Faculty Profiles - MIYOSHI Kentaroh

Papers - MIYOSHI Kentaroh

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臨床的N0・病理学的リンパ節転移陽性肺がんに対する肺切除の現状

諏澤憲, 三好健太郎, 大谷真二, 山本寛斉, 岡崎幹生, 杉本誠一郎, 山根正修, 大藤剛宏, 豊岡伸一

日本呼吸器外科学会雑誌 34 ( 3 ) O3 - 1 2020.8

Lung perfusion scintigraphy to detect chronic lung allograft dysfunction after living-donor lobar lung transplantation Reviewed

Yamamoto H

Sci Rep. 2020 Jun 29;10(1):10595. doi: 10.1038/s41598-020-67433-4. 2020.6

Lung perfusion scintigraphy to detect chronic lung allograft dysfunction after living-donor lobar lung transplantation. Reviewed International journal

Haruchika Yamamoto, Seiichiro Sugimoto, Takeshi Kurosaki, Kentaroh Miyoshi, Shinji Otani, Mikio Okazaki, Masaomi Yamane, Takahiro Oto, Shinichi Toyooka

Scientific reports 10 ( 1 ) 10595 - 10595 2020.6

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

Because chronic lung allograft dysfunction (CLAD) develops predominantly on one side after bilateral living-donor lobar lung transplantation (LDLLT), lung perfusion scintigraphy (Q-scinti) was expected to show a perfusion shift to the contralateral unaffected lung with the development of CLAD. Our study examined the potential usefulness of Q-scinti in the diagnosis of CLAD after bilateral LDLLT. We conducted a single-center retrospective cohort study of 58 recipients of bilateral LDLLT. The unilateral shift values on Q-scinti were calculated and compared between the CLAD group (N = 27) and the non-CLAD group (N = 31) from 5 years before to 5 years after the diagnosis of CLAD. The unilateral shift values in Q-scinti were significantly higher in the CLAD group than in the non-CLAD group from 5 years before the diagnosis of CLAD to 5 years after the diagnosis (P < 0.05). The unilateral shift values in Q-scinti were significantly correlated with the percent baseline values of the forced expiratory volume in 1 s (P = 0.0037), the total lung capacity (P = 0.0028), and the forced vital capacity (P = 0.00024) at the diagnosis of CLAD. In patients developing unilateral CLAD after bilateral LDLLT, Q-scinti showed a unilateral perfusion shift to the contralateral unaffected lung. Thus, Q-scinti appears to have the potential to predict unilateral CLAD after bilateral LDLLT.

DOI： 10.1038/s41598-020-67433-4

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Warm retrograde perfusion can remove more fat from lung grafts with fat embolism in a porcine model Reviewed

Irie M

Gen Thorac Cardiovasc Surg. 2020 Apr;68(4):363-369. doi: 10.1007/s11748-019-01245-w. Epub 2019 Nov 12. 2020.4

Plasma micro-RNA Levels are Associated with the Development of Chronic Lung Allograft Dysfunction after Bilateral Living-Donor and Cadaveric Lung Transplantation

T. Shiotani, S. Sugimoto, H. Yamamoto, D. Shimizu, K. Miyoshi, S. Otani, M. Okazaki, M. Yamane, T. Oto, S. Toyooka

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 39 ( 4 ) S194 2020.4

Publishing type：Research paper (scientific journal)

Copyright © 2020. Published by Elsevier Inc. PURPOSE: Micro-RNAs (miRNAs) regulate genes by selectively silencing their target messenger RNAs. Recently, serum levels of miRNA related to pulmonary fibrosis (miR-21 and miR-155), have been shown to be associated with the development of chronic lung allograft dysfunction (CLAD) after cadaveric lung transplantation (CLT). We investigated the relationship between miRNAs levels and CLAD after bilateral living-donor lobar lung transplantation (LDLLT) and CLT. METHODS: Blood samples were collected from a total of 70 patients who underwent bilateral LDLLT (n=39) and bilateral CLT (n=31), including patients with CLAD (the CLAD group, n=25) and those without CLAD (the non-CLAD group, n=45). Plasma miRNA levels (miR-21 and miR-155) were quantified using real-time PCR and compared between the two groups. The relationship between miRNA levels and the results of pulmonary function tests at the onset of CLAD was assessed. Appropriate cut-off values of miRNA levels were set for the diagnosis of CLAD. RESULTS: The median follow-up period was 3074 (1071-7523) days. Plasma miRNA levels of the CLAD group were significantly higher than those of the non-CLAD group (miR-21, P<0.001; miR-155, P=0.013) (Fig. 1). In the CLAD group, miRNA levels after LDLLT were comparable to those after CLT. Moreover, miRNA levels were significantly negatively correlated with the baseline values of forced expiratory volume in 1 second (FEV1) (miR-21, P<0.001; miR-155, P=0.039) and those of total lung cavity (TLC) (miR-21, P<0.001; miR-155, P=0.0012) (Fig. 2). An ROC analysis of the performance of miR-21 level as a marker of CLAD yielded an AUC of 0.94 at a threshold level of 6.51. Patients with miR-21 level≥6.51 showed significantly better CLAD-free survival than those with miR-21 level<6.51 (P<0.001) (Fig. 3). CONCLUSION: Plasma miRNA levels are associated with the development of CLAD after bilateral LDLLT and CLT, and might be a potential biomarker for the diagnosis of CLAD.

