Faculty Profiles - MIYOSHI Kentaroh

Papers - MIYOSHI Kentaroh

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Novel pulmonary abdominal normothermic regional perfusion circuit for simultaneous in-donor evaluation and preservation of lungs and abdominal organs in donation after circulatory death.

Shin Tanaka, Masashi Umeda, Hiroyuki Ujike, Tsuyoshi Ryuko, Yasuaki Tomioka, Kentaroh Miyoshi, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka

General thoracic and cardiovascular surgery 2025.3

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

OBJECTIVE: To overcome limitations of traditional ex vivo lung perfusion (EVLP) for controlled donation after circulatory death (cDCD) lungs, this study aimed to evaluate a novel pulmonary abdominal normothermic regional perfusion (PANRP) technique, which we uniquely designed, for in situ assessment of lungs from cDCD donors. METHODS: We modified the abdominal normothermic regional perfusion circuit for simultaneous lung and abdominal organ assessment using independent extracorporeal membrane oxygenation components. Blood was oxygenated via a membrane oxygenator and returned to the body, with pulmonary flow adjusted to maintain pressure < 25 mmHg. Femoral cannulation was performed, and the lungs were ventilated with standard settings. Organ function was assessed over 2 h using PaO2/FiO2, AST, ALT, BUN, and Cr measurements to monitor perfusion and oxygen delivery. RESULTS: PANRP maintained stable lung function, with P/F ratios above 300, and preserved abdominal organ parameters, including stable AST, ALT, BUN, and Cr levels. Adequate urine output was observed, indicating normal renal function. Pulmonary artery pressure remained < 20 mmHg, and pulmonary vascular resistance was kept at 400 dyn・s/cm5, showing no signs of lung dysfunction or injury throughout the circuit. CONCLUSIONS: PANRP offers a promising alternative to traditional EVLP for cDCD lung evaluation, allowing in situ assessment of multiple organs simultaneously. This approach may overcome logistical and economic challenges associated with ex vivo techniques, enabling a more efficient evaluation process. Further studies are warranted to confirm its clinical applicability and impact on long-term outcomes.

DOI： 10.1007/s11748-025-02137-y

Nightmare case of repeated hemorrhagic pancreatitis due to pancreatic head cancer in the acute stage after two-stage lung transplantation

Tatsuya Hayashi, Shin Tanaka, Tsuyoshi Ryuko, Yasuaki Tomioka, Kentaroh Miyoshi, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka

JHLT Open 100245 - 100245 2025.3

Long Short-Term Memory Algorithm for Personalized Tacrolimus Dosing: A Simple and Effective Time Series Forecasting Approach Post-Lung Transplantation. International journal

Haruki Choshi, Kentaroh Miyoshi, Maki Tanioka, Hayato Arai, Shin Tanaka, Kazuhiko Shien, Ken Suzawa, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 2024.11

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

BACKGROUND: Management of tacrolimus trough levels influences morbidity and mortality after lung transplantation. Several studies have explored pharmacokinetic and artificial intelligence models to monitor tacrolimus levels. However, many models depend on a wide range of variables, some of which, like genetic polymorphisms, are not commonly tested for in regular clinical practice. This study aimed to verify the efficacy of a novel approach simply utilizing time series data of tacrolimus dosing, with the objective of accurately predicting trough levels in the variety of clinical settings. METHODS: Data encompassing 36 clinical variables for each patient were gathered, and a multivariate long short-term memory algorithm was applied to forecast subsequent tacrolimus trough levels based on the selected clinical variables. The tool was developed using a dataset of 87,112 data points from 117 patients and its efficacy was confirmed using six additional cases. RESULTS: Shapley Additive exPlanations revealed a significant correlation between trough levels and prior dose-concentration data. By using simple trend learning of dose, administration route, and previous trough levels of tacrolimus, we could predict values within 30% of the actual values for 88.5% of time points, which facilitated the creation of a tool for simulating tacrolimus trough levels in response to dosage adjustments. The tool exhibited the potential for rectifying clinical misjudgments in a simulation cohort. CONCLUSIONS: Utilizing our time series forecasting tool, precise prediction of trough levels is attainable independently of other clinical variables, through the analysis of historical tacrolimus dose-concentration trends alone.

DOI： 10.1016/j.healun.2024.10.026

Late living-donor kidney transplantation from the same donor after living-donor lobar lung transplantation Reviewed

Tsuyoshi Ryuko, Seiichiro Sugimoto, Shin Tanaka, Kentaroh Miyoshi, Megumi Ishihara, Yuichi Shibuya, Shinichi Toyooka

JHLT Open 2024.11

Loss of Nr4a1 ameliorates endothelial cell injury and vascular leakage in lung transplantation from circulatory-death donor. International journal

Shinichi Kawana, Mikio Okazaki, Tomohisa Sakaue, Kohei Hashimoto, Kentaro Nakata, Haruki Choshi, Shin Tanaka, Kentaroh Miyoshi, Shinji Ohtani, Toshiaki Ohara, Seiichiro Sugimoto, Akihiro Matsukawa, Shinichi Toyooka

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 2024.10

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

BACKGROUND: Ischemia-reperfusion injury (IRI) stands as a major trigger for primary graft dysfunction (PGD) in lung transplantation (LTx). Especially in LTx from donation after cardiac death (DCD), effective control of IRI following warm ischemia (WIRI) is crucial to prevent PGD. This study aimed to identify the key factors affecting WIRI in LTx from DCD. METHODS: Previously reported RNA-sequencing dataset of lung WIRI was reanalyzed to identify nuclear receptor subfamily 4 group A member 1 (NR4A1) as the immediate early gene for WIRI. Dynamics of NR4A1 expression were verified using a mouse hilar clamp model. To investigate the role of NR4A1 in WIRI, a mouse model of LTx from DCD was established using Nr4a1 knockout (Nr4a1-/-) mice. RESULTS: NR4A1 was located around vascular cells, and its protein levels in the lungs increased rapidly and transiently during WIRI. LTｘ from Nr4a1-/- donors significantly improved pulmonary graft function compared to wild-type donors (P < 0.001). Histological analysis showed decreased microvascular endothelial cell death (P = 0.007), neutrophil infiltration (P < 0.001), and albumin leakage (P < 0.001). Evans blue permeability assay demonstrated maintained pulmonary microvascular barrier integrity in grafts from Nr4a1-/- donors, correlating with diminished pulmonary edema (P < 0.001). However, NR4A1 did not significantly affect the inflammatory response during WIRI, and IRI was not suppressed when a wild-type donor lung was transplanted into the Nr4a1-/- recipient. CONCLUSIONS: Donor NR4A1 plays a specialized role in the positive regulation of endothelial cell injury and microvascular hyperpermeability. These findings demonstrate the potential of targeting NR4A1 interventions to alleviate PGD and improve outcomes in LTx from DCD.

DOI： 10.1016/j.healun.2024.09.028

局所進行肺癌に対する治療を再考する切除可能局所進行肺癌に対する導入化学放射線療法の長期成績

諏澤憲, 岡田和大, 柳光剛志, 富岡泰章, 田中真, 枝園和彦, 三好健太郎, 岡崎幹生, 杉本誠一郎, 豊岡伸一

日本癌治療学会学術集会抄録集 62回 OPD5 - 5 2024.10

肺癌周術期治療の現在と未来術前導入化学放射線療法の経験に基づく当院の肺がん周術期治療の現状と工夫

枝園和彦, 柳光剛志, 富岡泰章, 田中真, 諏澤憲, 三好健太郎, 岡崎幹生, 杉本誠一郎, 豊岡伸一

日本癌治療学会学術集会抄録集 62回 OSY1 - 5 2024.10

再肺移植後急性期に膵頭部癌による出血性膵炎を繰り返したNightmare case

林龍也, 田中真, 石原恵, 堂口佳子, 梅田将志, 調枝治樹, 柳光剛志, 富岡泰章, 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

移植 59 ( 総会臨時 ) 255 - 255 2024.9

脳死片肺移植後の抗体関連型拒絶反応に対する集学的治療の経験

調枝治樹, 杉本誠一郎, 柳光剛志, 富岡泰章, 田中真, 堂口佳子, 石原恵, 枝園和彦, 諏澤憲, 三好健太郎, 岡崎幹生, 豊岡伸一

移植 59 ( 総会臨時 ) 294 - 294 2024.9

臓器移植レシピエントの感染症肺移植レシピエントにおける新型コロナウイルス感染症 5類移行後の現状

妹尾知哉, 杉本誠一郎, 調枝治樹, 柳光剛志, 富岡泰章, 田中真, 石原恵, 堂口佳子, 枝園和彦, 諏澤憲, 三好健太郎, 岡崎幹生, 豊岡伸一

移植 59 ( 総会臨時 ) 161 - 161 2024.9

肺移植後長期管理 Up to date 肺移植後の慢性腎臓病に対する長期管理 up to date

杉本誠一郎, 柳光剛志, 富岡泰章, 田中真, 石原恵, 堂口佳子, 諏澤憲, 枝園和彦, 三好健太郎, 岡崎幹生, 豊岡伸一

移植 59 ( 総会臨時 ) 173 - 173 2024.9

両側脳死肺移植後のサイトメガロウイルス感染症の予防にレテルモビルが有効だった一例

俣野貴慶, 杉本誠一郎, 田中真, 柳光剛志, 調枝治樹, 富岡泰章, 堂口佳子, 石原恵, 諏澤憲, 枝園和彦, 三好健太郎, 岡崎幹生, 豊岡伸一

移植 59 ( 総会臨時 ) 373 - 373 2024.9

肺移植後の機能性ディスペプシアに対しPEG-J留置が奏功した一例

柳光剛志, 杉本誠一郎, 田中真, 富岡泰章, 石原恵, 堂口佳子, 枝園和彦, 諏澤憲, 三好健太郎, 岡崎幹生, 豊岡伸一

移植 59 ( 総会臨時 ) 374 - 374 2024.9

臓器移植レシピエントの感染症肺移植レシピエントにおける新型コロナウイルス感染症 5類移行後の現状

妹尾知哉, 杉本誠一郎, 調枝治樹, 柳光剛志, 富岡泰章, 田中真, 石原恵, 堂口佳子, 枝園和彦, 諏澤憲, 三好健太郎, 岡崎幹生, 豊岡伸一

移植 59 ( 総会臨時 ) 161 - 161 2024.9

肺移植後長期管理 Up to date 肺移植後の慢性腎臓病に対する長期管理 up to date

杉本誠一郎, 柳光剛志, 富岡泰章, 田中真, 石原恵, 堂口佳子, 諏澤憲, 枝園和彦, 三好健太郎, 岡崎幹生, 豊岡伸一

移植 59 ( 総会臨時 ) 173 - 173 2024.9

再肺移植後急性期に膵頭部癌による出血性膵炎を繰り返したNightmare case

林龍也, 田中真, 石原恵, 堂口佳子, 梅田将志, 調枝治樹, 柳光剛志, 富岡泰章, 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

移植 59 ( 総会臨時 ) 255 - 255 2024.9

脳死片肺移植後の抗体関連型拒絶反応に対する集学的治療の経験

調枝治樹, 杉本誠一郎, 柳光剛志, 富岡泰章, 田中真, 堂口佳子, 石原恵, 枝園和彦, 諏澤憲, 三好健太郎, 岡崎幹生, 豊岡伸一

移植 59 ( 総会臨時 ) 294 - 294 2024.9

両側脳死肺移植後のサイトメガロウイルス感染症の予防にレテルモビルが有効だった一例

俣野貴慶, 杉本誠一郎, 田中真, 柳光剛志, 調枝治樹, 富岡泰章, 堂口佳子, 石原恵, 諏澤憲, 枝園和彦, 三好健太郎, 岡崎幹生, 豊岡伸一

移植 59 ( 総会臨時 ) 373 - 373 2024.9

肺移植後の機能性ディスペプシアに対しPEG-J留置が奏功した一例

柳光剛志, 杉本誠一郎, 田中真, 富岡泰章, 石原恵, 堂口佳子, 枝園和彦, 諏澤憲, 三好健太郎, 岡崎幹生, 豊岡伸一

移植 59 ( 総会臨時 ) 374 - 374 2024.9

Prophylactic effect of tissue flap in the prevention of bronchopleural fistula after surgery for lung cancer. Reviewed

Tomohiro Habu, Hiromasa Yamamoto, Kentaro Nakata, Kohei Hashimoto, Shin Tanaka, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka

Surgery today 2024.8

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

PURPOSE: Bronchopleural fistula (BPF) is a serious complication of lung resection. To avoid BPF, the bronchial stump/anastomotic site is often covered with a flap of surrounding tissue. One risk factor for BPF is radical lung resection after induction chemoradiotherapy for lung cancer. We retrospectively reviewed our database to elucidate the characteristics of tissue flaps that prevent BPF. METHODS: This retrospective study included 152 patients treated between 1999 and 2019. We examined the clinicopathological characteristics, including the type and thickness of the tissue flap used to cover the bronchial stump/anastomotic site, and postoperative complications, including BPF. RESULTS: BPF occurred in 5 patients (3.3%). All 5 patients had complications that could have affected delayed wound healing, such as pneumonia. The covering tissue flap thickness was significantly greater in patients without BPF than in those who developed BPF (p = 0.0290). Additionally, the tissue flap thickness was significantly greater than in those with BPF (p = 0.0077), even in high-risk patients who developed pneumonia or radiation pneumonitis on the operative side within 6 months postoperatively. CONCLUSION: Perioperative management is crucial to avoid complications affecting the healing of the bronchial stump/anastomotic site, and the covering tissue flap thickness may be an important factor in avoiding or minimizing BPF.

