Faculty Profiles - ARAKI Motoo

Papers - ARAKI Motoo

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松尾聡子, 谷本竜太, 杉本盛人, 津島友靖, 中村あや, 定平卓也, 和田里章悟, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

西日本泌尿器科 82 ( 5 ) 514 - 517 2020.12

Language：Japanese Publisher：西日本泌尿器科学会

症例は46歳,女性.子宮筋腫術後フォローアップMRIで,膀胱頸部に約3cm大の嚢胞性病変を指摘されていた.X年3月,頻尿・排尿痛を主訴に前医泌尿器科を受診した.保存的加療では排尿障害の改善が得られず,精査加療のためX年11月に当院紹介となった.腹部超音波検査で残尿は認めなかったが,尿道周囲に嚢胞性病変を認めた.内診では腟前壁に弾性軟の腫瘤を認めた.経腟的嚢胞穿刺の上,インジゴカルミンを注入すると,尿道鏡下に尿道5時方向より色素の噴出を認め,尿道憩室と診断した.その後,排尿障害が軽快したため経過観察としていたが,X+1年10月に膀胱炎様症状および排尿困難が再燃し,MRIで憩室の再増大を認めたため,外科的治療の方針とした.X+2年2月,経腟的尿道憩室切除術を施行した.憩室口は縫合閉鎖,憩室壁は可及的に切除し,残存する憩室壁内腔を可及的に掻爬した後,尿道周囲筋膜・腟前壁を縫合閉鎖した.周術期合併症を認めず,術後も排尿症状なく経過している.本症例における診断および術式で工夫したポイントを,若干の文献的考察を加え報告する.(著者抄録)

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【ロボット手術の教育方法-それぞれの施設での試み-】岡山大学病院泌尿器科におけるロボット手術教育の現状

小林泰之, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 定平卓也, 枝村康平, 荒木元朗, 渡辺豊彦, 那須保友

Japanese Journal of Endourology 33 ( 2 ) 221 - 224 2020.12

Language：Japanese Publisher：(一社)日本泌尿器内視鏡学会

2009年にダビンチSが薬事承認、2012年にロボット支援下腹腔鏡下前立腺全摘除術が保険収載されて以来、ロボット手術は急激に普及している。岡山大学病院関連施設においても、この数年間でダビンチが急速に普及し、13台(岡山大学病院を含む)のダビンチが稼働し45名の術者が執刀を行っている。しかしながら、各々施設での手術方法、指導方法は全く同じではない。関連施設内での人事異動にともない、岡山大学病院においても、様々な背景を有する術者が在籍するようになり、同一施設内にも関わらず複数の手術方法が乱立した。この状態に当施設のロボット手術教育はうまく対応できず、2015年頃より周術期成績も悪化の傾向を示した。この問題を解決するために、腹腔鏡手術教育にて培った"手術内容を統一し手術内容の再現性を高め、短いラーニングカーブを目指す"というコンセプトを応用し、この状況を乗り越えようと試みている。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J05817&link_issn=&doc_id=20201215380007&doc_link_id=10.11302%2Fjsejje.33.221&url=https%3A%2F%2Fdoi.org%2F10.11302%2Fjsejje.33.221&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Impact of Sarcopenia on Erectile Function after Nerve-Sparing Robot-Assisted Radical Prostatectomy. Reviewed International journal

Yosuke Mitsui, Takuya Sadahira, Yuki Maruyama, Ryota Sato, Acosta Gonzalez Herik Rodrigo, Koichiro Wada, Motoo Araki, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

The world journal of men's health 38 ( 4 ) 673 - 682 2020.11

Language：English Publishing type：Research paper (scientific journal) Publisher：Korean Society for Sexual Medicine and Andrology