DOI： 10.1016/j.healun.2020.01.792

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Prognostic Nutritional Index Negatively Correlates with Lung Allocation Score and Predicts Survival after Both Cadaveric and Living-Donor Lobar Lung Transplantation

H. Yamamoto, S. Sugimoto, T. Shiotani, K. Miyoshi, S. Otani, M. Okazaki, M. Yamane, T. Oto, S. Toyooka

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 39 ( 4 ) S311 2020.4

Publishing type：Research paper (scientific journal)

Copyright © 2020. Published by Elsevier Inc. PURPOSE: The preoperative nutritional status affects the clinical outcome of surgery. To predict the clinical outcome, a prognostic nutritional index (PNI) calculated using serum albumin levels (ALB) and total lymphocyte count (TLC) has been shown to be valuable in various fields of surgery. In this study, we investigated the relationship between PNI and lung allocation score (LAS) as well as the impact of PNI on outcomes of lung transplantation (LT), including cadaveric lung transplantation (CLT) and living-donor lobar lung transplantation (LDLLT). METHODS: Between June 2003 and August 2016, a total of 127 patients underwent LT at Okayama University Hospital, including 71 recipients of CLT and 56 recipients of LDLLT. The PNI was calculated by the following equation: PNI = (10 × ALB(g/dl)+(0.005 × TLC(/mm3)). The overall survival was evaluated by univariate analysis (the log rank test) and multivariate analysis (the Cox proportional hazard regression model) using preoperative factors, including sex, age, BMI, diagnosis, oxygen concentration, mechanical ventilation, tracheostomy, ECMO support, use of glucocorticoids, serum creatinine level, diabetes mellitus, LAS, and PNI. RESULTS: PNI was significantly negatively correlated with LAS (r=-0.3, P=0.00062) (Fig. 1A). The univariate analysis revealed that the overall survival was significantly worse in the patients with age>28 (P=0.047), BMI<24.2 (P=0.0098), LAS>58.04 (P=0.000072), PNI<46.35 (P=0.018) (Fig. 1B). The multivariate analysis demonstrated that age (P=0.00093), BMI (P=0.0024), and PNI (P=0.0047) were independent prognostic factors of worse outcome. In the subgroup analysis, low PNI is a significant prognostic factor of worse survival after CLT (P=0.015) (Fig. 1C) and LDLLT (P=0.041) (Fig. 1D). CONCLUSION: Preoperative nutritional evaluation using PNI could contribute to the assessment of LT recipient's severity and predict survival after both CLT and LDLLT.

DOI： 10.1016/j.healun.2020.01.700

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Right single lung transplantation using an inverted left donor lung: interposition of pericardial conduit for pulmonary venous anastomosis - a case report Reviewed

Yamamoto H

BMC Pulm Med. 2020 Feb 19;20(1):46. doi: 10.1186/s12890-020-1075-4. 2020.2

Favorable survival even with high disease-specific complication rates in lymphangioleiomyomatosis after lung transplantation-long-term follow-up of a Japanese center Reviewed

Kurosaki T

Clin Respir J. 2020 Feb;14(2):116-123. doi: 10.1111/crj.13108. Epub 2019 Nov 28. 2020.2

Negative impact of recipient SPRED2 deficiency on transplanted lung in a mouse model. Reviewed International journal

Kohei Hashimoto, Masaomi Yamane, Seiichiro Sugimoto, Yutaka Hirano, Takeshi Kurosaki, Shinji Otani, Kentaroh Miyoshi, Toshiaki Ohara, Mikio Okazaki, Teizo Yoshimura, Takahiro Oto, Akihiro Matsukawa, Shinichi Toyooka