DOI： 10.1007/s00595-024-02927-6

Augmented humoral response to third and fourth dose of SARS-CoV-2 mRNA vaccines in lung transplant recipients. Reviewed International journal

Shinichi Kawana, Seiichiro Sugimoto, Kei Matsubara, Haruki Choshi, Shin Tanaka, Megumi Ishihara, Tomohiro Habu, Kohei Hashimoto, Ken Suzawa, Kazuhiko Shien, Kentaroh Miyoshi, Mikio Okazaki, Masanori Nakayama, Shinichi Toyooka

Respiratory investigation 62 ( 5 ) 804 - 810 2024.7

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

BACKGROUND: Since lung transplant recipients (LTRs) exhibit low immunogenicity after two doses of SARS-CoV-2 mRNA vaccines, optimal vaccine strategies for SARS-CoV-2 are required in LTRs. This study aimed to investigate the efficacy and safety of the third and fourth doses of the SARS-CoV-2 mRNA vaccines in LTRs. METHODS: We conducted a single-center study of 73 LTRs and 23 healthy controls (HCs). Participants received two-to-four doses of SARS-CoV-2 mRNA vaccines. The LTRs were divided into three groups based on the number of vaccine dose. IgG titers against SARS-CoV-2 spike protein were measured, and adverse events were assessed. Factors associated with humoral response were analyzed using univariate and multivariate analyses. RESULTS: The Dose 4 group (n = 27) had a higher humoral response rate (P = 0.018) and higher levels of anti-SARS-CoV-2 IgG antibody (P = 0.04) than the Dose 2 group (n = 14). The Dose 3 group (n = 32) had lower humoral response rates (P = 0.005) and levels of anti-SARS-CoV-2 IgG antibody (P = 0.0005) than the HCs (n = 23) even after the same dose. Systemic adverse events were milder in the LTRs than in the HCs (P < 0.05). Increased number of vaccine dose was identified as a predictor of positive humoral response (P = 0.021). CONCLUSION: Booster doses of SARS-CoV-2 mRNA vaccines may enhance humoral response with mild adverse events in LTRs. Repeated vaccination might be warranted for LTRs to prevent SARS-CoV-2 infection.

DOI： 10.1016/j.resinv.2024.07.004

Pulmonary Vein Repair on Extracorporeal Life Support: A Potential Surgical Complication for 2-Staged Lung Transplantation: Case Report. Reviewed International journal

Shin Tanaka, Kentaroh Miyoshi, Seiichiro Sugimoto, Shinichi Toyooka

Transplantation proceedings 2024.5

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

Double-lung transplantation (DLT) is favored for enhanced long-term survival despite the risk of major complications, particularly in elderly patients or those with comorbidities. Two-stage contralateral single-lung transplantation (SLT) leading to DLT is considered a valuable option to combine the advantages of less invasive SLT with DLT survival benefits. This study detailed the intraoperative challenges encountered during the procedure. A 54-year-old patient with chronic lung allograft dysfunction after right SLT underwent contralateral (left) SLT because of left lung dysfunction. During surgery, unexpected complications arose from robust adhesions on the right side, a consequence of prior transplantation, causing difficulty in manipulating the heart position. The deep bifurcation of the left pulmonary vein posed challenges, leading to damage to the left atrium, necessitating extracorporeal circulation. Despite these complexities, successful anastomosis was achieved. This case highlights the importance of recognizing potential surgical difficulties in contralateral lung transplantation, particularly in cases with adhesions, and emphasizes the need for caution when managing deep pulmonary veins. This 2-stage approach holds promise for patients with poor health but emphasizes the significance of addressing the potential challenges inherent in the surgical procedure.

DOI： 10.1016/j.transproceed.2024.05.009

Utility of neutrophil-to-lymphocyte ratio as an indicator of tumor immune status in non-small cell lung cancer. Reviewed International journal

Kazuma Iwata, Ken Suzawa, Kohei Hashimoto, Shin Tanaka, Kazuhiko Shien, Kentaroh Miyoshi, Hiromasa Yamamoto, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka

Japanese journal of clinical oncology 2024.5

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

BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic biomarker in non-small cell lung cancer (NSCLC); however, the underlying biological rationale remains unclear. The present study aimed to explore the potential utility of NLR as a surrogate biomarker for immune response to cancer and to elucidate the underlying mechanism. METHODS: This retrospective study included the medical records of 120 patients with NSCLC who underwent surgery at the study institution in 2012. NLR in peripheral blood was determined from blood test within 30 days before surgery. Tumor immune status was evaluated using immunohistochemical staining to identify CD3+, CD8+ and FOXP3+ tumor-infiltrating lymphocytes (TILs), and the relationship of NLR, with clinicopathologic characteristics including 5-year overall survival (OS), and the tumor immune status was investigated. The median values of NLR and TIL count were used as cutoff points. RESULTS: The 5-year OS was significantly better in patients with low NLR (<2.2) than in those with high NLR (≥2.2) (70.1% vs. 56.8%, P = 0.042) and in patients with high CD3+ TIL count (≥242) than in those with low CD3+ TIL count (<242) (70% vs. 56.8%, P = 0.019). Additionally, the CD3+ TIL count was negatively correlated with preoperative NLR (P = 0.005). CONCLUSION: NLR might potentially reflect the immune status of tumor microenvironment, explaining its impact on prognosis of patients with NSCLC.

DOI： 10.1093/jjco/hyae058

Postoperative Complications in Living Donors for Lung Transplantation. Reviewed International journal

Shin Tanaka, Kento Fujii, Megumi Ishihara, Haruki Choshi, Kei Matsubara, Kohei Hashimoto, Shuji Okahara, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Hiromasa Yamamoto, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka

Transplantation direct 10 ( 5 ) e1617 2024.5

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

BACKGROUND: Living donor lobar lung transplantation is a life-saving procedure for critically ill patients. This requires 2 healthy donors exposed to risks and without medical benefit. Therefore, the donor's safety and minimal postoperative complications are crucial. This study aimed to investigate the short-term outcomes and identify the risk factors affecting these outcomes. METHODS: The data of 175 living donors enrolled between 1998 and 2022 were analyzed. Donors were divided into era 1 (1998-2009) and era 2 (2010-2022). RESULTS: The overall incidence of postoperative complications was 39%, of which 7% were major complications. Donors who underwent surgery on the right side had a higher incidence of delayed pulmonary fistulae (P = 0.01) and elevated liver enzyme levels (P = 0.028). Living donor surgery on the right side (P = 0.01), era 2 (P = 0.01), and the need for plasty (P = 0.04) were predictors of postoperative complications. CONCLUSIONS: Updated data on complications and their correlation with postoperative quality of life from this study could aid in the selection of potential donors and facilitate informed consent.

DOI： 10.1097/TXD.0000000000001617

Effective division of the intersegmental plane using a robotic stapler in robotic pulmonary segmentectomy. Reviewed

Mikio Okazaki, Ken Suzawa, Kazuhiko Shien, Kohei Hashimoto, Shin Tanaka, Kentaroh Miyoshi, Hiromasa Yamamoto, Seiichiro Sugimoto, Shinichi Toyooka

Surgery today 2024.4

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

PURPOSES: Robot-assisted thoracoscopic (RATS) segmentectomy is becoming increasingly common because of the expanded indications for segmentectomy and the widespread adoption of robotic surgery. The precise division of the intersegmental plane is necessary to ensure oncologic margins from the tumor and to preserve the lung function. In this study, we present a strategy for accurately dividing the intersegmental plane using a robotic stapler and review the surgical outcomes. METHODS: RATS portal segmentectomy was performed using the Da Vinci Xi system and the intersegmental plane was dissected using a robotic stapler. We evaluated the perioperative outcomes in 92 patients who underwent RATS portal segmentectomy between May 2020 and January 2023. These results were compared with those of 82 patients who underwent complete video-assisted thoracoscopic surgery (CVATS) during the same period. RESULTS: The operative and console times were 162 and 97 min, respectively. No intraoperative complications occurred, and postoperative complications were observed in four cases (4.3%). The operative time, blood loss, postoperative complications, and maximum incision size were significantly lower in the RATS group than in the CVATS group. However, RATS requires a significantly higher number of staplers than CVATS. CONCLUSIONS: The division of the intersegmental plane using a robotic stapler in RATS portal segmentectomy was, therefore, found to be safe and effective.

DOI： 10.1007/s00595-024-02840-y

Uncontrolled心臓死ドナー肺の利用率向上を可能とする新しい肺保護法の開発

氏家裕征, 田中真, 松原慧, 川名伸一, 林龍也, 梅田将志, 柳光剛志, 調枝治樹, 久保友次郎, 橋本好平, 枝園和彦, 諏澤憲, 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 38 ( 3 ) O52 - 8 2024.4

Impact of the neutrophil-to-lymphocyte ratio on patients with locally advanced non-small cell lung cancer who suffer radiation pneumonitis during the course of induction chemoradiotherapy followed by surgery. Reviewed

Yujiro Kubo, Hiromasa Yamamoto, Kei Matsubara, Kohei Hashimoto, Shin Tanaka, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Mikio Okazaki, Seiichiro Sugimoto, Kuniaki Katsui, Takao Hiraki, Katsuyuki Kiura, Shinichi Toyooka

Surgery today 2024.3

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

PURPOSE: Radiation pneumonitis (RP) is an obstacle for patients after surgery following induction chemoradiotherapy for locally advanced non-small cell lung cancer (LA-NSCLC). We performed a comparative analysis of the association between clinicopathological factors, including the neutrophil-to-lymphocyte ratio (NLR) and prognosis, in LA-NSCLC patients with or without RP during induction chemoradiotherapy followed by surgery. METHODS: The subjects of this analysis were 168 patients undergoing trimodality therapy for LA-NSCLC between January, 1999 and May, 2019. Patients were divided into two groups: the RP group (n = 41) and the non-RP group (n = 127). We compared the clinicopathological factors including the NLR between the groups and analyzed the association between the NLR and prognosis. RESULTS: The RP group had more patients with tumors located in the lower lobe, more bilobar resections, shorter operative times, no implementation of postoperative adjuvant chemotherapy, and a higher postoperative NLR than the non-RP group. There were no significant differences in serious postoperative complications and the prognosis. Patients with a low postoperative NLR had a significantly better prognosis in the non-RP group, and a trend toward a better prognosis even in the RP group. CONCLUSION: Postoperative NLR may be a useful prognostic factor, even for patients who suffer RP after trimodality therapy for LA-NSCLC.

