject to late complications, including chronic lung allograft dysfunction (CLAD), malignancy, infection, and chronic kidney disease (CKD) because of the need for lifelong immunosuppression. The rates of single cadaveric LT (CLT) and living-donor lobar LT (LDLLT) are higher than that of bilateral CLT in Japan. Here, we will describe the management of late complications and long-term outcome after LT in Japan. Attention should be paid to not only the phenotype of CLAD but also the difference in CLAD after CLT and after LDLLT as well as the timing of lung re-transplantation for advanced CLAD, especially after single CLT. Since post-transplant lymphoproliferative disorder is the most common malignancy after LT, infection monitoring for infection-related malignancies and appropriate screening are keys to the early diagnosis and treatment of malignancy after LT. The long-term management of infection after LT is also important, especially with regard to community-acquired pathogens, Aspergillus, and cytomegalovirus. When providing long-term care after LT, physicians should be aware of CKD and the timing of renal replacement therapy in cases with severe CKD. The widespread use of computed tomography and dialysis in Japan are beneficial for long-term survivors of LT. The similar survival outcomes of single CLT and LDLLT, compared with bilateral CLT, might contribute to improved long-term survival in Japan. Pulmonologists are encouraged to become further involved in long-term management after LT in Japan.

DOI： 10.21037/jtd-22-1679

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DOI： 10.1245/s10434-023-14311-8

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BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation is an uncommon strategy in Japan owing to the severe donor shortage and absence of urgent allocation policy. Moreover, the use of veno-venous (VV) ECMO for immunosuppressed patients is controversial; thus, applying ECMO to patients who await lung re-transplantation is challenging. CASE PRESENTATION: A 16-year-old lung transplant recipient with grade 3 bronchiolitis obliterans syndrome was waitlisted for lung re-transplantation. Eleven months later, he fell into severe respiratory acidosis with hypercapnia, which were not resolved with mechanical ventilation. VV ECMO was introduced to minimize lung stress and strain. Tracheostomy was additionally performed on day 5 after the start of ECMO, and respiratory condition swiftly improved; hence, the weaning process from VV ECMO began on day 9. Rehabilitation became implementable, and bilateral re-lung transplantation was successfully performed 6 months after the ECMO treatment. No critical complication related to the precedent use of ECMO was noted. CONCLUSIONS: VV ECMO can be a feasible treatment option even for lung transplant candidates awaiting re-transplantation for a prolonged period. Introduction of ECMO and tracheostomy in the early deterioration stage may be crucial to successful subsequent patient management.

DOI： 10.1186/s40792-023-01742-4

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BACKGROUND: The presence of tumor-infiltrating lymphocytes (TILs) and tertiary lymphoid structures (TLSs) in tumor tissue has been related to the prognosis in various malignancies. Meanwhile, neutrophil-to-lymphocyte ratio (NLR) as a systemic inflammation marker also has been associated with the prognosis in them. However, few reports have investigated the relationship between pulmonary metastases from sarcoma and these biomarkers. METHODS: We retrospectively recruited 102 patients undergoing metastasectomy for pulmonary metastases from uterine leiomyosarcoma at Okayama University Hospital from January 2006 to December 2019. TILs and TLSs were evaluated by immunohistochemical staining of surgically resected specimens of pulmonary metastases using anti-CD3/CD8/CD103/Foxp3/CD20 antibodies. NLR was calculated from the blood examination immediately before the most recent pulmonary metastasectomy. We elucidated the relationship between the prognosis and these factors. Because we considered that the status of tumor tissue and systemic inflammation were equally valuable, we also assessed the impact of the combination of TILs or TLSs and NLR on the prognosis. RESULTS: As for TILs, CD3-positive cells and CD8-positive cells were correlated with the prognosis. The prognosis was significantly better in patients with CD3-high group, CD8-high group, TLSs-high group, and NLR-low group, respectively. The prognosis of CD8-high/NLR-low group and TLSs-high/NLR-low group was significantly better than that of CD8-low/NLR-high group and TLSs-low/NLR-high group, respectively. CONCLUSIONS: CD3-positive TILs, CD8-positive TILs, TLSs, and NLR are correlated with the prognosis, respectively. The combination of CD8-positive TILs or TLSs and NLR may be the indicators to predict the prognosis of patients with pulmonary metastases from uterine leiomyosarcoma.