PURPOSE: To determine the impact of sarcopenia on erectile functional outcomes after a nerve-sparing (NS) robot-assisted radical prostatectomy (RARP) using patient-reported validated questionnaires. MATERIALS AND METHODS: In this retrospective study, RARP was performed on 841 patients at Okayama University Hospital, of which 132 underwent NS RARP. Erectile functional outcomes were assessed using the 5-item version of the International Index of Erectile Function (IIEF-5) and the Expanded Prostate Cancer Index Composite before and 1, 3, 6, and 12 months after surgery. Automated measurement of skeletal muscle at L3 was achieved using volume analyzer software and normalizing for height (cm²/m²) to calculate skeletal muscle index (SMI). Patients who had an IIEF-5≤4 comprised the group with erectile dysfunction (ED), and those with an IIEF-5≤5 made up the non-ED group. RESULTS: This study enrolled 95 patients of median age 65 years with a preoperative IIEF-5 of 16. There were no significant differences between patients with and without sarcopenia among those with preoperative IIEF-5. Postoperatively, in the ED group, SMI and preoperative IIEF-5 were significantly lower than in the non-ED group. Multiple linear regression analysis revealed that (1) both SMI and preoperative IIEF-5 were independent predictors of ED, and (2) sarcopenia and preoperative IIEF-5 were predictors of ED at 12 months after NS RARP. CONCLUSIONS: Patients with sarcopenia can have worse erectile functional outcomes after NS RARP. Sarcopenia and a lower preoperative IIEF-5 score may be predictive of postoperative ED.

DOI： 10.5534/wjmh.200036

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UTUCに対するKidney-sparing surgeryの現状と課題岡山大学の手技と成績

和田耕一郎, 丸山雄樹, 荒木元朗, 小林泰之, 定平卓也, 高本篤, 佐古智子, 枝村康平, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 SY - 1 2020.11

これから始めるロボット支援下仙骨腟固定術ロボット支援腹腔鏡下仙骨腟固定術の導入に向けて

佐古智子, 岩田健宏, 西村慎吾, 高本篤, 枝村康平, 小林泰之, 荒木元朗, 石井亜矢乃, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 SY - 1 2020.11

腹腔鏡技術認定医実際の教育現場を紹介します! 岡山大学泌尿器科における腹腔鏡教育

小林泰之, 富永悠介, 枝村康平, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 荒木元朗, 渡辺豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 SY - 1 2020.11

当院におけるロボット支援腹腔鏡下腎部分切除術後再発症例の検討

河田達志, 坪井一馬, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 P - 2 2020.11

岡山大学病院におけるBioJetシステムを用いたMRI/US融合下経会陰的前立腺生検の初期

高本篤, 河田達志, 小林泰之, 岩田健宏, 西村慎吾, 佐古智子, 枝村康平, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 O - 1 2020.11

初心者向けの新術式一筆書きHoLEPの提案と教育効果について

富永悠介, 宗田大二郎, 坪井一馬, 岩田健宏, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 O - 4 2020.11

RALP術中にモノポーラーシザースのチップカバーが脱落し、発見が困難であった一例

長尾賢太郎, 宗田大二郎, 岩田健宏, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

日本泌尿器内視鏡学会総会 34回 O - 2 2020.11

Combined Laparoscopic and CT Monitoring of the Ice-Ball Margin during Cryoablation for Renal Cell Carcinoma Associated with von Hippel-Lindau Disease: First Case. Reviewed

Takanori Sekito, Motoo Araki, Takao Hiraki, Mayu Uka, Toshiyuki Komaki, Yusuke Matsui, Toshihiro Iguchi, Satoshi Katayama, Kasumi Yoshinaga, Shogo Watari, Yuki Maruyama, Yosuke Mitsui, Risa Kubota, Takuya Sadahira, Shingo Nishimura, Koichiro Wada, Atsushi Takamoto, Kohei Edamura, Tomoko Sako, Yasuyuki Kobayashi, Toyohiko Watanabe, Susumu Kanazawa, Yasutomo Nasu

Acta medica Okayama 74 ( 5 ) 443 - 448 2020.10

Authorship：Corresponding author Language：English

We report a 47-year-old Japanese female with 10 previous treatments for multiple bilateral renal cell carcinoma (RCC) associated with von Hippel-Lindau disease. The 14-mm right lower pole renal tumor was in contact with the right ureter. Laparoscopic cryoablation was performed to protect the ureter wrapped with gauze. Computed tomography (CT) monitoring was used to confirm the precise ≥ 6 mm ice-ball margin. There was no local progression at 6-months post-surgery. The serum creatinine has been stable. This is apparently the first report of combined laparoscopic and CT monitoring of an ice-ball formation and its margin during cryoablation for RCC.