DOI： 10.1007/s00595-024-02816-y

Effects of case volume on short- and long-term outcomes following cadaveric lung transplantation in Japan. Reviewed International journal

Masayuki Chida, Takashi Inoue, Takahiro Nakajima, Yoshinori Okada, Hisashi Oishi, Jun Nakajima, Masaaki Sato, Ichiro Yoshino, Hidemi Suzuki, Daisuke Nakajima, Yasushi Shintani, Takashi Kanou, Shinichi Toyooka, Kentaroh Miyoshi, Takeshi Shiraishi, Toshihiko Sato, Keitaro Matsumoto, Takeshi Nagayasu, Yasushi Hoshikawa, Yasushi Matsuda, Sumiko Maeda, Hiroshi Date

Journal of thoracic disease 16 ( 2 ) 1473 - 1479 2024.2

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

BACKGROUND: Despite the low number of lung transplantations (LTs) in Japan, 10 LT facilities are accredited and good outcomes have been reported. A database review was conducted to clarify the impact of case volume at LT facilities in Japan on short- and long-term outcomes. METHODS: All cadaveric LT cases treated between 2000 and 2021 in Japan were analyzed using the database of the Japanese Society of Lung and Heart-Lung Transplantation (JSLHT). The nine institutions represented were categorized into the low-volume (LV; <80 cumulative LT cases, <8 LTs/year, n=5) and high-volume (HV; ≥80 cumulative LT cases, ≥8 LTs/year, n=4) centers. Ninety-day and 1-year mortality, as well as 5- and 10-year survival data were evaluated. RESULTS: A total of 658 cadaveric LTs were performed at the nine institutions. The 90-day rates of mortality at the HV and LV centers were 3.5% and 3.9%, respectively (P=0.801), while the 1-year mortality rates were 9.2% and 11.5%, respectively (P=0.199). Additionally, log-rank analysis of Kaplan-Meier curves showing case volume did not reveal a significant difference in long-term survival between the HV and LV centers (P=0.272), though the LV centers had wide differences for long-term outcomes (P=0.030). CONCLUSIONS: Case volume did not have effects on short- or long-term outcomes following LT in Japan, while there were large variations in long-term outcomes among the LV centers compared to those of the HV centers.

DOI： 10.21037/jtd-23-90

Plasma concentrations of histidine-rich glycoprotein in primary graft dysfunction after lung transplantation. Reviewed International journal

Toshio Shiotani, Seiichiro Sugimoto, Yasuaki Tomioka, Shin Tanaka, Toshiharu Mitsuhashi, Ken Suzawa, Kazuhiko Shien, Kentaroh Miyoshi, Hiromasa Yamamoto, Mikio Okazaki, Shinichi Toyooka

Interdisciplinary cardiovascular and thoracic surgery 2024.2

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

OBJECTIVES: Histidine-rich glycoprotein has been reported as an anti-inflammatory glycoprotein that inhibits acute lung injury in mice with sepsis and as a prognostic biomarker in patients with sepsis. We investigated the relationship between plasma concentrations of histidine-rich glycoprotein and the risk of occurrence of primary graft dysfunction. METHODS: According to the primary graft dysfunction grade at post-transplant 72 hours, patients who underwent lung transplantation were divided into three groups: non-primary graft dysfunction group (grade 0-1), moderate primary graft dysfunction group (grade 2), and severe primary graft dysfunction group (grade 3). The plasma concentrations of histidine-rich glycoprotein measured daily during the first post-transplant 7 days were compared among the three groups. Appropriate cutoff values of the concentrations were set for survival analyses after lung transplantation. RESULTS: A total of 68 patients were included. The plasma histidine-rich glycoprotein concentration at post-transplant 72 hours was significantly lower in the severe primary graft dysfunction group (n = 7) than in the other two groups (non-primary graft dysfunction group (n = 43), P = 0.042; moderate primary graft dysfunction group (n = 18), P = 0.040). Patients with plasma histidine-rich glycoprotein concentration ≥34.4 µg/mL at post-transplant 72 hours had significantly better chronic lung allograft dysfunction-free survival (P = 0.012) and overall survival (P = 0.037) than those with the concentration <34.4 µg/mL. CONCLUSIONS: Plasma histidine-rich glycoprotein concentrations at post-transplant 72 hours might be associated with the risk of development of primary graft dysfunction.

DOI： 10.1093/icvts/ivae021

Long-term outcomes of lung transplantation requiring renal replacement therapy: A single-center experience. Reviewed International journal

Yasuaki Tomioka, Seiichiro Sugimoto, Toshio Shiotani, Kei Matsubara, Haruki Choshi, Megumi Ishihara, Shin Tanaka, Kentaroh Miyoshi, Shinji Otani, Shinichi Toyooka

Respiratory investigation 62 ( 2 ) 240 - 246 2024.1

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

BACKGROUND: Life-long immunosuppressive therapy after lung transplantation (LT) may lead to end-stage renal disease (ESRD), requiring renal replacement therapy (RRT). We aimed to investigate the characteristics and long-term outcomes of patients undergoing LT and requiring RRT. METHODS: This study was a single-center, retrospective cohort study. The patients were divided into the RRT (n = 15) and non-RRT (n = 170) groups. We summarized the clinical features of patients in the RRT group and compared patient characteristics, overall survival, and chronic lung allograft dysfunction (CLAD)-free survival between the two groups. RESULTS: The cumulative incidences of ESRD requiring RRT after LT at 5, 10, and 15 years were 0.8 %, 7.6 %, and 25.2 %, respectively. In the RRT group, all 15 patients underwent hemodialysis but not peritoneal dialysis, and two patients underwent living-donor kidney transplantation. The median follow-up period was longer in the RRT group than in the non-RRT group (P < 0.001). The CLAD-free survival and overall survival did not differ between the two groups. The 5-year survival rate even after the initiation of hemodialysis was 53.3 %, and the leading cause of death in the RRT group was infection. CONCLUSIONS: Favorable long-term outcomes can be achieved by RRT for ESRD after LT.

DOI： 10.1016/j.resinv.2024.01.001

Successful Living-donor Lobar Lung Transplantation With BK Virus-related Hemorrhagic Cystitis Throughout the Perioperative Period. Reviewed International journal

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

Transplantation direct 10 ( 1 ) e1556 2024.1

原発不明肺門リンパ節小細胞がんの1切除例 Reviewed

守安江梨伽, 諏澤憲, 柳光剛志, 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

肺癌 63 ( 7 ) 1007 - 1008 2023.12

扁平上皮癌転化を来したEGFR変異肺腺癌に対してサルベージ手術を施行した1例 Reviewed

藤井龍之介, 諏澤憲, 柳光剛志, 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, 槇本剛

肺癌 63 ( 7 ) 1005 - 1005 2023.12

【移植医療の最前線】肺移植 Invited

田中真, 石原恵, 三好健太郎, 杉本誠一郎, 豊岡伸一

Pharma Medica 40 ( 3 ) 133 - 138 2023.11

Language：Japanese Publisher：(株)メディカルレビュー社

＜文献概要＞日本の肺移植は1998年に始まり、2022年末までに累計1,036例が行われてきた。改正臓器移植法の施行後、脳死ドナーの提供数は増加傾向ではあるが、依然としてドナー不足は深刻で肺移植待機患者の平均待機期間は2年半、待機中の死亡率は40%である。臓器提供が少ない現状のなか、日本では肺移植において世界とは異なる独自の取り組みが行われてきた。生体肺移植、ドナー肺利用率の向上、片肺移植がその特徴であり海外と比較しても遜色のない肺移植後生存率である。しかしこのような取り組みだけではドナープールのわずかな増加にしか貢献せず、近年増加する肺移植登録患者を救うことができない。より現実的に有望な新しいドナーソースとして、心臓死後のドナー提供が考えられる。心停止ドナー肺移植はすでに一部の欧米諸国で盛んに行われ、各国のドナー数の増加に寄与している。国際的なデータによれば、心停止ドナー肺移植の生存率は脳死肺ドナーと同等である。また他臓器を含めた心停止ドナー移植の導入には、腹部臓器常温局所灌流装置などの技術が寄与し、これによって臓器利用率が向上する可能性がある。今後、日本における心停止ドナー移植の導入には倫理的な課題は山積みであり、慎重な検討が必要である。

Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J01750&link_issn=&doc_id=20231207200004&doc_link_id=issn%3D0289-5803%26volume%3D40%26issue%3D3%26spage%3D133&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0289-5803%26volume%3D40%26issue%3D3%26spage%3D133&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Impact of changes in skeletal muscle mass and quality during the waiting time on outcomes of lung transplantation. Reviewed International journal

Akikazu Hagiyama, Seiichiro Sugimoto, Shin Tanaka, Kei Matsubara, Kentaroh Miyoshi, Yoshimi Katayama, Masanori Hamada, Masuo Senda, Shinichi Toyooka

Clinical transplantation e15169 2023.10

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

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

In vivo lung perfusion for prompt recovery from primary graft dysfunction after lung transplantation. Reviewed International journal

Kei Matsubara, Kentaroh Miyoshi, Shinichi Kawana, Yujiro Kubo, Dai Shimizu, Yasuaki Tomioka, Toshio Shiotani, Haruchika Yamamoto, Shin Tanaka, Takeshi Kurosaki, Toshiaki Ohara, Mikio Okazaki, Seiichiro Sugimoto, Akihiro Matsukawa, Shinichi Toyooka

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 2023.10

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

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

Author Correction: 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 ) 16721 - 16721 2023.10

ドナー因子と肺移植成績岡山大学脳死肺移植例におけるドナー因子と短・長期アウトカム Reviewed

三好健太郎, 田中真, 杉本誠一郎, 調枝治樹, 松原慧, 富岡泰章, 塩谷俊雄, 橋本好平, 黒崎毅史, 大谷真二, 岡崎幹夫, 山根正修, 豊岡伸一

日本胸部外科学会定期学術集会 76回 LPD2 - 4 2023.10

ライフイベント時に本当に必要な支援とは? 高いチーム力でダイバーシティとインクルージョンを目指す当院のキャリア支援

小林純子, 竹原裕子, 溝尾妙子, 菊地覚次, 三好健太郎, 黒田新士, 田邊俊介, 楳田祐三, 小谷恭弘, 杉本誠一郎, 岡崎幹生, 枝園忠彦, 豊岡伸一, 藤原俊義, 笠原真悟

日本臨床外科学会雑誌 84 ( 増刊 ) S73 - S73 2023.10

Long-term management and outcome of lung transplantation in Japan. Invited Reviewed International journal

Seiichiro Sugimoto, Kei Matsubara, Shin Tanaka, Kentaroh Miyoshi, Megumi Ishihara, Shinichi Toyooka

Journal of thoracic disease 15 ( 9 ) 5182 - 5194 2023.9

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

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

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

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

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

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

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

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

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

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

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

S100A8/A9 as a prognostic biomarker in lung transplantation. Reviewed International journal

Kentaro Nakata, Mikio Okazaki, Shinichi Kawana, Yujiro Kubo, Dai Shimizu, Shin Tanaka, Kohei Hashimoto, Ken Suzawa, Kazuhiko Shien, Kentaroh Miyoshi, Hiromasa Yamamoto, Seiichiro Sugimoto, Shinichi Toyooka

Clinical transplantation e15006 2023.4

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

Prognostic factors for lung transplant recipients focusing on age and gender: the Japanese lung transplantation report 2022.