DOI： 10.1245/s10434-023-14176-x

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PURPOSE: Chronic lung allograft dysfunction (CLAD) is a known long-term fatal disorder after lung transplantation. In this study, we evaluated the CLAD classification of the International Society for Heart and Lung Transplantation (ISHLT) for living-donor lobar lung transplantation (LDLLT). METHODS: We conducted a single-center retrospective review of data from 73 patients who underwent bilateral LDLLT between 1998 and 2019. Factors related to opacity on computed tomography (CT) and restriction on pulmonary function tests (PFTs) were also analyzed. RESULTS: Overall, 26 (36%) patients were diagnosed with CLAD, including restrictive allograft syndrome (RAS), n = 10 (38.5%); bronchiolitis obliterans syndrome (BOS), n = 8 (30.8%); mixed, n = 1 (3.8%); undefined, n = 2 (7.7%); and unclassified, n = 5 (19.2%). The 5-year survival rate after the CLAD onset was 60.7%. The survival of patients with BOS was significantly better than that of patients with RAS (p = 0.012). In particular, patients with restriction on PFT had a significantly worse survival than those without restriction (p = 0.001). CONCLUSIONS: CLAD after bilateral LDLLT does not have a major impact on the recipient survival, especially in patients with BOS. Restriction on PFT may predict a particularly poor prognosis in patients with CLAD after bilateral LDLLT.

DOI： 10.1007/s00595-023-02729-2

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INTRODUCTION: The percentage of low attenuation area (%LAA) on computed tomography (CT) is useful for evaluating lung emphysema, and higher %LAA was observed in patients with chronic lung allograft dysfunction (CLAD). This study investigated the relationship between the %LAA and the development of CLAD after bilateral lung transplantation (LT). METHODS: We conducted a single-center retrospective study of 75 recipients who underwent bilateral LT; the recipients were divided into a CLAD group (n = 30) and a non-CLAD group (n = 45). The %LAA was calculated using CT and compared between the two groups from 4 years before to 4 years after the diagnosis of CLAD. The relationships between the %LAA and the percent baseline values of the pulmonary function test parameters were also calculated. RESULTS: The %LAA was significantly higher in the CLAD group than in the non-CLAD group from 2 years before to 2 years after the diagnosis of CLAD (P < .05). In particular, patients with bronchiolitis obliterans syndrome (BOS) exhibited significant differences even from 4 years before to 4 years after diagnosis (P < .05). Significant negative correlations between the %LAA and the percent baseline values of the forced expiratory volume in 1 s (r = -.36, P = .0031), the forced vital capacity (r = -.27, P = .027), and the total lung capacity (r = -.40, P < .001) were seen at the time of CLAD diagnosis. CONCLUSION: The %LAA on CT was associated with the development of CLAD and appears to have the potential to predict CLAD, especially BOS, after bilateral LT.

DOI： 10.1111/ctr.15077

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PURPOSE: Although the performance lung transplantation (LTx) in the elderly (≥ 60 years) has increased globally, the situation in Japan remains quite different, because the age limit at registration for cadaveric transplantation is 60 years. We investigated the long-term outcomes of LTx in the elderly in Japan. METHODS: This was a single-center retrospective study. We divided the patients into two groups according to age: the younger group (< 60 years; Y group; n = 194) and the elderly group (≥ 60 years; E group; n = 10). We performed three-to-one propensity score matching to compare the long-term survival between the E and Y groups. RESULTS: In the E group, the survival rate was significantly worse (p = 0.003), and single-LTx was more frequent (p = 0.036). There was a significant difference in the indications for LTx between the two groups (p < 0.001). The 5-year survival rate after single-LTx in the E group was significantly lower than that in the Y group (p = 0.006). After propensity score matching, the 5-year survival rates of the two groups were comparable (p = 0.55). However, the 5-year survival rate after single-LTx in the E group was significantly lower than that in the Y group (p = 0.007). CONCLUSION: Elderly patients showed acceptable long-term survival after LTx.