Transplant immunology 57 101242 - 101242 2019.12

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

Ischemia-reperfusion injury (IRI) after lung transplantation mainly contributes to the development of primary graft dysfunction. The Sprouty-related EVH1-domain-containing (SPRED) protein family inhibits the mitogen activated protein kinase/extracellular-signal-regulated kinase (MAPK/ERK) pathway. Our study was aimed at examining the role of SPRED2 in IRI in mice that received orthotopic lung transplantation. Syngeneic mouse lung transplantation was performed in wild-type C57BL/6 J (WT) mice and Spred2 knockout (Spred2-/-) mice on the C57BL/6 J background from the WT donor. Four hours after reperfusion, blood gas analysis was performed, and lung grafts were sacrificed and analyzed. By using arterial oxygen tension measurements and histological evaluation using Lung Injury Score, we revealed more severe IRI in the grafts transplanted to Spred2-/- recipients, which manifested as exacerbated airway epithelial cell damage, interstitial edema with hemorrhage and neutrophil infiltration. Intragraft ERK1/2 activation and expression levels of proinflammatory cytokines and chemokines in Spred2-/- recipients were higher than those in WT recipients. SPRED2 plays an important role in protecting the lungs from IRI in lung transplantation recipients. We suggest that focused treatments suppressing the activity of the MAPK/ERK pathway in transplantation recipients could be the potential therapeutic option for the prevention of lung IRI.

DOI： 10.1016/j.trim.2019.101242

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腹臥位による後方アプローチ併用ロボット支援下ダンベル型神経鞘腫摘出術

岡崎幹生, 諏澤憲, 塩谷俊雄, 三好健太郎, 大谷真二, 山本寛斉, 杉本誠一郎, 山根正修, 大藤剛宏, 豊岡伸一

肺癌 59 ( 6 ) 745 - 745 2019.11

サルベージ治療・オリゴ再発に対する局所治療戦略術前化学放射線療法後手術を行った局所進行肺癌術後再発症例の臨床経過

諏澤憲, 枝園和彦, 三好健太郎, 大谷真二, 山本寛斉, 岡崎幹生, 杉本誠一郎, 山根正修, 大藤剛宏, 豊岡伸一

肺癌 59 ( 6 ) 586 - 586 2019.11

Bリンパ球過形成を伴う小結節性胸腺腫瘍の1切除例

上山廉起, 岡崎幹生, 塩谷俊雄, 諏澤憲, 三好健太郎, 大谷真二, 山本寛斉, 杉本誠一郎, 山根正修, 大藤剛宏, 豊岡伸一

肺癌 59 ( 6 ) 923 - 923 2019.11

頭頸部癌治療歴を有する非小細胞肺がん患者に対する手術症例の検討

高津史明, 諏澤憲, 枝園和彦, 三好健太郎, 大谷真二, 山本寛斉, 岡崎幹生, 杉本誠一郎, 山根正修, 大藤剛宏, 豊岡伸一

肺癌 59 ( 6 ) 711 - 711 2019.11

SPECT/CTを用いて切除範囲を評価した左肺底動脈大動脈起始症の1例

山本諒, 杉本誠一郎, 中田憲太郎, 塩谷俊雄, 三好健太郎, 大谷真二, 山本寛斉, 岡崎幹生, 山根正修, 大藤剛宏, 豊岡伸一, 末澤孝徳

肺癌 59 ( 5 ) 509 - 509 2019.10

肺移植後移植片慢性機能不全の予防と治療-本邦における肺移植開始後20年での現状- 肺移植後移植片慢性機能不全(CLAD)における血中micro-RNA発現量の検討 Reviewed

塩谷俊雄, 杉本誠一郎, 松原慧, 山本治慎, 二萬英斗, 三好健太郎, 大谷真二, 岡崎幹生, 山根正修, 大藤剛宏, 豊岡伸一

移植 54 ( 総会臨時 ) 189 - 189 2019.9

生体・脳死肺移植における予後予測因子としてのPrognostic Nutrition Index(PNI)の有用性 Reviewed

山本治慎, 杉本誠一郎, 塩谷俊雄, 三好健太郎, 大谷真二, 岡崎幹生, 山根正修, 大藤剛宏, 豊岡伸一

移植 54 ( 総会臨時 ) 215 - 215 2019.9

ドナー胸腔内所見により再斡旋によるレシピエント変更後に肺移植を行った1例 Reviewed

松原慧, 大谷真二, 山本治慎, 塩谷俊雄, 難波圭, 二萬英斗, 諏澤憲, 三好健太郎, 山本寛斉, 岡崎幹生, 杉本誠一郎, 山根正修, 大藤剛宏, 豊岡伸一