Hisashi Oishi, Yoshinori Okada, Masaaki Sato, Jun Nakajima, Daisuke Nakajima, Takeshi Shiraishi, Toshihiko Sato, Takashi Kanou, Yasushi Shintani, Kentaroh Miyoshi, Shinichi Toyooka, Sumiko Maeda, Masayuki Chida, Keitaro Matsumoto, Takeshi Nagayasu, Hidemi Suzuki, Ichiro Yoshino, Yasushi Matsuda, Yasushi Hoshikawa, Hiroshi Date

Surgery today 2023.4

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

PURPOSE: To clarify the impact of donor and recipient characteristics on the survival of recipients before and after lung transplantation in the Japanese population. METHODS: Patients' data were collected for retrospective analysis from all authorized lung transplant centers in Japan. We included 1963 patients listed for lung transplantation by the end of December 2021, comprised of 658 deceased-donor and 270 living-donor lung transplants. RESULTS: Primary disease had a significant impact on the mortality of patients waiting for transplantation. The indications for transplant significantly affected the post-transplant survival rate of deceased-donor lung transplant recipients. The recipient's age also significantly affected the post-transplant survival rate of the deceased-donor and living-donor lung transplant recipients. The recipients of grafts transplanted from donors aged 61 years or older showed a worse post-transplant survival rate (≧60 years old). The survival rate for the combination of a female donor to a male recipient among the deceased-donor lung transplant recipients was the worst among the four combinations. CONCLUSION: The donor and recipient characteristics significantly impacted the survival of recipients after lung transplantation. The underlying mechanism of the negative impact of the gender mismatch of female donor to male recipient on post-transplant survival needs to be investigated further.

DOI： 10.1007/s00595-023-02686-w

Diagnostic value of circulating microRNA-21 in chronic lung allograft dysfunction after bilateral cadaveric and living-donor lobar lung transplantation. Reviewed International journal

Toshio Shiotani, Seiichiro Sugimoto, Yasuaki Tomioka, Haruchika Yamamoto, Shin Tanaka, Kentaroh Miyoshi, Ken Suzawa, Kazuhiko Shien, Hiromasa Yamamoto, Mikio Okazaki, Shinichi Toyooka

Heliyon 9 ( 4 ) e14903 2023.4

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

BACKGROUND: MicroRNAs (miRNAs) involved in the pathogenesis of pulmonary fibrosis have been shown to be associated with the development of chronic lung allograft dysfunction (CLAD) after lung transplantation (LT). We investigated the role of circulating miRNAs in the diagnosis of CLAD after bilateral LT, including cadaveric LT (CLT) and living-donor lobar LT (LDLLT). METHODS: The subjects of this retrospective study were 37 recipients of bilateral CLT (n = 23) and LDLLT (n = 14), and they were divided into a non-CLAD group (n = 24) and a CLAD group (n = 13). The plasma miRNA levels of the two groups were compared, and correlations between their miRNAs levels and percent baseline forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and total lung capacity (TLC) values were calculated from one year before to one year after the diagnosis of CLAD. RESULTS: The plasma levels of both miR-21 and miR-155 at the time of the diagnosis of CLAD were significantly higher in the CLAD group than in the non-CLAD group (miR-21, P = 0.0013; miR-155, P = 0.042). The miR-21 levels were significantly correlated with the percent baseline FEV1, FVC, and TLC value of one year before and at the time of diagnosis of CLAD (P < 0.05). A receiver operating characteristic curve analysis of the performance of miR-21 levels in the diagnosis of CLAD yielded an area under the curve of 0.89. CONCLUSION: Circulating miR-21 appears to be of potential value in diagnosing CLAD after bilateral LT.

DOI： 10.1016/j.heliyon.2023.e14903

脳死両肺移植後患者における血栓性微小血管障害症(Thorombotic microangiopathy:TMA)

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

移植 57 ( 4 ) 415 - 415 2023.4

非小細胞肺がんにおける腫瘍免疫状態指標としての好中球・リンパ球比(NLR)の有用性

岩田一馬, 諏澤憲, 松原慧, 橋本好平, 田中真, 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

日本外科学会定期学術集会抄録集 123回 DP - 2 2023.4

待機中に二次性肺高血圧を発症した特発性肺線維症に対する脳死左片肺移植術

調枝治樹, 三好健太郎, 清水大, 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

移植 57 ( 4 ) 394 - 394 2023.4

Donor's long-term quality of life following living-donor lobar lung transplantation. Reviewed International journal

Kento Fujii, Shin Tanaka, Megumi Ishihara, Kei Matsubara, Kohei Hashimoto, Shuji Okahara, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Shinji Otani, Hiromasa Yamamoto, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka

Clinical transplantation 37 ( 4 ) e14927 2023.2

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 physical component summary. Additionally, many donors did not complain of pain or dyspnea. CONCLUSIONS: Living lung donors maintained 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. This article is protected by copyright. All rights reserved.

DOI： 10.1111/ctr.14927

Functional Blockage of S100A8/A9 Ameliorates Ischemia-Reperfusion Injury in the Lung. Reviewed International journal

Kentaro Nakata, Mikio Okazaki, Tomohisa Sakaue, Rie Kinoshita, Yuhei Komoda, Dai Shimizu, Haruchika Yamamoto, Shin Tanaka, Ken Suzawa, Kazuhiko Shien, Kentaroh Miyoshi, Hiromasa Yamamoto, Toshiaki Ohara, Seiichiro Sugimoto, Masaomi Yamane, Akihiro Matsukawa, Masakiyo Sakaguchi, Shinichi Toyooka

Bioengineering (Basel, Switzerland) 9 ( 11 ) 2022.11

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

(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

術前画像によるTis/T1肺腺癌の予後予測モデル

吉川真生, 枝園和彦, 松原慧, 田中真, 諏澤憲, 三好健太郎, 山本寛斉, 岡崎幹生, 杉本誠一郎, 豊岡伸一

肺癌 62 ( 6 ) 711 - 711 2022.11

サルベージ手術・コンバージョン手術・インダクション手術導入化学放射線療法後に再発を認めた非小細胞肺がん症例に対する局所治療の意義

枝園和彦, 吉川真生, 大亀正義, 橋本好平, 田中真, 諏澤憲, 三好健太郎, 山本寛斉, 岡崎幹生, 杉本誠一, 木浦勝行, 豊岡伸一

肺癌 62 ( 6 ) 532 - 532 2022.11

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・総リンパ球数の検討

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

肺癌 62 ( 6 ) 622 - 622 2022.11

局所進行肺癌に対する集学的治療における末梢血好中球/リンパ球比(NLR)と放射線肺臓炎の関連

久保友次郎, 山本寛斉, 松原慧, 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, 勝井邦彰, 平木隆夫, 豊岡伸一

肺癌 62 ( 6 ) 704 - 704 2022.11

臓器保存の最前線 Ex vivo lung perfusion技術を体内へ応用したIn vivo Lung Recoveryによる新規治療戦略

松原慧, 三好健太郎, 黒崎毅史, 川名伸一, 久保友次郎, 清水大, 橋本好平, 田中真, 岡崎幹生, 杉本誠一郎, 豊岡伸一

移植 57 ( 総会臨時 ) 182 - 182 2022.10

Inhibiting S100A8/A9 attenuates airway obstruction in a mouse model of heterotopic tracheal transplantation. Reviewed International journal

Dai Shimizu, Mikio Okazaki, Seiichiro Sugimoto, Rie Kinoshita, Kentaro Nakata, Shin Tanaka, Kohei Hashimoto, Kentaroh Miyoshi, Masaomi Yamane, Akihiro Matsukawa, Masakiyo Sakaguchi, Shinichi Toyooka

Biochemical and biophysical research communications 629 86 - 94 2022.8

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

Although bronchiolitis obliterans syndrome (BOS) is a major cause of death after lung transplantation, an effective drug therapy for BOS has not yet developed. Here, we assessed the effectiveness of a neutralizing anti-S100 calcium binding protein (S100) A8/A9 antibody against BOS. A murine model of heterotopic tracheal transplantation was used. Mice were intraperitoneally administered control IgG or the S100A8/A9 antibody on day 0 and twice per week until they were sacrificed. Tissue sections were used to evaluate the obstruction ratio, epithelium-preservation ratio, α-smooth muscle actin (SMA)-positive myofibroblast infiltration, and luminal cell death. Quantitative reverse transcriptase-polymerase chain reaction analysis was performed to analyze the mRNA-expression levels of collagen, inflammatory cytokines, and chemokines on days 7, 14, and 21. The anti-S100A8/A9 antibody significantly improved the obstruction ratio and epithelium-preservation ratio, with less α-SMA-positive myofibroblast infiltration compared to the control group. Antibody treatment reduced the type-III collagen: type-I collagen gene-expression ratio. The antibody also significantly suppressed the number of dead cells in the graft lumen. The expression levels of tumor growth factor β1 and C-C motif chemokine 2 on day 21, but not those of interleukin-1β, interleukin-6, and tumor necrosis factor α, were significantly suppressed by S100A8/A9 antibody treatment. These findings suggest that S100A8/A9 may be a potential therapeutic target for BOS after lung transplantation.

DOI： 10.1016/j.bbrc.2022.08.087

Lung recruitment after cardiac arrest during procurement of atelectatic donor lungs is a protective measure in lung transplantation. Reviewed International journal

Eito Niman, Kentaroh Miyoshi, Toshio Shiotani, Tomohiro Toji, Takuro Igawa, Shinji Otani, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka

Journal of thoracic disease 14 ( 8 ) 2802 - 2811 2022.8

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

Background: Brain-dead donors are susceptible to pulmonary atelectasis (AT). In procurement surgery, lung recruitment under circulatory conditions and cold-flushing for atelectatic donor lungs often provoke graft injury due to the acute blood inflow. We hypothesized that lung recruitment without blood circulation can mitigate graft injury. This study aimed to examine the benefits of lung recruitment subsequent to cardiac arrest using a porcine lung-transplant model. Methods: Thirteen donor pigs were categorized into the non-atelectatic (No-AT) group (n=3) representing a healthy control group; AT-BCR group (n=5), in which AT was reverted by conventional blood-circulated recruitment (BCR); and AT-no-BCR group (n=5), in which AT was reverted by no-BCR following circulatory arrest. In the atelectatic donor models, the left main bronchus was ligated for 24 hours prior to lung procurement. Left lung transplantation (LTx) was subsequently performed in the thirteen recipient pigs. After 6 hours evaluation, the recipients were euthanized and the lung grafts were excised. Results: The post-transplant PaO2/FiO2 ratio was significantly higher in the AT-no-BCR group than in the AT-BCR group (P=0.015). Wet/dry ratio, histological findings of graft injury and tissue interleukin-8 expression in the AT-no-BCR group were similar to those of the No-AT group. Conclusions: Lung recruitment without circulation after circulatory arrest could be more protective for atelectatic donor lung than the conventional procedure.

DOI： 10.21037/jtd-22-226

One-step nucleic acid amplification for intraoperative diagnosis of lymph node metastasis in lung cancer patients: a single-center prospective study. International journal

Kei Namba, Ken Suzawa, Kazuhiko Shien, Akihiro Miura, Yuta Takahashi, Shunsaku Miyauchi, Kota Araki, Kentaro Nakata, Shuta Tomida, Shin Tanaka, Kentaroh Miyoshi, Shinji Otani, Hiromasa Yamamoto, Mikio Okazaki, Seiichiro Sugimoto, Junichi Soh, Masaomi Yamane, Shinichi Toyooka

Scientific reports 12 ( 1 ) 7297 - 7297 2022.5

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

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 (CK19) 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 CK19 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.

DOI： 10.1038/s41598-022-11064-4

Survival and prognostic factors in patients undergoing pulmonary metastasectomy for lung metastases from retroperitoneal sarcoma. Reviewed International journal

Fumiaki Takatsu, Hiromasa Yamamoto, Yasuaki Tomioka, Shin Tanaka, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Shinji Otani, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Katsuhito Takahashi, Shinichi Toyooka

World journal of surgical oncology 20 ( 1 ) 114 - 114 2022.4

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

BACKGROUND: 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. METHODS: 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. RESULTS: 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%, n = 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 < 15 months, and size of metastasis (≥ 27 mm) were associated with poor survival. CONCLUSION: 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.

DOI： 10.1186/s12957-022-02552-y

[Chronic Lung Allograft Dysfunction after Living-donor Lobar Lung Transplantation].