DOI： 10.1007/s00595-023-02699-5

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Renal dysfunction is a long-term complication associated with an increased mortality after lung transplantation (LT). We investigated the association of single-nucleotide polymorphisms (SNPs) with the development of renal dysfunction after LT using a Japanese-specific SNP array. First, eligible samples of 34 LT recipients were genotyped using the SNP array and divided into two groups, according to the presence of homozygous and heterozygous combinations of mutant alleles of the 162 renal-related SNPs. To identify candidate SNPs, the renal function tests were compared between the two groups for each SNP. Next, we investigated the association between the candidate SNPs and the time course of changes of the estimated glomerular filtration rate (eGFR) in the 99 recipients until 10 years after the LT. ΔeGFR was defined as the difference between the postoperative and preoperative eGFR values. Eight SNPs were identified as the candidate SNPs in the 34 recipients. Validation analysis of these 8 candidate SNPs in all the 99 recipients showed that three SNPs, namely, rs10277115, rs4690095, and rs792064, were associated with significant changes of the ΔeGFR. Pre-transplant identification of high-risk patients for the development of renal dysfunction after LT based on the presence of these SNPs might contribute to providing personalized medicine.

DOI： 10.1038/s41598-023-36143-y

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Pulmonary alveolar proteinosis (PAP) affecting transplanted lungs is not well recognized. Herein, we report two cases of PAP after lung transplantation (LTx). The first case was a 4-year-old boy with hereditary pulmonary fibrosis who underwent bilateral LTx and presented with respiratory distress on postoperative day (POD) 23. He was initially treated for acute rejection, died due to infection on POD 248, and was diagnosed with PAP at autopsy. The second case involved a 52-year-old man with idiopathic pulmonary fibrosis who underwent bilateral LTx. On POD 99, chest computed tomography revealed ground-glass opacities. Bronchoalveolar lavage and transbronchial biopsy led to a diagnosis of PAP. Follow-up with immunosuppression tapering resulted in clinical and radiological improvement. PAP after lung transplantation mimics common acute rejection; however, is potentially transient or resolved with tapering immunosuppression, as observed in the second case. Transplant physicians should be aware of this rare complication to avoid misconducting immunosuppressive management.

DOI： 10.1002/rcr2.1160

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: S100A8/A9 is a damage-associated molecule that augments systemic inflammation. However, its role in the acute phase after lung transplantation (LTx) remains elusive. This study aimed to determine S100A8/A9 levels after lung transplantation (LTx) and evaluate their impact on overall survival (OS) and chronic lung allograft dysfunction (CLAD)-free survival. METHODS: Sixty patients were enrolled in this study, and their plasma S100A8/A9 levels were measured on days 0, 1, 2, and 3 after LTx. The association of S100A8/A9 levels with OS and CLAD-free survival was assessed using univariate and multivariate Cox regression analyses. RESULTS: S100A8/A9 levels were elevated in a time-dependent manner until 3 days after LTx. Ischemic time was significantly longer in the high S100A8/9 group than in the low S100A8/A9 group (p = .017). Patients with high S100A8/A9 levels (> 2844 ng/mL) had worse prognosis (p = .031) and shorter CLAD-free survival (p = .045) in the Kaplan-Meier survival analysis than those with low levels. Furthermore, multivariate Cox regression analysis showed that high S100A8/A9 levels were a determinant of poor OS (hazard ratio [HR]: 3.7; 95% confidence interval [CI]: 1.2-12; p = .028) and poor CLAD-free survival (HR: 4.1; 95% CI: 1.1-15; p = .03). In patients with a low primary graft dysfunction grade (0-2), a high level of S100A8/A9 was also a poor prognostic factor. CONCLUSIONS: Our study provided novel insights into the role of S100A8/A9 as a prognostic biomarker and a potential therapeutic target for LTx.

DOI： 10.1111/ctr.15006

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publisher：(一社)日本外科学会  

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Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.heliyon.2023.e14903

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Language：English   Publishing type：Research paper (scientific journal)  

INTRODUCTION: Living-donor lobar lung transplantation is an alternative procedure to deceased donation lung transplantation. It involves graft donation from healthy donors; however, only a few reports have discussed its long-term prognosis in living lung donors and their associated health-related quality of life. This study aimed to examine living lung donors' health-related quality of life. METHODS: In our cross-sectional survey of living lung donors, we assessed health-related quality of life-based on three key aspects (physical, mental, and social health) using the 36-Item Short Form Health Survey. We also evaluated chronic postoperative pain and postoperative breathlessness using the numeric rating scale and the modified Medical Research Council Dyspnea scale, respectively. RESULTS: We obtained consent from 117 of 174 living lung donors. The average scores of the living lung donors on the 36-Item Short Form Health Survey were higher than the national average. However, some donors had poorer physical, mental, and social health, with lower summary scores than the national averages. Low mental component summary predictors included donor age (<40 years; odds ratio = 10.2; p < .001) and recipient age (<18 years; odds ratio = 2.73; p < .032). Low role-social component summary predictors included high lung allocation score (≥50; odds ratio = 3.94, p < .002) and recipient death (odds ratio = 3.64; p = .005). There were no predictors for a physical component summary. Additionally, many donors did not complain of pain or dyspnea. CONCLUSIONS: Living lung donors maintained an acceptable long-term health-related quality of life after surgery. Potential donors should be informed of relevant risk factors, and high-risk donors should receive appropriate support.