DOI： 10.18926/AMO/60806

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ハイリスク腎移植game changers DSA陽性ハイリスク腎移植 Invited

西村慎吾, 荒木元朗, 関戸崇了, 吉永香澄, 和田里章悟, 丸山雄樹, 光井洋介, 窪田理沙, 定平卓也, 岩田健宏, 高本篤, 佐古智子, 枝村康平, 和田耕一郎, 小林泰之, 渡邉豊彦, 那須保友

西日本泌尿器科 82 ( 増刊 ) 90 - 90 2020.10

新たなin vivoイメージング技術から明らかになった、タダラフィルによる腎虚血/再灌流後好中球浸潤低下(The novel in vivo imaging techniques for visualizing neutrophil infiltration following renal ischemia/reperfusion which was reduced by tadalafil)

丸山雄樹, 荒木元朗, 城所研吾, 十川裕史, 吉永香澄, 光井洋介, 定平卓也, 和田耕一郎, 渡部昌実, 渡邉豊彦, 柏原直樹, 那須保友

西日本泌尿器科 82 ( 増刊 ) 136 - 136 2020.10

Correlation between lumbar skeletal muscle size and urinary incontinence after radical prostatectomy. Reviewed International journal

Yosuke Mitsui, Takuya Sadahira, Toyohiko Watanabe, Motoo Araki, Yuki Maruyama, Ryota Sato, Acosta Gonzalez Herik Rodrigo, Koichiro Wada, Masami Watanabe, Michael B Chancellor, Yasutomo Nasu

Lower urinary tract symptoms 12 ( 3 ) 245 - 252 2020.9

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

OBJECTIVES: Urinary incontinence is a major concern after radical prostatectomy because it can decrease quality of life. The aim of the present study was to explore the effect of preoperative skeletal muscle on urinary quality of life after robot-assisted radical prostatectomy. METHODS: A total of 762 patients underwent robot-assisted radical prostatectomy. Longitudinal health-related quality of life was evaluated using the Expanded Prostate Cancer Index Composite instrument. The skeletal muscle area at the level of the third lumbar vertebra was assessed preoperatively by computed tomography and was standardized to height to obtain the skeletal muscle index. Reduced skeletal muscle size (RSMS) was defined as a skeletal muscle index ≤ 53 or ≤ 43 cm2 /m2 in patients with a body mass index (BMI) ≥25 or < 25, respectively. RESULTS: A total of 301 patients were included in this study, of whom 91 were classified as having RSMS (30.2%). Non-RSMS patients exhibited better urinary function at 12 months (P = .012) and better urinary continence recovery at 2 weeks and 12 months (P = .033 and P = .014, respectively) after prostatectomy compared with RSMS patients. Univariate and multivariate analyses identified preoperative RSMS as a significant and independent predictor of urinary incontinence (odds ratio = 1.77, P = .028). CONCLUSIONS: Patients with RSMS had a lower urinary quality of life compared with non-RSMS patients after robot-assisted radical prostatectomy, and RSMS, independent of age or BMI, was predictive of postoperative urinary incontinence.