Seiichiro Sugimoto, Shin Tanaka, Kentaroh Miyoshi, Shinichi Toyooka

Kyobu geka. The Japanese journal of thoracic surgery 75 ( 4 ) 297 - 301 2022.4

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

Long-term survival after living-donor lobar lung transplantation (LDLLT) is hampered by the development of chronic lung allograft dysfunction( CLAD), similar to the clinical courses seen in some recipients of cadaveric lung transplantation( CLT). CLAD after bilateral LDLLT has been shown to be characterized by the development in the unilateral lung due to differences in the immunological features of the two donors. Based on this characteristic, we found that lung perfusion scintigraphy, which can show a perfusion shift to the contralateral unaffected lung with the development of CLAD, had the potential to predict unilateral CLAD after bilateral LDLLT. Moreover, we found that CLAD, especially restrictive allograft syndrome, developed significantly later after bilateral LDLLT than after bilateral CLT, although the CLAD-free survival and overall survival after bilateral LDLLT were similar to those after bilateral CLT. We describe our experience of CLAD after bilateral LDLLT since the first case of LDLLT in Japan.

【肺移植の現況と課題そして展望】生体肺移植後の慢性移植肺機能不全(CLAD)

杉本誠一郎, 田中真, 三好健太郎, 豊岡伸一

胸部外科 75 ( 4 ) 297 - 301 2022.4

Paediatric lung transplantation: the impact of age on the survival. Reviewed

Shinji Otani, Haruchika Yamamoto, Shin Tanaka, Yasuaki Tomioka, Kei Matsubara, Dai Shimizu, Toshio Shiotani, Ken Suzawa, Kentaroh Miyoshi, Hiromasa Yamamoto, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka

Surgery today 52 ( 11 ) 1540 - 1550 2022.3

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

OBJECTIVES: We herein review the outcomes of paediatric lung transplantation (LTx) and analyse subgroups divided by age. METHODS: We retrospectively reviewed 43 consecutive paediatric LTx recipients (< 18 years old: cadaveric LTx [n = 9], living-donor lobar LTx [n = 34]). We also analysed subgroups of patients 1-6 years old (n = 10) and 7-17 years old (n = 33). RESULTS: The 1-, 5- and 10-year overall survival (OS) rates in paediatric recipients were 93%, 82% and 67%, respectively. The 1-, 5- and 10-year graft dysfunction (GD)-free survival rates in paediatric recipients were 85%, 59% and 31%, respectively. The 1- and 5-year OS in the 1- to 6-year-old vs. 7- to 17-year-old groups were 70% vs. 100% and 48% vs. 93%, respectively (p < 0.0001). The 1- and 5-year GD-free survival rates in the 1- to 6-year-old vs. 7- to 17-year-old groups were 60% vs. 93% and 24% vs. 69%, respectively (p = 0.024). The 1- to 6-year-old group showed higher rates of non-standard LTx (p = 0.0001), interstitial pneumonia (p = 0.004) and ventilator dependency (p = 0.007) than the 7- to 17-year-old group. CONCLUSION: Paediatric recipients under 7 years old seemed to have a higher risk of mortality and GD than those 7 years old and older.

DOI： 10.1007/s00595-022-02492-w

Completely Video-assisted Thoracoscopic Lobectomy for Congenital Lobar Emphysema in a Young Adult. Reviewed

Tsuyoshi Ryuko, Hiromasa Yamamoto, Seiichiro Sugimoto, Ken Suzawa, Kentaroh Miyoshi, Shinji Otani, Mikio Okazaki, Masaomi Yamane, Shinichi Toyooka

Acta medica Okayama 76 ( 1 ) 89 - 92 2022.2

Language：English

Congenital lobar emphysema (CLE) is defined as the hyperinflation of pulmonary lobes due to obstruction of the flow of air via a known or unknown etiology, which causes pressure symptoms in the adjacent organs. CLE is mainly diagnosed in the neonatal period, and very few adult cases have been reported. Here we report a 34-year-old male with muscular dystrophy who was diagnosed with CLE on examination. He underwent a right lower lobectomy via 3-portal completely video-assisted thoracoscopic surgery, and his symptoms improved. Thoracoscopic surgery helped preserve the respiratory muscles and led to the improvement of respiratory function in this patient.

DOI： 10.18926/AMO/63217

Acute Pulmonary Edema Due to Arteriovenous Shunt Placement after Lung Transplant. Reviewed International journal

Dai Shimizu, Kentaroh Miyoshi, Seiichiro Sugimoto, Tomoko Toma, Yusuke Matsuda, Yasuaki Tomioka, Toshio Shiotani, Shinji Otani, Masaomi Yamane, Shinichi Toyooka

The Annals of thoracic surgery 2022.1

Authorship：Corresponding author Language：English

Lung transplant recipients are often complicated by immunosuppressant-induced nephropathy, which may require renal replacement therapy. We report a case of unilateral lung edema and pulmonary hypertension due to arteriovenous fistula placement in a patient with unilateral chronic lung allograft dysfunction after bilateral living-donor lobar lung transplantation. Lung transplant recipients with limited residual vascular beds, such as lobar graft or severe deviation in lung perfusion, are vulnerable to the acute increase in blood flow due to arteriovenous fistula placement and can easily develop pulmonary edema regardless of the left ventricular function. Hence, careful volume control is required.

DOI： 10.1016/j.athoracsur.2021.12.017

Lung transplantation for idiopathic multicentric Castleman disease: potential efficacy and tolerability of a humanized anti-interleukin-6 receptor monoclonal antibody International journal

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

Surgical Case Reports 7 ( 1 ) 209 - 209 2021.12

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

<title>Abstract</title><sec>
<title>Background</title>
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.

</sec><sec>
<title>Case presentation</title>
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.

</sec><sec>
<title>Conclusions</title>
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.

</sec>

DOI： 10.1186/s40792-021-01297-2

Other Link： https://link.springer.com/article/10.1186/s40792-021-01297-2/fulltext.html

Pulmonary Enteric Adenocarcinoma Harboring a BRAF G469V Mutation.

Dai Shimizu, Hiromasa Yamamoto, Kazuhiko Shien, Kohei Taniguchi, Kentaroh Miyoshi, Kei Namba, Kumi Mesaki, Seiichiro Sugimoto, Junichi Soh, Masaomi Yamane, Shinichi Toyooka

Acta medica Okayama 75 ( 6 ) 759 - 762 2021.12

Language：English

Pulmonary enteric adenocarcinoma (PEAC) is a rare subtype of lung cancer that should be differentiated from colorectal cancer metastasis. Little is known about its genetic background. An 84-year-old male with adenocarcinoma of the lung underwent left upper lobectomy. The histology of the surgical specimen was suggestive of PEAC. Gastrointestinal and colorectal fiberscopy revealed no evidence of colorectal cancer. Next-generation sequencing of the tumor identified a G469V substitution in serine/threonine-protein kinase B-raf (BRAF). Based on the higher prevalence of the G469 substitution in BRAF-mutant lung adenocarcinoma than in BRAFmutant colorectal cancer, the tumor likely originated from the lung. Identification of mutational genotype may be of some help in distinguishing PEAC from the lung metastasis of colorectal cancer.

DOI： 10.18926/AMO/62819

Long-term outcomes of living-donor lobar lung transplantation Reviewed International journal

Seiichiro Sugimoto, Hiroshi Date, Kentaroh Miyoshi, Shinji Otani, Megumi Ishihara, Masaomi Yamane, Shinichi Toyooka

The Journal of Thoracic and Cardiovascular Surgery 2021.11

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

OBJECTIVE: Although living-donor lobar lung transplantation (LDLLT) enables an intermediate survival similar to cadaveric lung transplantation, the long-term outcome remains unknown. We examined the long-term outcomes of 30 patients who received LDLLT more than 16 years previously. METHODS: We retrospectively reviewed the clinical data of 30 patients who underwent LDLLT (bilateral LDLLT, 29 patients; single LDLLT, 1 pediatric patient) between October 1998 and April 2004. RESULTS: LDLLT was performed for 25 female and 5 male patients ranging in age from 8 to 55 years. The diagnoses included pulmonary hypertension (n = 11), pulmonary fibrosis (n = 7), bronchiolitis obliterans (n = 5), and others (n = 7). At a median follow-up of 205 months, 22 patients were alive and 8 were dead. The causes of death were infection (n = 3), malignancy (n = 2), acute rejection (n = 2), and chronic lung allograft dysfunction (CLAD; n = 1). Unilateral CLAD occurred in 17 patients (56.7%), but only 1 of these patients subsequently developed bilateral CLAD. Two patients underwent bilateral cadaveric lung retransplantations. The 5-, 10-, and 15-year CLAD-free survival rates were 80.0%, 62.8%, and 44.3%, respectively. Malignancy occurred in 7 patients. Two of 5 patients with chronic kidney disease requiring hemodialysis underwent living-donor kidney transplantation. The 5-, 10-, and 15-year overall survival rates were 96.7%, 86.7%, and 73.3%, respectively. CONCLUSIONS: Although only 2 lobes are implanted, LDLLT provides encouraging long-term outcomes. In patients with unilateral CLAD, the functioning contralateral graft might contribute to a favorable long-term outcome.

DOI： 10.1016/j.jtcvs.2021.08.090

Effect of preoperative long-term use of corticosteroids on the development of post-transplant lymphoproliferative disorders after lung transplantation: a single-center experience in Japan

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

Surgery Today 52 ( 4 ) 697 - 704 2021.10

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

PURPOSE: Post-transplant lymphoproliferative disorder (PTLD) is a major complication of lung transplantation (LTx). However, few studies on PTLD in Asian populations have been reported. We explored the characteristics of Japanese PTLD cases after LTx. METHODS: We retrospectively reviewed 195 cases of LTx at our institute. We summarized the clinical experiences of 7 PTLD cases and analyzed the patient characteristics and survival outcomes of patients with (n = 7) and without (n = 188) PTLD. RESULTS: All PTLD patients were taking corticosteroids preoperatively (p = 0.0030), and the duration of preoperative corticosteroid therapy was significantly longer in the PTLD group (p = 0.0064) than in the non-PTLD group. The overall survival after LTx was significantly worse in the PTLD group (p = 0.027) than in the non-PLTD group. Among the three patients who died within 1 year after the PTLD onset, two died of opportunistic infections without residual PTLD lesions. Chronic lung allograft dysfunction (CLAD) or bronchiolitis obliterans at an autopsy were diagnosed after PTLD treatment in four cases. CONCLUSIONS: Long-term preoperative corticosteroid therapy may be a risk factor for PTLD after LTx. Opportunistic infections are lethal complications of PTLD, regardless of the effectiveness of PTLD treatment. CLAD occurs at a high rate after PTLD treatment, and close monitoring is required.

DOI： 10.1007/s00595-021-02390-7

Other Link： https://link.springer.com/article/10.1007/s00595-021-02390-7/fulltext.html

Meticulous closure of collateral vessels in the perihilar mediastinal pleura to control intraoperative bleeding during lung transplantation for pulmonary hypertension Reviewed International journal

Haruchika Yamamoto, Seiichiro Sugimoto, Kentaro Imanishi, Kohei Hashimoto, Kentaroh Miyoshi, Shinji Otani, Masaomi Yamane, Shinichi Toyooka

Journal of Thoracic Disease 13 ( 10 ) 5658 - 5669 2021.10

Language：English Publishing type：Research paper (scientific journal) Publisher：AME Publishing Company

Background: Massive blood transfusion compensating hemorrhage during lung transplantation (LT) results in primary graft dysfunction (PGD) and worse outcomes after LT. Collateral vessels in the perihilar mediastinal pleura could be the source of hemorrhage during LT in patients with pulmonary hypertension (PH). The purpose of this study was to examine the effect of closure with hemoclips of the vessels in the perihilar mediastinal pleura on the risk of intraoperative hemorrhage and outcomes after LT in patients with PH. Methods: We retrospectively reviewed 80 patients who underwent LT, including 13 patients with primary PH, 29 patients with secondary PH, and 38 patients with non-PH. Results: The median number of hemoclips was significantly higher in the primary PH group than in the non-PH group (P=0.0045) or secondary PH group (P=0.0060). The intraoperative blood loss, transfusion volume, maximum PGD grade, and the 30-day and 90-day mortality rates in the primary PH group were equivalent to those in the other two groups. Conclusions: Meticulous closure of collateral vessels in the perihilar mediastinal pleura during LT in patients with primary PH allowed intraoperative hemorrhage to be controlled and might be associated with acceptable mortality rate in these patients similar to that of LT in patients with other diseases.