DOI： 10.1111/ctr.14927

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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Language：Japanese   Publisher：(一社)日本呼吸理学療法学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media {LLC}  

<jats:title>Abstract</jats:title><jats:p>One-step nucleic acid amplification (OSNA) is a rapid intraoperative molecular detection technique for sentinel node assessment via the quantitative measurement of target cytokeratin 19 (<jats:italic>CK19</jats:italic>) mRNA to determine the presence of metastasis. It has been validated in breast cancer but its application in lung cancer has not been adequately investigated. 214 LNs from 105 patients with 100 primary lung cancers, 2 occult primary lung tumors, and 3 metastatic lung tumors, who underwent surgical lung resection with LN dissection between February 2018 and January 2020, were assessed. Resected LNs were divided into two parts: one was snap-frozen for OSNA and the other underwent rapidly frozen histological examination. Intraoperatively collected LNs were evaluated by OSNA using loop-mediated isothermal amplification and compared with intraoperative pathological diagnosis as a control. Among 214 LNs, 14 were detected as positive by OSNA, and 11 were positive by both OSNA and intraoperative pathological diagnosis. The sensitivity and specificity of OSNA was 84.6% and 98.5%, respectively. The results of 5 of 214 LNs were discordant, and the remainder all matched (11 positive and 198 negative) with a concordance rate of 97.7%. Although the analysis of public mRNA expression data from cBioPortal showed that <jats:italic>CK19</jats:italic> expression varies greatly depending on the cancer type and histological subtype, the results of the five cases, except for primary lung cancer, were consistent. OSNA provides sufficient diagnostic accuracy and speed and can be applied to the intraoperative diagnosis of LN metastasis for non-small cell lung cancer.</jats:p>

DOI： 10.1038/s41598-022-11064-4

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media {LLC}  

<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Background</jats:title>
<jats:p>Soft-tissue sarcomas are rare malignancies that consist of many different histologic subtypes and arise in various locations in the body. In patients with lung metastases from retroperitoneal sarcomas, the long-term outcomes and prognostic factors are unknown. This study is a retrospective review of patients undergoing pulmonary metastasectomy for retroperitoneal sarcoma metastases at one institution, with the purpose of determining prognostic factors and clinical outcomes.</jats:p>
</jats:sec><jats:sec>
<jats:title>Methods</jats:title>
<jats:p>This is a single-center, retrospective cohort study of patients undergoing pulmonary metastasectomy for lung metastases from various sarcomas at Okayama University Hospital from January 2006 to December 2018. The Kaplan-Meier method and log-rank test were used for the analyses, and cut-off values of continuous variables were determined by a receiver operating characteristic curve analysis.</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>Twenty-four patients underwent the first pulmonary metastasectomy for lung metastases from retroperitoneal sarcoma in our hospital. Leiomyosarcoma was the most common histologic subtype of retroperitoneal sarcoma (79.2%, <jats:italic>n</jats:italic> = 19). Median overall survival was 49.9 months, and the 3-year and 5-year survival rates after the first pulmonary metastasectomy were 62.5% and 26.4% respectively. In univariate analysis, age ≥56 years, disease-free interval &lt; 15 months, and size of metastasis (≥ 27 mm) were associated with poor survival.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusion</jats:title>
<jats:p>Pulmonary metastasectomy can be considered as an effective management strategy in retroperitoneal sarcoma patients with lung metastases in appropriately selected cases, just as it is for other sarcomas.</jats:p>
</jats:sec>