DOI： 10.1111/luts.12312

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Tumor suppressor REIC/Dkk-3 and its interacting protein SGTA inhibit glucocorticoid receptor to nuclear transport. Reviewed International journal

Takehiro Iwata, Takuya Sadahira, Kazuhiko Ochiai, Hideo Ueki, Takanori Sasaki, Peng Haung, Motoo Araki, Toyohiko Watanabe, Yasutomo Nasu, Masami Watanabe

Experimental and therapeutic medicine 20 ( 2 ) 1739 - 1745 2020.8

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

REIC/Dkk-3 is a tumor suppressor, and its expression is significantly downregulated in a variety of human cancer types. A previous study performed yeast two-hybrid screening and identified the small glutamine-rich tetratricopeptide repeat-containing protein α (SGTA), known as a negative modulator of cytoplasmic androgen receptor (AR) signaling, which is a novel interacting partner of REIC/Dkk-3. The previous study also indicated that the REIC/Dkk-3 protein interferes with the dimerization of SGTA and then upregulates the AR transport and signaling in human prostate cancer PC3 cells. Since the transport of some steroid receptors to nucleus is conducted similarly by dynein motor-dependent way, the current study aimed to investigate the role of SGTA and REIC/Dkk-3 in the transport of other glucocorticoid receptors (GR). In vitro reporter assays for the cytoplasmic GR transport were performed in human prostate cancer PC3 cells and 293T cells. As for the SGTA protein, a suppressive effect on the GR transport to the nucleus was observed in the cells. As for the REIC/Dkk-3 protein, an inhibitory effect was observed for the GR transport in PC3 cells. Under the depleted condition of SGTA by short-hairpin (sh)RNA, the downregulation of GR transport by REIC/Dkk-3 was significantly enhanced compared with the non-depleted condition in PC3 cells, suggesting a compensatory role of REIC/Dkk-3 in the SGTA mediated inhibition of GR transport. The current study therefore demonstrated that SGTA inhibited the cytoplasmic transport of GR in 293T and PC3 cells, and REIC/Dkk-3 also inhibited the cytoplasmic transport of GR in PC3 cells. These results may be used to gain novel insight into the GR transport and signaling in normal and cancer cells.

DOI： 10.3892/etm.2020.8819

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Preoperative Use of Alpha-1 Receptor Blockers in Male Patients Undergoing Extracorporeal Shock Wave Lithotripsy for a Ureteral Calculus. Reviewed

Takashi Yoshioka, Kenji Omae, Tatsushi Kawada, Yosuke Inoue, Morito Sugimoto, Tadashi Oeda, Shinya Uehara, Motoo Araki, Shunichi Fukuhara

Acta medica Okayama 74 ( 4 ) 293 - 299 2020.8

Language：English Publishing type：Research paper (scientific journal) Publisher：Okayama University Medical School

In this retrospective single-center cohort study, we investigated the impact of preoperative use of an alpha-1 adrenergic receptor (AR) blocker on the outcome of single-session extracorporeal shock wave lithotripsy (SWL) in 193 male patients who underwent SWL for a single ureteral calculus between 2006 and 2016. We reviewed their medical records to obtain the data on the preoperative use of alpha-1 AR blockers. The primary outcome was treatment success after single-session SWL. We performed a multivariable logistic regression analysis adjusting for clinically important confounders to examine the association between preoperative use of alpha-1 AR blockers and the treatment success of SWL. Among the 193 patients, 15 (7.8%) were taking an alpha-1 AR blocker preoperatively. A multivariable analysis showed that preoperative use of an alpha-1 AR blocker was a significant negative predictor for treatment success of SWL (adjusted odds ratio 0.17; 95% confidence intervals, 0.04-0.74). Our findings suggest that the preoperative use of an alpha-1 AR blocker was a negative predictor of treatment success of SWL in male patients with a single ureteral calculus. Clinicians should pay more attention to the preoperative drug use in determining an appropriate stone therapy modality.