DOI： 10.21037/jtd-21-1119

Protective effects of anti-HMGB1 monoclonal antibody on lung ischemia reperfusion injury in mice Reviewed

Kentaro Nakata, Mikio Okazaki, Dai Shimizu, Ken Suzawa, Kazuhiko Shien, Kentaroh Miyoshi, Shinji Otani, Hiromasa Yamamoto, Seiichiro Sugimoto, Masaomi Yamane, Daiki Ousaka, Toshiaki Ohara, Akihiro Matsukawa, Masahiro Nishibori, Shinichi Toyooka

Biochemical and Biophysical Research Communications 573 164 - 170 2021.10

The prognostic nutritional index is correlated negatively with the lung allocation score and predicts survival after both cadaveric and living-donor lobar lung transplantation. Reviewed

Haruchika Yamamoto, Seiichiro Sugimoto, Junichi Soh, Toshio Shiotani, Kentaroh Miyoshi, Shinji Otani, Mikio Okazaki, Masaomi Yamane, Shinichi Toyooka

Surgery today 51 ( 10 ) 1610 - 1618 2021.10

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

PURPOSE: The prognostic nutritional index (PNI), calculated based on the serum albumin levels and the total lymphocyte count, has been identified as a predictor of clinical outcomes in various fields of surgery. In this study, we investigated the relationship between the PNI and the lung allocation score (LAS) as well as the impact of the PNI on the outcomes of both cadaveric lung transplantation (CLT) and living-donor lobar lung transplantation (LDLLT). METHODS: We reviewed retrospective data for 127 recipients of lung transplantation (LT), including 71 recipients of CLT and 56 recipients of LDLLT. RESULTS: The PNI was correlated significantly and negatively with the LAS (r = - 0.40, P = 0.0000037). Multivariate analysis revealed that age (P = 0.00093), BMI (P = 0.00087), and PNI (P = 0.0046) were independent prognostic factors of a worse outcome after LT. In a subgroup analysis, survival after both CLT (P = 0.015) and LDLLT (P = 0.041) was significantly worse in the low PNI group than in the high PNI group. CONCLUSION: Preoperative nutritional evaluations using the PNI can assist with the assessment of disease severity in LT recipients and may predict survival after both CLT and LDLLT.

DOI： 10.1007/s00595-021-02244-2

片肺移植における二次性肺高血圧の影響当院の片側脳死肺移植症例の検討から

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

日本胸部外科学会定期学術集会 74回 LOP15 - 2 2021.10

血漿Histidine-rich glycoprotein濃度と肺移植後一時移植機能不全との関係

塩谷俊雄, 杉本誠一郎, 富岡泰章, 田中真, 諏澤憲, 枝園和彦, 三好健太郎, 山本寛斉, 岡崎幹生, 山根正修, 豊岡伸一

日本胸部外科学会定期学術集会 74回 LOD17 - 1 2021.10

未来のための今大河の時代に入った心臓移植・肺移植心停止下肺移植本邦での挑戦

田中真, Mejia Lucas Hoyos, Gomez-De-Antonioa David, 松原慧, 枝園和彦, 諏澤憲, 三好健太郎, 山本寛斉, 岡崎幹生, 杉本誠一郎, 豊岡伸一

日本胸部外科学会定期学術集会 74回 SP7 - 6 2021.10

綿密な術前準備を行った低肺機能患者の両側続発性高度気胸の1手術例

土生智大, 諏澤憲, 坂田龍平, 久保友次郎, 岩田一馬, 松田直樹, 富岡泰章, 塩谷俊雄, 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, 豊岡伸一

日本胸部外科学会定期学術集会 74回 LCPA2 - 1 2021.10

複雑気管支形成の適応、手術手技と成績局所進行非小細胞肺癌に対する導入化学放射線療法後の複雑気管支形成術

山本寛斉, 田中真, 枝園和彦, 諏澤憲, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

日本胸部外科学会定期学術集会 74回 LPD2 - 7 2021.10

綿密な術前準備を行った低肺機能患者の両側続発性高度気胸の1手術例

土生智大, 諏澤憲, 坂田龍平, 久保友次郎, 岩田一馬, 松田直樹, 富岡泰章, 塩谷俊雄, 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, 豊岡伸一

日本胸部外科学会定期学術集会 74回 LCPA2 - 1 2021.10

片肺移植における二次性肺高血圧の影響当院の片側脳死肺移植症例の検討から

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

日本胸部外科学会定期学術集会 74回 LOP15 - 2 2021.10

OSNA法を用いた肺がん所属リンパ節転移診断の臨床有用性の検討

諏澤憲, 難波圭, 枝園和彦, 三浦章博, 荒木恒太, 宮内俊策, 中田憲太郎, 富岡泰章, 田中真, 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, 豊岡伸一

肺癌 61 ( 6 ) 666 - 666 2021.10

当院での様々な開胸アプローチの経験

田中真, 富岡泰章, 枝園和彦, 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, 豊岡伸一

肺癌 61 ( 6 ) 572 - 572 2021.10

肉腫多発肺転移に対する肺切除術

山本寛斉, 田中真, 枝園和彦, 諏澤憲, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

肺癌 61 ( 6 ) 663 - 663 2021.10

複雑気管支形成の適応、手術手技と成績局所進行非小細胞肺癌に対する導入化学放射線療法後の複雑気管支形成術

山本寛斉, 田中真, 枝園和彦, 諏澤憲, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

日本胸部外科学会定期学術集会 74回 LPD2 - 7 2021.10

気管支断端被覆の適応と方法局所進行非小細胞肺癌に対する術前化学放射線療法後肺切除術における気管支断端および吻合部被覆の検討

土生智大, 山本寛斉, 田中真, 諏澤憲, 枝園和彦, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

日本胸部外科学会定期学術集会 74回 LDB2 - 5 2021.10

気管支断端被覆の適応と方法局所進行非小細胞肺癌に対する術前化学放射線療法後肺切除術における気管支断端および吻合部被覆の検討

土生智大, 山本寛斉, 田中真, 諏澤憲, 枝園和彦, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

日本胸部外科学会定期学術集会 74回 LDB2 - 5 2021.10

Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Locally Advanced Non-small-cell Lung Cancer Treated with Trimodality Therapy Reviewed International journal

Shimpei Tsudaka, Hiromasa Yamamoto, Hiroki Sato, Kuniaki Katsui, Ken Suzawa, Kazuhiko Shien, Kentaroh Miyoshi, Shinji Otani, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Katsuyuki Kiura, Susumu Kanazawa, Shinichi Toyooka

Annals of Surgical Oncology 28 ( 9 ) 4880 - 4890 2021.9

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

PURPOSE: Current evidence suggests that the neutrophil-to-lymphocyte ratio (NLR) is a prognostic factor in several types of cancer. In this study, we aimed to evaluate the prognostic impact of clinicopathological factors, including postoperative NLR, in patients with locally advanced non-small-cell lung cancer (LA-NSCLC) who underwent surgery after chemoradiotherapy (CRT) with or without postoperative adjuvant chemotherapy. METHODS: The medical records of LA-NSCLC patients treated with trimodality therapy at our institution between June 1999 and May 2019 were reviewed. The association between several clinicopathological factors and overall survival (OS) was analyzed. RESULTS: A total of 168 patients were included in this study. Regarding the prognosis, the 5-year OS rate was 68.1%, and the 2-year recurrence-free survival rate was 66.1% in the entire population. In multivariate analysis, we identified that high postoperative NLR, not pretreatment or preoperative NLR, was one of the independent factors for unfavorable OS (NLR high vs NLR low; hazard ratio = 2.45, 95% confidence interval: 1.53-3.94, p < 0.001). In addition, among patients with high postoperative NLR, patients who received postoperative adjuvant chemotherapy showed significantly better 5-year OS compared with those who did not (p = 0.016). On the other hand, postoperative adjuvant chemotherapy had no impact on the prognosis in patients with low NLR (p = 0.19). CONCLUSIONS: Our results suggest that high postoperative NLR was not only an independent unfavorable prognostic factor in patients with LA-NSCLC who were treated with trimodality therapy, but also a promising indicator for postoperative treatment in this population.

DOI： 10.1245/s10434-021-09690-9

Other Link： https://link.springer.com/article/10.1245/s10434-021-09690-9/fulltext.html

肺移植におけるドナー不足にどう取組むか心停止ドナー肺移植、スペインでの経験を踏まえて

田中真, 石上恵美, 石原恵, 富岡泰章, 枝園和彦, 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, 豊岡伸一

移植 56 ( 総会臨時 ) SSY9 - 4 2021.9

肺移植に関連した感染症(待機中から術後慢性期まで) Clostridioides difficile感染症診療ガイドライン作成に伴う当院での肺移植周術期の検討

久保友次郎, 田中真, 石上恵美, 石原恵, 坂田龍平, 富岡泰章, 枝園和彦, 諏澤憲, 大谷真二, 山本寛斉, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

移植 56 ( 総会臨時 ) SSY4 - 4 2021.9

肺移植におけるドナー不足にどう取組むか心停止ドナー肺移植、スペインでの経験を踏まえて

田中真, 石上恵美, 石原恵, 富岡泰章, 枝園和彦, 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, 豊岡伸一

移植 56 ( 総会臨時 ) SSY9 - 4 2021.9

マウス異所性気管移植モデルを用いたS100A8/A9抗体の慢性移植肺機能不全に対する効果の検討

清水大, 岡崎幹生, 木下理恵, 中田憲太郎, 三好健太郎, 大谷真二, 杉本誠一郎, 山根正修, 阪口政清, 豊岡伸一

移植 56 ( 総会臨時 ) P2 - 11 2021.9

肺移植に関連した感染症(待機中から術後慢性期まで) びまん性汎細気管支炎に対する肺移植後の慢性期管理と長期成績

杉本誠一郎, 三好健太郎, 田中真, 富岡泰章, 石原恵, 石上恵美, 諏澤憲, 枝園和彦, 山本寛斉, 岡崎幹生, 山根正修, 豊岡伸一

移植 56 ( 総会臨時 ) SSY4 - 5 2021.9

肺移植に関連した感染症(待機中から術後慢性期まで) びまん性汎細気管支炎に対する肺移植後の慢性期管理と長期成績

杉本誠一郎, 三好健太郎, 田中真, 富岡泰章, 石原恵, 石上恵美, 諏澤憲, 枝園和彦, 山本寛斉, 岡崎幹生, 山根正修, 豊岡伸一

移植 56 ( 総会臨時 ) SSY4 - 5 2021.9

肺移植における多職種連携新型コロナウイルス感染症(COVID-19)流行下での肺移植後患者フォローの工夫と課題

石原恵, 杉本誠一郎, 石上恵美, 鶴園真理, 山下里美, 難波由美子, 富岡泰章, 田中真, 三好健太郎, 大谷真二, 山根正修, 豊岡伸一

移植 56 ( 総会臨時 ) SWS3 - 2 2021.9

肺移植に関連した感染症(待機中から術後慢性期まで) Clostridioides difficile感染症診療ガイドライン作成に伴う当院での肺移植周術期の検討

久保友次郎, 田中真, 石上恵美, 石原恵, 坂田龍平, 富岡泰章, 枝園和彦, 諏澤憲, 大谷真二, 山本寛斉, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