移植 54 ( 総会臨時 ) 315 - 315 2019.9

ハイリスク症例に対する肺移植高度の胸膜癒着を認めたレシピエントに対する肺移植 Reviewed

杉本誠一郎, 塩谷俊雄, 山本治慎, 大河知世, 三好健太郎, 大谷真二, 岡崎幹生, 山根正修, 大藤剛宏, 豊岡伸一

移植 54 ( 総会臨時 ) 174 - 174 2019.9

Lung transplantation via cardiopulmonary bypass: excellent survival outcomes from extended criteria donors. Reviewed

Hirosh Taka, Kentaroh Miyoshi, Takeshi Kurosaki, Takuma Douguchi, Hideshi Itoh, Seiichiro Sugimoto, Masaomi Yamane, Motomu Kobayashi, Shingo Kasahara, Takahiro Oto

General thoracic and cardiovascular surgery 67 ( 7 ) 624 - 632 2019.7

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

OBJECTIVES: The role of intraoperative cardiopulmonary bypass (CPB) in lung transplant (LTx) surgery is controversial. CPB enables slow pulmonary reperfusion and initial ventilation with low oxygen concentrations, both theoretically protective of transplanted lungs. In this study, we explored clinical outcomes following extended criteria donor LTx surgery implementing a thoroughly protective allograft reperfusion strategy using CPB. METHODS: Thirty-nine consecutive adult patients who underwent bilateral LTx with elective CPB and protective allograft reperfusion were reviewed. Bilaterally implanted lungs were reperfused simultaneously, via slow CPB flow reduction and initial ventilation with 21% oxygen and nitric oxide, followed by a brief modified ultrafiltration. During weaning from CPB, mean pulmonary arterial pressure was strictly maintained at 10-15 mmHg by controlling CPB and pulmonary flow. The clinical outcomes in 23 patients who received lungs from extended criteria donors (ECD group) were elucidated and compared to 16 patients undergoing LTx from standard criteria donors (SCD group). RESULTS: No life-threatening deterioration was observed to graft functionality during the first 72 h after LTx in the ECD group; however, only one patient required post-transplant extracorporeal membrane oxygenation. In three of 23 ECD LTx patients (12%), surgical revision for bleeding was required. Survival outcomes for the ECD group were favorable, with 100% survival at 6-months, 87.0% at 1-year, and 80.7% at 5-years. Outcomes in the ECD group were comparable to those in the SCD group. CONCLUSIONS: Despite a certain extent of risk associated with full-dose heparinization, use of CPB does not undermine survival outcomes after ECD LTx surgery if protective allograft reperfusion is securely performed.

DOI： 10.1007/s11748-019-01067-w

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Lung transplant candidates with idiopathic pulmonary fibrosis and long-term pirfenidone therapy: Treatment feasibility influences waitlist survival. Reviewed International journal

Shin Tanaka, Kentaroh Miyoshi, Hisao Higo, Takeshi Kurosaki, Shinji Otani, Seiichiro Sugimoto, Masaomi Yamane, Katsuyuki Kiura, Shinichi Toyooka, Takahiro Oto

Respiratory investigation 57 ( 2 ) 165 - 171 2019.3

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

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a chronically progressive lung disease with exceptionally poor prognosis. While lung transplantation (LTx) is considered the last-resort therapeutic option, dismal waitlist mortality still hampers the salvage of patients with IPF. Pirfenidone, originally designed for IPF treatment, has increasingly been utilized. This study aimed to evaluate whether Pirfenidone could influence outcomes of patients with IPF on the Japanese LTx waitlist. METHODS: This retrospective single-center cohort study included 25 consecutive patients with IPF who were registered as LTx candidates at our institution between July 1999 and August 2016. Patients with a history of pretransplant Pirfenidone therapy (Pirfenidone group) were compared with those with no history (non-Pirfenidone group). RESULTS: In total, 6 (24%) patients received Pirfenidone as pretransplant therapy for 45.2 (range, 18.6-66.8) months. During the treatment period, the Pirfenidone group achieved a significant reduction in the decline rate of the forced vital capacity (-6.2% vs. -0.3%, p = 0.04) and a lower lung allocation score (31 vs. 41, p = 0.013) compared with the non-Pirfenidone group. The Pirfenidone group exhibited 100% waitlist survival three years after registration that was comparable to other indications, and 66% of the patients were still alive at the time of organ availability. No patient in the Pirfenidone group developed Pirfenidone-related surgical complications postoperatively. CONCLUSIONS: Patients with IPF successfully managed with long-term Pirfenidone therapy achieved favorable outcomes after LTx registration, comparable to other patients with LTx indications. The tolerability to antifibrotic therapy can be a predictor of waitlist survival.

DOI： 10.1016/j.resinv.2018.12.002

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