DOI： 10.1186/s12957-022-02552-y

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(1) Background: Lung ischemia-reperfusion (IR) injury increases the mortality and morbidity of patients undergoing lung transplantation. The objective of this study was to identify the key initiator of lung IR injury and to evaluate pharmacological therapeutic approaches using a functional inhibitor against the identified molecule. (2) Methods: Using a mouse hilar clamp model, the combination of RNA sequencing and histological investigations revealed that neutrophil-derived S100A8/A9 plays a central role in inflammatory reactions during lung IR injury. Mice were assigned to sham and IR groups with or without the injection of anti-S100A8/A9 neutralizing monoclonal antibody (mAb). (3) Results: Anti-S100A8/A9 mAb treatment significantly attenuated plasma S100A8/A9 levels compared with control IgG. As evaluated by oxygenation capacity and neutrophil infiltration, the antibody treatment dramatically ameliorated the IR injury. The gene expression levels of cytokines and chemokines induced by IR injury were significantly reduced by the neutralizing antibody. Furthermore, the antibody treatment significantly reduced TUNEL-positive cells, indicating the presence of apoptotic cells. (4) Conclusions: We identified S100A8/A9 as a novel therapeutic target against lung IR injury.

DOI： 10.3390/bioengineering9110673

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DOI： 10.1016/j.bbrc.2022.08.087

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media {LLC}  

DOI： 10.1007/s00595-022-02492-w

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press ({OUP})  

<jats:title>Abstract</jats:title>
<jats:p />
<jats:sec>
<jats:title>OBJECTIVES</jats:title>
<jats:p>Bronchial anastomotic complications remain a major concern in lung transplantation. We aim to compare 2 different techniques, continuous suture (CS) versus interrupted suture (IS) by analysing airway complications requiring intervention.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>METHODS</jats:title>
<jats:p>Lung transplantations between January 2015 and December 2020 were included. Airway complications requiring intervention were classified following the 2018 International Society for Heart and Lung Transplantation consensus and analysed comparing 3 groups of patients according to surgical technique: group A, both anastomosis performed with CS; group B, both with interrupted; and group C, IS for 1 side and CS for the contralateral side.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>RESULTS</jats:title>
<jats:p>A total of 461 anastomoses were performed in 245 patients. The incidence of airway complications requiring intervention was 5.7% [95% confidence interval (CI): 2.8–8.6] per patient (14/245) and 3.7% (95% CI: 2.0–5.4) per anastomosis (17/461). Complications that required intervention were present in 5 out of 164 (3.1%) anastomosis with interrupted technique, and in 12/240 (5%) with CS. No significant differences were found between techniques (P = 0.184). No statistical differences were found among group A, B or C in terms of incidence of anastomotic complications, demographics, transplant outcomes or overall survival (log-rank P = 0.513). In a multivariable analysis, right laterality was significantly associated to complications requiring intervention (OR 3.7 [95% CI: 1.1–12.3], P = 0.030). Endoscopic treatment was successful in 12 patients (85.7%). Retransplantation was necessary in 2 patients.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>CONCLUSIONS</jats:title>
<jats:p>In summary, although it seems that anastomotic complications requiring intervention occur more frequently with CS, there are no statistical differences compared to IS. Endoscopic treatment offers good outcomes in most of the airway complications after lung transplantation.</jats:p>
</jats:sec>

DOI： 10.1093/ejcts/ezac493

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier {BV}  

DOI： 10.1016/j.arbres.2021.06.013

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Language：Japanese   Publisher：(株)南江堂  

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2022&ichushi_jid=J00349&link_issn=&doc_id=20220401120013&doc_link_id=issn%3D0021-5252%26volume%3D75%26issue%3D4%26spage%3D297&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0021-5252%26volume%3D75%26issue%3D4%26spage%3D297&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Publishing type：Research paper (scientific journal)   Publisher：Frontiers Media {SA}  

DOI： 10.1111/tri.14120

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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Language：Japanese   Publisher：(一社)日本胸部外科学会  

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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Language：Japanese   Publisher：(一社)日本胸部外科学会  

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Language：Japanese   Publisher：(一社)日本胸部外科学会  

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Language：Japanese   Publisher：(一社)日本胸部外科学会  

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Language：Japanese   Publishing type：Research paper (other academic)   Publisher：(一社)日本胸部外科学会  