移植 56 ( 総会臨時 ) SSY4 - 4 2021.9

生体肺移植後CLADにおける2019年ISHLT新基準にもとづく予後評価

松原慧, 三好健太郎, 大谷真二, 川名伸一, 久保友次郎, 清水大, 富岡泰章, 田中真, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

移植 56 ( 総会臨時 ) O23 - 1 2021.9

肺移植後の慢性期合併症とその管理肺移植後の慢性腎臓病に対して血液透析を導入した症例の検討

富岡泰章, 杉本誠一郎, 川名伸一, 久保友次郎, 清水大, 松原慧, 田中真, 枝園和彦, 諏澤憲, 三好健太郎, 山本寛斉, 岡崎幹生, 山根正, 豊岡伸一

移植 56 ( 総会臨時 ) SWS8 - 4 2021.9

マウス異所性気管移植モデルを用いたS100A8/A9抗体の慢性移植肺機能不全に対する効果の検討

清水大, 岡崎幹生, 木下理恵, 中田憲太郎, 三好健太郎, 大谷真二, 杉本誠一郎, 山根正修, 阪口政清, 豊岡伸一

移植 56 ( 総会臨時 ) P2 - 11 2021.9

Robot-assisted thoracoscopic lobectomy for severe incomplete interlober fissure Reviewed International journal

Mikio Okazaki, Ken Suzawa, Kazuhiko Shien, Kentaroh Miyoshi, Shinji Otani, Hiromasa Yamamoto, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka

Journal of Surgical Case Reports 2021 ( 8 ) rjab336 2021.8

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

<title>Abstract</title>
An incomplete interlobar fissure makes thoracoscopic lobectomy difficult and is predictive of morbidity after thoracoscopic lobectomy. This report demonstrates the robot-assisted thoracoscopic (RATS) lobectomy technique for patients with severe incomplete interlobar fissures. A fissureless approach was chosen for pulmonary resection. Near-infrared fluorescence imaging with intravenous indocyanine green (ICG) was used to detect the interlobar line after transection of the bronchus, pulmonary artery and vein. Interlobar fissure was identified and divided by robotic staplers. This combined technique using ICG and fissureless lobectomy made RATS lobectomy safe for patients with severe incomplete interlobar fissures.

DOI： 10.1093/jscr/rjab336

Emphysematous changes and lower levels of plasma irisin are associated with bronchiolitis obliterans syndrome after bilateral living-donor lobar lung transplantation Reviewed

Toshio Shiotani, Seiichiro Sugimoto, Haruchika Yamamoto, Kentaroh Miyoshi, Shinji Otani, Ken Suzawa, Hiromasa Yamamoto, Mikio Okazaki, Masaomi Yamane, Shinichi Toyooka

Surgery Today 52 ( 2 ) 294 - 305 2021.7

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

PURPOSE: Decreased irisin levels may be associated with the development of emphysema. Similarly, emphysematous changes may develop in patients with chronic lung allograft dysfunction (CLAD) after living-donor lobar lung transplantation (LDLLT). We investigated the severity of emphysematous changes and the relationship between irisin levels and CLAD after bilateral LDLLT and cadaveric lung transplantation (CLT). METHODS: The subjects of this retrospective study were 59 recipients of bilateral LDLLT (n = 31) or CLT (n = 28), divided into a non-CLAD group (n = 41), a LDLLT-CLAD group (n = 11), and a CLT-CLAD group (n = 7). We compared the severity of emphysematous changes, the skeletal muscle mass, and the plasma irisin levels among the groups. RESULTS: The emphysematous changes were significantly more severe in the LDLLT-CLAD and CLT-CLAD groups (p = 0.046 and 0.036), especially in patients with bronchiolitis obliterans syndrome (BOS), than in the non-CLAD group. Although the skeletal muscle mass was similar in all the groups, the plasma irisin levels were significantly lower in the LDLLT-CLAD group (p = 0.022), especially in the patients with BOS after LDLLT, than in the non-CLAD group. CONCLUSION: Emphysematous changes and lower levels of plasma irisin were associated with CLAD, especially in patients with BOS, after bilateral LDLLT.

DOI： 10.1007/s00595-021-02339-w

Other Link： https://link.springer.com/article/10.1007/s00595-021-02339-w/fulltext.html

“Hybrid Lung Transplantation” Combining Living Donor and Cadaveric Lung Transplants: Report of 2 Cases Reviewed

Takeshi Kurosaki, Takahiro Oto, Shinji Otani, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka

Transplantation Proceedings 53 ( 6 ) 2004 - 2007 2021.7

Lung transplantation for bronchiectasis due to hyper-immunoglobulin E syndrome Reviewed International journal

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

The Annals of Thoracic Surgery 113 ( 4 ) e251-e253 2021.7

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

Hyperimmunoglobulin E syndrome (HIES) is one of the primary immunodeficiencies characterized by recurrent staphylococcal skin and lung infections that result in lung destruction and critically diminished pulmonary function. Despite the lack of definitive treatment, there have been no reports of successful lung transplantation for HIES patients. We report the case of a 42-year-old woman with HIES with progressive bronchiectasis whose pulmonary infection was controlled before transplantation, and subsequent lung transplantation was uneventful. Lung transplantation may be feasible in HIES if the patient is immunologically stable preoperatively and perioperative infections, especially Aspergillus infections, are well controlled.

DOI： 10.1016/j.athoracsur.2021.05.088

The prognostic impact of sarcopenia on elderly patients undergoing pulmonary resection for non-small cell lung cancer Reviewed

Akihiro Miura, Hiromasa Yamamoto, Hiroki Sato, Yasuaki Tomioka, Toshio Shiotani, Ken Suzawa, Kentaroh Miyoshi, Shinji Otani, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka

Surgery Today 51 ( 7 ) 1203 - 1211 2021.7

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

PURPOSE: The number of elderly patients who undergo surgery is increasing, even though they are at a high risk due to a decreased physical strength. Furthermore, sarcopenia is generally associated with a poor prognosis in patients with non-small cell lung cancer (NSCLC). METHODS: This study included NSCLC patients ≥ 65 years old who underwent pulmonary resection in our hospital between 2012 and 2015. Sarcopenia was assessed using the psoas muscle mass index based on computed tomography at the level of the third lumbar vertebra. We elucidated the impact of sarcopenia on short- and long-term outcomes after surgery. RESULTS: We enrolled 259 patients, including 179 with sarcopenia. Patients with sarcopenia before surgery tended to have postoperative complications (p = 0.0521), although they did not show a poor prognosis. In patients with sarcopenia, a multivariate analysis revealed that postoperative complications and the progression of sarcopenia 1 year after surgery were significant risk factors for a poor prognosis (p = 0.0169 and 0.00370, respectively). CONCLUSIONS: The progression of sarcopenia after surgery is associated with a poor prognosis in elderly NSCLC patients with sarcopenia. A strategy to prevent postoperative progressive sarcopenia may be necessary for improving the clinical outcome of this population.

DOI： 10.1007/s00595-020-02221-1

Other Link： https://link.springer.com/article/10.1007/s00595-020-02221-1/fulltext.html

シャント造設を契機に片側肺の肺水腫及び肺高血圧を来した両側生体肺移植後CLADの一例

清水大, 三好健太郎, 東馬智子, 松田裕介, 松原慧, 富岡泰章, 塩谷俊雄, 山本治慎, 大谷真二, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

移植 56 ( 1 ) 104 - 104 2021.7

肺移植後成績の芳しくないレシピエント群-乳幼児肺移植

大谷真二, 石原恵, 石上恵美, 松原慧, 清水大, 富岡泰章, 山本治慎, 塩谷俊雄, 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, 豊岡伸一

移植 56 ( 1 ) 76 - 76 2021.7

BKウイルス感染症による出血性膀胱炎で周術期治療に難渋した小児生体肺移植の1例

富岡泰章, 大谷真二, 石上恵美, 石原恵, 松原慧, 清水大, 山本治慎, 塩谷俊雄, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

移植 56 ( 1 ) 100 - 100 2021.7

脊柱側彎症患者に対する脳死両肺移植、術後合併症の経験

山本治慎, 大谷真二, 清水大, 松原慧, 富岡泰章, 塩谷俊雄, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

移植 56 ( 1 ) 102 - 102 2021.7

Circulating anti-human leukocyte antigen IgM antibodies as a potential early predictor of allograft rejection and a negative clinical outcome after lung transplantation Reviewed

Kazuaki Miyahara, Kentaroh Miyoshi, Takeshi Kurosaki, Shinji Otani, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka

Surgery Today 2021.5

肺移植における予後改善に向けての取組生体肺移植と脳死肺移植の違いに着目した慢性移植肺機能不全(CLAD)の早期診断を目指した取り組み

杉本誠一郎, 塩谷俊雄, 山本治慎, 富岡泰章, 諏澤憲, 三好健太郎, 大谷真二, 山本寛斉, 岡崎幹生, 山根正修, 豊岡伸一

日本呼吸器外科学会雑誌 35 ( 3 ) PD2 - 4 2021.5

Vessel sealerを常時用いたRATS手技

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

日本呼吸器外科学会雑誌 35 ( 3 ) RV5 - 1 2021.5

N2肺癌に対する術前導入化学放射線療法後手術症例における好中球/リンパ球比の検討

山本寛斉, 津高慎平, 富岡泰章, 塩谷俊雄, 諏澤憲, 三好健太郎, 大谷真二, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

日本呼吸器外科学会雑誌 35 ( 3 ) O8 - 1 2021.5

RATS? VATS? Uniportal VATS?〜あなたならどのアプローチを選ぶ?〜肥満症例や不全分葉症例から見たRATSの有用性

岡崎幹生, 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, 豊岡伸一

日本呼吸器外科学会雑誌 35 ( 3 ) PD3 - 3 2021.5

UNCX遺伝子多型と肺移植後の腎機能障害との関係

富岡泰章, 杉本誠一郎, 山本治慎, 清水大, 松原慧, 塩谷俊雄, 諏澤憲, 三好健太郎, 大谷真二, 山本寛斉, 岡崎幹生, 山根正修, 豊岡伸一

日本呼吸器外科学会雑誌 35 ( 3 ) RO17 - 2 2021.5

ロボット支援手術第2世代術者のラーニングカーブ

大谷真二, 岡崎幹生, 坂田龍平, 松田直樹, 岩田一馬, 高津史明, 諏澤憲, 三好健太郎, 山本寛斉, 杉本誠一郎, 山根正修, 豊岡伸一

日本呼吸器外科学会雑誌 35 ( 3 ) MO58 - 1 2021.5

肺移植後移植片慢性機能不全におけるGoddard scoreの検討

塩谷俊雄, 杉本誠一郎, 山本治慎, 富岡泰章, 諏澤憲, 三好健太郎, 大谷真二, 山本寛斉, 岡崎幹生, 山根正修, 豊岡伸一

日本呼吸器外科学会雑誌 35 ( 3 ) O18 - 3 2021.5

肺移植における最適な術前予後予測スコアリング法 9つの術前予後予測スコアリング法の検証から

山本治慎, 杉本誠一郎, 富岡泰章, 塩谷俊雄, 清水大, 松原慧, 三好健太郎, 大谷真二, 岡崎幹生, 山根正修, 豊岡伸一

日本呼吸器外科学会雑誌 35 ( 3 ) O18 - 5 2021.5

Long-term clinical follow-up after lung transplantation in patient with scoliosis: a case report Reviewed

Haruchika Yamamoto, Shinji Otani, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka

General Thoracic and Cardiovascular Surgery 69 ( 4 ) 752 - 755 2021.4

当院における小児肺移植の成績

大谷真二, 富岡泰章, 松原慧, 清水大, 山本治慎, 塩谷俊雄, 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, 豊岡伸一

日本外科学会定期学術集会抄録集 121回 PS - 8 2021.4

小児に対するABO血液型不一致の両側脳死肺移植の経験

塩谷俊雄, 杉本誠一郎, 松原慧, 富岡泰章, 清水大, 山本治慎, 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 55 ( 4 ) 491 - 491 2021.3

