Faculty Profiles - MIYOSHI Kentaroh

Papers - MIYOSHI Kentaroh

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ASO Visual Abstract: Prognostic Impact of Tumor-Infiltrating Lymphocytes, Tertiary Lymphoid Structures, and Neutrophil-to-Lymphocyte Ratio in Pulmonary Metastases from Uterine Leiomyosarcoma. Reviewed International journal

Naoki Matsuda, Hiromasa Yamamoto, Tomohiro Habu, Kazuma Iwata, Kei Matsubara, Shin Tanaka, Kohei Hashimoto, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Tomohiro Toji, Mikio Okazaki, Seiichiro Sugimoto, Katsuhito Takahashi, Shinichi Toyooka

Annals of surgical oncology 2023.9

Successful management of temporary veno-venous extracorporeal membrane oxygenation for a pediatric lung transplant recipient with bronchiolitis obliterans syndrome awaiting lung re-transplantation: a case report. Reviewed International journal

Yasuaki Tomioka, Kentaroh Miyoshi, Shin Tanaka, Seiichiro Sugimoto, Rie Kanai, Tetsuro Nikai, Shinichi Toyooka, Masaomi Yamane

Surgical case reports 9 ( 1 ) 163 - 163 2023.9

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

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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Prognostic Impact of Tumor-Infiltrating Lymphocytes, Tertiary Lymphoid Structures, and Neutrophil-to-Lymphocyte Ratio in Pulmonary Metastases from Uterine Leiomyosarcoma. Reviewed International journal

Annals of surgical oncology 2023.9

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

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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生体肺移植後の慢性腎臓病に対して生体腎移植を施行した2例

柳光剛志, 杉本誠一郎, 調枝治樹, 田中真, 橋本好平, 枝園和彦, 諏澤憲, 三好健太郎, 山本寛斉, 岡崎幹生, 石原恵, 豊岡伸一

移植 58 ( 総会臨時 ) 298 - 298 2023.9

Miracle Recovery Case 肺移植待機中の重度の心原性ショックに対してECMO+IMPELLAによる循環補助で救命し、回復期に肺移植を施行した症例

田中真, 石上恵美, 石原恵, 調枝治樹, 橋本好平, 枝園和彦, 諏澤憲, 三好健太郎, 山本寛斎, 岡崎幹生, 杉本誠一郎, 豊岡伸一

移植 58 ( 総会臨時 ) 135 - 135 2023.9

Pushing the Border!攻めの肺移植 DQ-DSA陽性生体肺移植レシピエントに対する両側脳死再肺移植

三好健太郎, 調枝治樹, 富岡泰章, 石原恵, 田中真, 杉本誠一郎, 山根正修, 久保友次郎, 川名伸一, 清水大, 松原慧, 橋本好平, 岡崎幹生, 豊岡伸一

移植 58 ( 総会臨時 ) 148 - 148 2023.9

Restrictive allograft dysfunction rather than bronchiolitis obliterans syndrome had a major impact on the overall survival after living-donor lobar lung transplantation. Reviewed

Kei Matsubara, Shinji Otani, Haruchika Yamamoto, Kohei Hashimoto, Shin Tanaka, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Hiromasa Yamamoto, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka

Surgery today 2023.7

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

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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Elderly lung transplant recipients show acceptable long-term outcomes for lung transplantation: A propensity score-matched analysis. Reviewed

Yasuaki Tomioka, Shin Tanaka, Shinji Otani, Toshio Shiotani, Haruchika Yamamoto, Kentaroh Miyoshi, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka

Surgery today 2023.6

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

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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Identification of genetic loci associated with renal dysfunction after lung transplantation using an ethnic-specific single-nucleotide polymorphism array. Reviewed International journal

Yasuaki Tomioka, Seiichiro Sugimoto, Haruchika Yamamoto, Shuta Tomida, Toshio Shiotani, Shin Tanaka, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Shinji Otani, Hiromasa Yamamoto, Mikio Okazaki, Masaomi Yamane, Shinichi Toyooka

Scientific reports 13 ( 1 ) 8912 - 8912 2023.6

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

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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Pulmonary alveolar proteinosis after lung transplantation: Two case reports and literature review. Reviewed International journal

Shinichi Kawana, Kentaroh Miyoshi, Shin Tanaka, Seiichiro Sugimoto, Dai Shimizu, Kei Matsubara, Mikio Okazaki, Noboru Hattori, Shinichi Toyooka

Respirology case reports 11 ( 6 ) e01160 2023.6

Authorship：Corresponding author Language：English

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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Endobronchial Metastasis with Bloody Sputum 20 Years after Complete Resection of type A Non-Invasive Thymoma. Reviewed

Mototsugu Watanabe, Hiromasa Yamamoto, Kentaroh Miyoshi, Seiichiro Sugimoto, Shinichi Toyooka

Acta medica Okayama 77 ( 3 ) 331 - 334 2023.6

Language：English

Masaoka stage I type A thymomas rarely recur. We report the case of an 82-year-old man who developed endobronchial metastasis after thymothymectomy for Masaoka stage I type A thymoma. Twenty years after surgery, the patient developed bloody sputum, and chest computed tomography revealed a neoplasm obstructing the right upper lobe bronchus of the lung with enlarged mediastinal lymph nodes. He underwent right upper lobectomy and mediastinal lymph node dissection. Although preoperative pathological diagnosis was squamous cell carcinoma of the lung, postoperative histopathology revealed endobronchial metastasis of the thymoma. Nine years later, at age 89, the patient is alive and well.