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BACKGROUND: Idiopathic multicentric Castleman disease (iMCD) is a rare polyclonal lymphoproliferative disease caused by the overrepresentation of interleukin-6 (IL-6). Tocilizumab (TCZ) is a humanized monoclonal antibody that binds to the IL-6 receptor and is approved for the treatment of iMCD. The efficacy and tolerability of TCZ in patients with iMCD undergoing lung transplantation (LTx) remain unknown. CASE PRESENTATION: We present the case of a 48-year-old iMCD patient with end-stage lung disease (ESLD) who was successfully treated with cadaveric single-LTx. Intravenous TCZ was used to stabilize the iMCD patient every 2 weeks, except for withdrawal immediately after LTx. At 32 month post-transplant, the patient remained asymptomatic without evidence of rejection, development of de novo donor-specific antibody (DSA), and recurrent iMCD in the native lung. CONCLUSIONS: Single-LTx can be a feasible treatment option for ESLD caused by iMCD. TCZ can be used safely and may be beneficial in recipients with iMCD, and TCZ in combination with usual immunosuppression can be helpful in stabilizing iMCD patients pre- and post-LTx.

DOI： 10.1186/s40792-021-01297-2

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Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press ({OUP})  

DOI： 10.1093/ejcts/ezab121

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publisher：(一社)日本移植学会  

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Language：Japanese   Publishing type：Research paper (other academic)   Publisher：(一社)日本移植学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press ({OUP})  

<jats:title>Abstract</jats:title>
<jats:sec>
<jats:title>OBJECTIVES</jats:title>
<jats:p />
<jats:p>We reviewed the incidence of coronavirus disease 2019 cases and the postoperative outcomes of patients who had thoracic surgery during the beginning and at the highest point of transmission in our community.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>METHODS</jats:title>
<jats:p>We retrospectively reviewed patients who had undergone elective thoracic surgery from 12 February 2020 to 30 April 2020 and were symptomatic or tested positive for severe acute respiratory syndrome coronavirus 2 infection within 14 days after surgery, with a focus on their complications and potential deaths.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>RESULTS</jats:title>
<jats:p>Out of 101 surgical procedures, including 57 primary oncological resections, 6 lung transplants and 18 emergency procedures, only 5 cases of coronavirus disease 2019 were identified, 3 in the immediate postoperative period and 2 as outpatients. All 5 patients had cancer; the median age was 64 years. The main virus-related symptom was fever (80%), and the median onset of coronavirus disease 2019 was 3 days. Although 80% of the patients who had positive test results for severe acute respiratory syndrome coronavirus 2 required in-hospital care, none of them were considered severe or critical and none died.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>CONCLUSIONS</jats:title>
<jats:p>These results indicate that, in properly selected cases, with short preoperative in-hospital stays, strict isolation and infection control protocols, managed by a dedicated multidisciplinary team, a surgical procedure could be performed with a relatively low risk for the patient.</jats:p>
</jats:sec>

DOI： 10.1093/ejcts/ezaa324

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Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

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Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media {LLC}  

DOI： 10.1007/s11748-019-01245-w

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press ({OUP})  

<jats:title>Abstract</jats:title>
<jats:p>The technique of pneumonectomy, back-table lung preservation, double-sleeve resection and reimplantation of basal segments (the Oto procedure) has been proposed as a useful technique for the management of locally advanced central lung cancer with short-term follow-up. We report the long-term outcomes of 5 consecutive patients who underwent the Oto procedure.</jats:p>

DOI： 10.1093/ejcts/ezy431

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Publishing type：Research paper (scientific journal)   Publisher：Spandidos Publications  

DOI： 10.3892/ijo.2019.4768

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media {LLC}  

DOI： 10.1007/s00595-018-1717-9

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media {LLC}  

DOI： 10.1007/s00595-018-1730-z

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier {BV}  

DOI： 10.1016/j.resinv.2018.12.002

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media {LLC}  

DOI： 10.1038/s41598-018-33848-3

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Language：Japanese   Publisher：(一社)日本遺伝性腫瘍学会  

52歳女性。異時性両側乳癌(40歳時、47歳時)にて手術。右乳房には術後放射線療法を受けていた。血縁者がLi-Fraumeni症候群と診断されたため、本人も遺伝学的検査を希望し、施行したところTP53遺伝子の変異(p.Arg248Gln)を認めた。全身の腫瘍サーベイランスとして施行したPET/CTにて右肺上葉の腫瘍を認め、胸腔鏡補助下右上葉切除術、リンパ節郭清を施行した。肺腺癌pT1aN0M0 pStage IAであった。Li-Fraumeni症候群症例に対する初回サーベイランスとしてPET/CTが有用であることが示唆された。(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2017&ichushi_jid=J03931&link_issn=&doc_id=20171201300006&doc_link_id=%2Fcg3kazok%2F2017%2F001701%2F007%2F0022-0025%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcg3kazok%2F2017%2F001701%2F007%2F0022-0025%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier {BV}  