DOI： 10.18926/AMO/60367

Association of Severe Microscopic Hematuria with Successful Conservative Treatment of Single Uncomplicated Ureteral Calculus: A Multicenter Cohort Study. Reviewed International journal

Satoshi Katayama, Takashi Yoshioka, Tomoko Sako, Wataru Murao, Motoo Araki, Toyohiko Watanabe, Tadasu Takenaka

European urology focus 7 ( 4 ) 812 - 817 2020.4

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

BACKGROUND: Although detection of microscopic hematuria is a well-known diagnostic method for urolithiasis, its ability to predict urolithiasis treatment outcomes in adults is unknown. OBJECTIVE: To evaluate the role of microscopic hematuria in conservative treatment of ureteral calculus. DESIGN, SETTING, AND PARTICIPANTS: This cohort study involved 482 patients who were diagnosed with a single uncomplicated ureteral calculus (≤10 mm) using computed tomography and underwent conservative therapy at two Japanese community hospitals between 2013 and 2018. Patients were divided into three groups according to the severity of microscopic hematuria (no, ≤4; mild to moderate, 5-99; and severe, ≥100 red blood cells per high-power field) and as determined during the first emergency department or urologic outpatient clinic visit. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: A multivariate logistic regression analysis was performed to estimate the odds ratio for successful conservative therapy at 28 d after the diagnosis. Statistical significance was set at p < 0.05. RESULTS AND LIMITATIONS: Of the 482 patients, 81 (16.8%), 209 (43.4%), and 192 (39.8%) had no, mild to moderate, and severe microscopic hematuria, respectively. After adjustments for six relevant confounders, severe microscopic hematuria showed a significant association with successful conservative therapy at 28 d (adjusted odds ratio, 1.91; 95% confidence interval, 1.02-3.57; p = 0.043), whereas mild to moderate microscopic hematuria did not (adjusted odds ratio, 1.05; 95% confidence interval, 0.57-1.93; p = 0.872) when compared with no microscopic hematuria. CONCLUSIONS: Severe microscopic hematuria was significantly associated with successful conservative therapy for single uncomplicated ureteral calculus. PATIENT SUMMARY: Microscopic hematuria might have predictive value for conservative treatment of a single uncomplicated ureteral calculus. Using the presence or absence of blood in urine and other predictive factors, clinicians may lead patients with a single uncomplicated ureteral calculus to successful conservative therapy.

DOI： 10.1016/j.euf.2020.04.004

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Clinical experience with pembrolizumab in the treatment of advanced urothelial cancer

Yusuke Tominaga, Atsushi Takamoto, Takanori Sekito, Syogo Watari, Yuko Oiwa, Risa Kubota, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Tomoko Sako, Koichiro Wada, Kohei Edamura, Yasuyuki Kobayashi, Motoo Araki, Toyohiko Watanabe, Yasutomo Nasu

Nishinihon Journal of Urology 82 ( 1 ) 106 - 110 2020.4

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The West Japan Urological Association

[Introduction and objective) Pembrolizumab, a programmed death one checkpoint inhibitor, was approved as second-line treatment of advanced urothelial cancer (UC). We performed a pilot study to investigate the effect of pembrolizumab. [Methods and patients) 19 patients who were treated with pembrolizumab from April 2018 to July 2019 were retrospectively reviewed and analyzed to evaluate efficacy and safety. Pembrolizumab was administered after platinum-based chemotherapy. [Results) The median age was 68 years old
male-to-female ratio was 14:5
primary lesions were upper urinary tract, bladder and others (10, 7 and 2, respectively)
recurrence lesions were lymph nodes, lung, bone and liver (14, 9, 4 and 2, respectively). The median number of cycles was three courses (range, 1-16). The objective response rate, median progression-free survival period (PFS), and median overall survival period (OS) were 24%, 2.7 months and 9.1 months, respectively. Pembrolizumab showed a long-term effect for all responsive cases until the end of the follow-up period. Immune-related adverse events (irAE) were observed in four patients. Neutrophil-to-lymphocyte ratio was negatively correlated with PFS, but not significantly correlated with OS. [Conclusion) Pembrolizumab demonstrated a comparable efficacy and safety profile in the treatment of advanced UC. In particular, responsive cases showed a durable response. Further investigation is required to identify predictive markers that can be routinely used in clinical practice.