DOI： 10.18926/AMO/65503

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術後46年で胸膜播種再発をきたした無巨核球性血小板減少を伴う赤芽球癆と重症筋無力症合併胸腺腫の一切除例

梅田将志, 諏澤憲, 田中真, 橋本好平, 枝園和彦, 三好健太郎, 山本寛斉, 岡崎幹生, 杉本誠一郎, 豊岡伸一

日本呼吸器外科学会雑誌 37 ( 3 ) P69 - 3 2023.6

肺虚血再灌流障害に対する高ヒスチジン糖タンパク質(HRG)補充療法の有用性

久保友次郎, 杉本誠一郎, 調枝治樹, 氏家裕征, 川名伸一, 清水大, 松原慧, 橋本好平, 田中真, 枝園和彦, 諏澤憲, 三好健太郎, 山本寛斉, 岡崎幹生, 豊岡伸一

日本呼吸器外科学会雑誌 37 ( 3 ) O19 - 2 2023.6

多発肋骨骨折に対する金属ワイヤ固定の工夫 Twisted wire splint法

柳光剛志, 三好健太郎, 松原慧, 橋本好平, 田中真, 枝園和彦, 諏澤憲, 山本寛斉, 岡崎幹生, 杉本誠一郎, 豊岡伸一

日本呼吸器外科学会雑誌 37 ( 3 ) P30 - 3 2023.6

椎体浸潤を伴う非小細胞肺癌に対する術前導入化学放射線療法後手術症例の治療成績の検討

林直宏, 山本寛斉, 橋本好平, 田中真, 枝園和彦, 諏澤憲, 三好健太郎, 岡崎幹生, 杉本誠一郎, 豊岡伸一

日本呼吸器外科学会雑誌 37 ( 3 ) O8 - 2 2023.6

子宮肉腫肺転移における腫瘍浸潤リンパ球・三次リンパ様構造・末梢血好中球リンパ球比の検討

山本寛斉, 松田直樹, 橋本好平, 田中真, 枝園和彦, 諏澤憲, 三好健太郎, 岡崎幹生, 杉本誠一郎, 豊岡伸一

日本呼吸器外科学会雑誌 37 ( 3 ) O14 - 7 2023.6

肺移植レシピエントにおけるSARS-CoV-2ワクチン追加接種の有効性の検討

川名伸一, 杉本誠一郎, 松原慧, 田中真, 三好健太郎, 調枝治樹, 氏家裕征, 久保友次郎, 清水大, 橋本好平, 枝園和彦, 諏澤憲, 山本寛斉, 岡崎幹生, 豊岡伸一

日本呼吸器外科学会雑誌 37 ( 3 ) O17 - 2 2023.6

67歳の間質性肺炎に対する両側生体肺移植の経験

調枝治樹, 杉本誠一郎, 田中真, 氏家裕征, 松原慧, 橋本好平, 枝園和彦, 諏澤憲, 三好健太郎, 山本寛斉, 岡崎幹生, 豊岡伸一

日本呼吸器外科学会雑誌 37 ( 3 ) O18 - 2 2023.6

慢性移植肺機能不全(CLAD)に対する再肺移植の術式と長期成績

杉本誠一郎, 調枝治樹, 氏家裕征, 川名伸一, 久保友次郎, 松原慧, 田中真, 橋本好平, 諏澤憲, 枝園和彦, 三好健太郎, 山本寛斉, 岡崎幹生, 豊岡伸一

日本呼吸器外科学会雑誌 37 ( 3 ) O18 - 4 2023.6

The impact of prognostic nutrition index on the waitlist mortality of lung transplantation. Reviewed

Kei Matsubara, Shinji Otani, Haruchika Yamamoto, Yasuaki Tomioka, Toshio Shiotani, Kentaroh Miyoshi, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka

General thoracic and cardiovascular surgery 71 ( 5 ) 306 - 312 2023.5

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

OBJECTIVE: The prognostic nutrition index (PNI), calculated using serum albumin and total lymphocyte count, is a recent topical index related to inflammation. Preoperative PNI is regarded as a new preoperative prognostic score in lung transplantation (LTx). This study aimed to investigate the impact of PNI at the time of registration as a prognostic parameter of mortality on the waiting list for LTx. METHODS: A retrospective review was conducted on the data of 132 adult patients registered for LTx in our department between January 2013 and June 2020. Patients who finally received LTx were analyzed as censored data. The overall survival was evaluated using the Kaplan-Meier method for pre-registered clinical factors including the PNI at the time of registration. Overall survival was calculated from the date of listing to the Japan Organ Transplant Network to the date of death. RESULTS: The low-PNI group had a significantly worse prognosis. Multivariate analysis demonstrated that age (p = 0.023), idiopathic interstitial pneumonia (p < 0.001), lung allocation score (LAS) (p < 0.001), and PNI (p < 0.001) were independent prognostic factors for waitlist mortality. CONCLUSIONS: PNI at the time of registration can be an independent prognostic parameter in registered candidates for LTx.

DOI： 10.1007/s11748-022-01895-3

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Papers - MIYOSHI Kentaroh