DOI： 10.1016/j.athoracsur.2017.03.019

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

背景. 近年、癌治療の向上で癌患者の長期生存例は増加傾向にある。しかし一方で多重癌の報告が散見されるようになり問題となっている。症例. 77歳男性。右上葉小細胞肺癌(cT1aN3M0、Stage IIIB)に対してCisplatin+etoposideによる化学療法4コースと46Gyの放射線療法を施行した。以後再燃なく経過観察が行われていた。初回治療から11年後に咳、痰、胸痛を認め精査を行った結果、右上葉肺癌cT2aN0M0、cStage IB:左上葉肺癌cT1aN0M0、cStage IA:喉頭癌cT1N0M0、cStage IAの重複癌の出現を認めた。まずは最も進行度の高い右肺癌に対して右肺上中葉+上大静脈部分切除を施行した。術後の呼吸機能低下があり、左肺癌の手術は困難と判断したため、左肺癌に対しては66Gyの放射線療法を施行し、その後喉頭癌に対しても66Gyの放射線療法を施行した。結論. 小細胞肺癌に対して化学放射線療法後に重複癌を認めた症例を経験したので、文献的考察を加えて報告する。(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2015&ichushi_jid=J01244&link_issn=&doc_id=20150814280005&doc_link_id=%2Fec7jaluc%2F2015%2F005503%2F005%2F0171-0175%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fec7jaluc%2F2015%2F005503%2F005%2F0171-0175%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(NPO)日本肺癌学会  

背景. 放射線治療後の長期生存例では放射線誘発癌が問題となることがある。症例. 67歳、男性。健診で胸部異常陰影を指摘された。精査で右上葉の肺扁平上皮癌(cT2aN2M0、stage IIIA)と診断し、mitomycin+vindesine+cisplatin(MMC+VDS+CDDP)による化学療法2コースと60Gyの同時性放射線療法を施行した。治療の結果complete response(CR)であり、以後再燃なく経過観察されていた。8年後のCT検査で放射線治療後器質化肺内に、腫瘤の出現を認めた。異時性の原発性肺癌(cT2aN0M0、stage IB)と考え右上葉切除術を施行し、小細胞癌と大細胞癌が混在した腫瘍(pT4N0M0、stage IIIA)と診断した。本症例は、初回癌と二次癌の組織型が異なること、放射性瘢痕肺内に腫瘍が増生していること、照射から8年経過していることから、放射線誘発癌である可能性が高いと考えられた。術後CDDP+irinotecanによる化学療法を4コース施行し、1年目の現在無再発生存中である。結論. 放射線誘発癌は潜伏期間が長く、慎重な長期経過観察が必要であると考えられた。(著者抄録)

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

症例は56歳男性。20年前に甲状腺腫を指摘され、他院にて腺腫様甲状腺腫と診断され経過観察されていた。ここ数年左頸部の腫瘤は徐々に増悪し、最近になり呼吸困難を自覚してきたため近医受診した。胸部CT検査にて甲状腺両葉の著明な腫大とそれによる左右からの気管圧迫狭窄を認めたため当院紹介となった。甲状腺左葉は体表に向かって約12cmに腫大しており、右葉は後縦隔に進展し気管分岐部まで達していたため縦隔内甲状腺腫として手術を施行した。頸部横切開を置き、頸部からの操作で腫瘍摘出を試みた。甲状腺左葉は摘出可能であったが後縦隔内に進展している右葉は頸部からのアプローチでは剥離困難であったため胸骨縦切開を追加し甲状腺腫を摘出した。病理組織診断は腺腫様甲状腺腫であった。術後経過は良好で術後9日目に退院となった。頸部切開に胸骨縦切開を追加し摘出した縦隔内甲状腺腫の1例を経験したので若干の文献的考察を加えて報告する。(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2014&ichushi_jid=J02256&link_issn=&doc_id=20140929290023&doc_link_id=10.2995%2Fjacsurg.28.827&url=https%3A%2F%2Fdoi.org%2F10.2995%2Fjacsurg.28.827&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