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Factors predicting pathological upgrading after prostatectomy in patients with Gleason grade group 1 prostate cancer based on opinion-matched biopsy specimens. Reviewed International journal

Yuki Maruyama, Takuya Sadahira, Motoo Araki, Yosuke Mitsui, Koichiro Wada, Acosta Gonzalez Herik Rodrigo, Kazuaki Munetomo, Yasuyuki Kobayashi, Masami Watanabe, Hiroyuki Yanai, Toyohiko Watanabe, Yasutomo Nasu

Molecular and clinical oncology 12 ( 4 ) 384 - 389 2020.4

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

The present study investigated the concordance between Gleason scores assigned to prostate biopsy specimens by outside pathologists and a urological pathology expert, and determined the risk of upgrading between opinion-matched Gleason grade group (GGG) 1 biopsy specimens and radical prostatectomy specimens. Between January 2012 and May 2018, 733 patients underwent robot-assisted radical prostatectomy. Patients whose original biopsy specimens from outside hospitals were reviewed by a urological pathology expert Okayama University Hospital were included. Patients who had received neoadjuvant hormonal therapy were excluded. Logistic regression analysis was used to identify predictors of upgrading among GGG 1 diagnoses. A total of 403 patients were included in the present study. Agreement in GGG between initial and second-opinion diagnoses was present in 256 cases (63.5%). Although opinion-matched cases improved concordance between biopsy and prostatectomy specimen GGG compared with single-opinion cases (initial, 35.2%; second-opinion, 36.5%; matched, 41.4%), 71% (56/79) of cases classified as GGG 1 were upgraded after prostatectomy. Multivariate analysis revealed that prostate-specific antigen density and Prostate Imaging Reporting and Data System version 2 score were significant predictors of upgrading (odds ratio, 1.10; P=0.01; and odds ratio, 1.88; P=0.03, respectively). In conclusion, the GGG concordance rate between needle-core biopsy and radical prostatectomy specimens was higher in opinion-matched cases; however, 71% of opinion-matched GGG1 cases were upgraded after robot-assisted radical prostatectomy. Urologists should propose treatment strategies or further biopsy rather than active surveillance for patients with GGG1 and a high PSAD and/or PI-RADS score.

DOI： 10.3892/mco.2020.1996

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Quality of Life and Mental Satisfaction Improve Slowly in Preemptive Kidney Transplantation Compared With Nonpreemptive Kidney Transplantation. Reviewed International journal

Yosuke Mitsui, Motoo Araki, Yuki Maruyama, Kasumi Yoshinaga, Takuya Sadahira, Koichiro Wada, Katsuyuki Tanabe, Masashi Kitagawa, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Transplantation proceedings 52 ( 3 ) 740 - 747 2020.4

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

BACKGROUND AND AIMS: Preemptive kidney transplantation (PEKT) is recognized as the best therapy to avoid dialysis. However, it is not clear whether PEKT recipients experience an improvement in quality of life (QoL) after kidney transplantation (KT) that exceeds that of non-PEKT recipients, since PEKT recipients have not experienced the heavy burden of dialysis. The aim of this study was to compare the changes in QoL for PEKT and non-PEKT recipients following transplantation. METHODS: Patients included in this study underwent living donor KT in our hospital. We excluded patients with incomplete SF-36 scores and with factors that could affect QoL, such as complications or rejection. QoL was assessed by the Short Form 36-Item Health Survey version 2.0 preoperatively and 3 and 12 months postoperatively. RESULTS: Eighty-eight patients underwent living donor KT in our hospital. Twelve PEKT and 20 non-PEKT recipients were enrolled in this retrospective study. In the non-PEKT group, both the physical and mental domain scores dramatically improved from baseline at 3 months, and remained at a similar level at 12 months. In contrast, in the PEKT group, only 1 domain of the physical and mental score improved at 3 months, and the social functioning score gradually improved at 12 months. Although the mental component score showed significant improvement in the non-PEKT group, it did not change in the PEKT group. CONCLUSIONS: The improvement of QoL after transplantation is more evident in the non-PEKT group. PEKT recipients have less mental satisfaction than non-PEKT recipients.

DOI： 10.1016/j.transproceed.2020.01.042

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