症例は19歳男性。2011年6月の胸部X線写真で心陰影に重なる肺の腫瘤影を指摘され、8月の胸部X線写真では腫瘤影が増大していた。発熱、咳、痰などの自覚症状は全く認めなかった。胸腹部造影CT検査にて腹部大動脈より分岐する異常血管を認め、左肺葉内分画症と診断し手術を施行した。分画肺は大きく開胸左下葉切除術を施行した。分画肺は周囲への癒着が強く剥離に難渋した。術後1日目に急激な胸部痛の増強と胸腔ドレーンより暗赤色の排液を多量に認めた。精査の結果、食道裂孔ヘルニアの嵌頓による胃穿孔と診断した。再開胸し胃の穿孔部を自動縫合器で部分切除。腹腔内へ胃を還納し、食道裂孔を縫縮した。分画肺の癒着剥離操作で食道裂孔周囲の組織が脆弱化したため生じた合併症の可能性がある。食道裂孔近傍に癒着を強く認める肺切除症例では閉胸時、本症例のような病態を念頭に置く必要があると考えられた。(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2014&ichushi_jid=J02256&link_issn=&doc_id=20140818260019&doc_link_id=10.2995%2Fjacsurg.28.657&url=https%3A%2F%2Fdoi.org%2F10.2995%2Fjacsurg.28.657&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(株)南江堂  

62歳男。中学生時代から左下腿内側部に皮膚びらんを生じており、約10年前には同部皮膚潰瘍の下肢静脈うっ滞に高位結紮術を受けた。更に3年後、再診で動静脈瘻と診断され、コイル塞栓術後に弾力包帯着用したが、その後は受診していなかった。今回、17年経過で皮膚潰瘍病変の悪化で受診となった。所見では浮腫はないが、左大腿・下腿の周囲径が右側に比して大きく、表在静脈は拡張し、皮膚の肥厚がみられ、褐色調変化していた。また、左下腿内側部に約12×6.5cm大の悪臭を伴う皮膚潰瘍ほか、左足第1指爪外側に約7mm大の易出血性不良肉芽を認められたが、下肢動脈拍動は触知された。一方、超音波では足背側部から下腿内側部に動静脈シャント血流を多数認め、足背動脈と足背部皮下静脈は拡張していた。更に下肢動脈造影CTでは左下腿に動静脈が多数網状に走行しており、瘻部位特定は困難で、大腿動静脈や膝窩動静脈は左側で拡張していた。以上より、治療として3回のコイル塞栓術を行なった結果、潰瘍近位、中部は潰瘍が浅く縮小し、下腿皮下静脈拡張も消褪傾向となり、上昇していたCK値も3ヵ月後には低下傾向となった。尚、第1指不良肉芽は縮小したものの、のちに潰瘍遠位部に深い潰瘍を形成したため、足背動脈から分岐する大きな動静脈瘻を足関節神経ブロック下に2ヵ所結紮することで遠位部も表在化し、治癒傾向が認められた。

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2014&ichushi_jid=J00393&link_issn=&doc_id=20140124190015&doc_link_id=issn%3D0016-593X%26volume%3D76%26issue%3D2%26spage%3D192&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0016-593X%26volume%3D76%26issue%3D2%26spage%3D192&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier {BV}  

DOI： 10.1016/j.healun.2010.11.010

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Language：Japanese   Publisher：岡山医学会  

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Language：English   Publisher：Elsevier {BV}  

DOI： 10.1016/j.healun.2023.02.1279

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Language：English   Publisher：Elsevier {BV}  

DOI： 10.1016/j.healun.2023.02.888

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：Elsevier {BV}  

DOI： 10.1016/j.healun.2022.01.1512

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DOI： 10.1016/j.healun.2022.01.112

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DOI： 10.1016/j.healun.2022.01.623

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DOI： 10.1016/j.healun.2018.01.570

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DOI： 10.1016/j.healun.2018.01.1186

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Language：Japanese   Publisher：(一社)日本移植学会  

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DOI： 10.1016/j.healun.2017.01.1495

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DOI： 10.1016/j.healun.2017.01.1064

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DOI： 10.1016/j.healun.2016.01.1064

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Language：Japanese   Publisher：(NPO)日本呼吸器内視鏡学会  

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