高IgE症候群による気管支拡張症に対して両側脳死肺移植を施行した1例

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

移植 55 ( 4 ) 507 - 507 2021.3

脳死片肺移植を施行した多中心性キャッスルマン病の1例

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

移植 55 ( 4 ) 506 - 506 2021.3

反転肺移植術の可能性当院で経験した3症例

山本治慎, 大谷真二, 日笠友起子, 黒崎毅史, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一, 小林求, 大藤剛宏

移植 55 ( 4 ) 453 - 453 2021.3

小児に対するABO血液型不一致の両側脳死肺移植の経験

塩谷俊雄, 杉本誠一郎, 松原慧, 富岡泰章, 清水大, 山本治慎, 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 55 ( 4 ) 491 - 491 2021.3

Lung transplantation for Kartagener syndrome: technical aspects and morphological adaptation of the transplanted lungs. Reviewed

Haruchika Yamamoto, Seiichiro Sugimoto, Kentaroh Miyoshi, Shinji Otani, Masaomi Yamane, Shinichi Toyooka

General thoracic and cardiovascular surgery 69 ( 3 ) 588 - 592 2021.3

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

While technical considerations in lung transplantation for Kartagener syndrome have been discussed, little information is available about the postoperative morphological changes of the grafted lungs. Herein, we discuss both the technical aspects and postoperative morphological adaptation of the grafted lungs in a case of Kartagener syndrome. A 46-year-old male patient with Kartagener syndrome underwent bilateral cadaveric lung transplantation. The right arterial anastomosis for transplantation of the size-matched grafts required technical elaboration. After the transplantation, we found a free space in the cardiac notch of the left lung and partial collapse of the lower lobe of the right lung due to dextrocardia. Follow-up computed tomography performed on day 42 after the transplantation demonstrated resolution of the atelectasis and morphological adaptation of the grafts into the recipient's chest cavity with dextrocardia. Considering such early morphological adaptation of size-matched grafts, lobar reduction could be avoided in lung transplantation for Kartagener syndrome.

DOI： 10.1007/s11748-020-01509-w

脳死肺移植後、タクロリムス濃度調整に難渋した、クローン病合併レシピエントの1例

松原慧, 大谷真二, 金聖暎, 今井祥子, 開原裕子, 長谷川祐子, 清水大, 富岡泰章, 山本治慎, 塩谷俊雄, 三好健太郎, 杉本誠一郎, 山根正修, 大藤剛宏, 豊岡伸一

移植 55 ( 4 ) 508 - 508 2021.3

高IgE症候群による気管支拡張症に対して両側脳死肺移植を施行した1例

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

移植 55 ( 4 ) 507 - 507 2021.3

Successful Bronchoscopic Treatment for Postoperative Bronchopleural Fistula Using N-butyl-2-cyanoacrylate (NBCA): Report of a Post-completion Pneumonectomy Case with a History of Induction Chemoradiotherapy Followed by Bilobectomy for Advanced Lung Cancer.

Toshio Shiotani, Hiromasa Yamamoto, Riko Katsube, Yasuaki Tomioka, Ken Suzawa, Kentaroh Miyoshi, Shinji Otani, Mikio Okazaki, Seiichiro Sugimoto, Junichi Soh, Masaomi Yamane, Shinichi Toyooka

Acta medica Okayama 75 ( 1 ) 91 - 94 2021.2

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

Bronchopleural fistula (BPF) is a severe complication following lung resection. We present the case of a patient with a history of advanced lung cancer, who had undergone induction chemoradiotherapy followed by right middle and lower lobectomy, and who developed BPF after completion right pneumonectomy. Although we had covered the bronchial stump with an omental pedicled flap, BPF was found on postoperative day 19. We covered the fistula with n-butyl-2-cyanoacrylate (NBCA) using bronchoscopy. Although we had to repeat the NBCA treatment, we ultimately cured the patient's BPF and no recurrence was observed up to 15.2 months after surgery.

DOI： 10.18926/AMO/61440

Long-term Follow-up of Living-Donor Kidney Transplantation after Cadaveric Lung Transplantation.

Toshio Shiotani, Seiichiro Sugimoto, Kota Araki, Yasuaki Tomioka, Kentaroh Miyoshi, Shinji Otani, Masaomi Yamane, Shinichi Toyooka

Acta medica Okayama 75 ( 1 ) 87 - 89 2021.2

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

Although chronic kidney disease (CKD) commonly develops after lung transplantation (LT), living-donor kid-ney transplantation (LDKT) for CKD after LT is known to provide favorable outcomes. We describe the long-term follow-up findings of a patient who underwent LDKT after bilateral cadaveric LT. A 37-year-old male underwent LDKT for CKD 18 years after receiving bilateral cadaveric LT. He developed chronic lung allograft dysfunction (CLAD) 20 years after the LT; however, at 26 years after the initial LT, he is still alive with no pro-gression of CLAD or CKD. KT could be a viable option for CKD even after LT in Japan.

DOI： 10.18926/AMO/61439

A Simple Prognostic Benefit Scoring System for Sarcoma Patients with Pulmonary Metastases: Sarcoma Lung Metastasis Score Reviewed

Haruchika Yamamoto, Hiromasa Yamamoto, Junichi Soh, Etsuji Suzuki, Kei Namba, Ken Suzawa, Kentaroh Miyoshi, Shinji Otani, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Takashi Yorifuji, Katsuhito Takahashi, Shinichi Toyooka

Annals of Surgical Oncology 2020.11

肺移植における抗HLA抗体と抗体関連拒絶反応抗胸腺細胞グロブリンをfirst lineとした肺移植後急性期抗体関連拒絶反応の治療成績

三好健太郎, 大谷真二, 杉本誠一郎, 富岡泰章, 塩谷俊雄, 黒崎毅史, 諏澤憲, 山本寛斎, 岡崎幹生, 山根正修, 豊岡伸一

日本胸部外科学会定期学術集会 73回 LWS1 - 1 2020.10

肺移植における新しい肺保存法とグラフト機能評価法(ex vivo lung perfusion(EVLP)を含む) 肺移植における無気肺ドナーからの臓器保護的肺摘出法

二萬英斗, 三好健太郎, 塩谷俊雄, 山本治慎, 黒崎毅史, 大谷真二, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

日本胸部外科学会定期学術集会 73回 LSY3 - 3 2020.10

集学的治療が行われた局所進行肺癌患者における末梢血好中球/リンパ球比(NLR)の予後的意義について

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

肺癌 60 ( 6 ) 658 - 658 2020.10

間質性肺炎合併肺癌:To treat, or not to treat? 間質性肺炎合併肺癌に対する外科的治療

山本寛斉, 松原慧, 富岡泰章, 塩谷俊雄, 諏澤憲, 三好健太郎, 大谷真二, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

肺癌 60 ( 6 ) 481 - 481 2020.10

当院の肺移植後リンパ増殖性疾患7例の検討治療後のCLAD発症と日和見感染症による死亡をどう防ぐか

清水大, 大谷真二, 富岡泰章, 松原慧, 塩谷俊雄, 山本治慎, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

移植 55 ( 総会臨時 ) 246 - 246 2020.10

当院における高齢者レシピエント症例の検討

富岡泰章, 大谷真二, 清水大, 松原慧, 山本治慎, 塩谷俊雄, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

移植 55 ( 総会臨時 ) 253 - 253 2020.10

肉腫多発肺転移手術症例における末梢血好中球/リンパ球比(NLR)の予後予測因子としての意義

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

日本胸部外科学会定期学術集会 73回 LOO2 - 2 2020.10

肺移植におけるLiquid biopsy ドナー由来血中遊離DNAとマイクロRNA

杉本誠一郎, 塩谷俊雄, 富岡泰章, 石上恵美, 石原恵, 諏澤憲, 三好健太郎, 大谷真二, 山本寛斉, 岡崎幹生, 山根正修, 豊岡伸一

移植 55 ( 総会臨時 ) 242 - 242 2020.10

ロボット支援手術におけるリンパ節郭清手技 VATS、単孔式VATSと比較して

岡崎幹生, 諏澤憲, 富岡泰章, 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, 豊岡伸一

日本胸部外科学会定期学術集会 73回 LRS1 - 3 2020.10

間質性肺炎合併肺癌の予後における末梢血好中球/リンパ球比(NLR)の影響

松原慧, 山本寛斉, 富岡泰章, 塩谷俊雄, 諏澤憲, 三好健太郎, 大谷真二, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

日本胸部外科学会定期学術集会 73回 LOO1 - 54 2020.10

肺移植待機患者の予後予測におけるPrognostic Nutrition Index(PNI)の有用性

松原慧, 大谷真二, 清水大, 富岡泰章, 山本治慎, 塩谷俊雄, 三好健太郎, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

移植 55 ( 総会臨時 ) 353 - 353 2020.10

最新低侵襲手術におけるリンパ節郭清手技:単孔式VATS vs ロボット支援手術 RATSにおけるリンパ節郭清手技

岡崎幹生, 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, 豊岡伸一

肺癌 60 ( 6 ) 464 - 464 2020.10

最新低侵襲手術におけるリンパ節郭清手技:単孔式VATS vs ロボット支援手術 RATSにおけるリンパ節郭清手技

岡崎幹生, 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, 豊岡伸一

肺癌 60 ( 6 ) 464 - 464 2020.10

高分化腺癌-いつ切るの? すりガラス成分を有する小型肺癌に対する治療の至適介入時期

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, 豊岡伸一

肺癌 60 ( 6 ) 484 - 484 2020.10

ハイリスク症例をいかに手術に繋げるか? 導入放射線化学療法後の局所進行非小細胞肺癌に対する手術後に反回神経麻痺を発症した症例の検討

杉本誠一郎, 諏澤憲, 富岡泰章, 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, 豊岡伸一

肺癌 60 ( 6 ) 492 - 492 2020.10

間質性肺炎合併肺癌:To treat, or not to treat? 間質性肺炎合併肺癌に対する外科的治療

山本寛斉, 松原慧, 富岡泰章, 塩谷俊雄, 諏澤憲, 三好健太郎, 大谷真二, 岡崎幹生, 杉本誠一郎, 山根正修, 豊岡伸一

肺癌 60 ( 6 ) 481 - 481 2020.10

新時代の肺癌治療〜集学的治療の一環としての外科手術進行肺癌に対し完全治癒を目指した術前導入治療後の外科手術

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

日本胸部外科学会定期学術集会 73回 LSY2 - 6 2020.10

ハイリスク症例をいかに手術に繋げるか? 導入放射線化学療法後の局所進行非小細胞肺癌に対する手術後に反回神経麻痺を発症した症例の検討

杉本誠一郎, 諏澤憲, 富岡泰章, 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, 豊岡伸一

肺癌 60 ( 6 ) 492 - 492 2020.10

非小細胞肺癌手術症例と末梢血リンパ球/単球比とその継時的変化の関連の検討

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

肺癌 60 ( 6 ) 587 - 587 2020.10

高分化腺癌-いつ切るの? すりガラス成分を有する小型肺癌に対する治療の至適介入時期

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, 豊岡伸一

肺癌 60 ( 6 ) 484 - 484 2020.10

Airway bacteria of the recipient but not the donor are relevant to post-lung transplant pneumonia Reviewed

Konishi Y

Gen Thorac Cardiovasc Surg. 2020 Aug;68(8):833-840. doi: 10.1007/s11748-019-01273-6. Epub 2019 Dec 17. 2020.8

右下肺静脈・左心房経由で左心室まで浸潤した小細胞肺癌に対する緊急手術の1例

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

日本呼吸器外科学会雑誌 34 ( 3 ) RV3 - 1 2020.8

抗HMGB1抗体による肺虚血再灌流障害の抑制

中田憲太郎, 岡崎幹生, 清水大, 宮内俊作, 荒木恒太, 三浦章博, 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, 大藤剛弘, 豊岡伸一

日本呼吸器外科学会雑誌 34 ( 3 ) O47 - 4 2020.8

気胸を合併し、発見された肺原発血管肉腫の1切除例

毛利謙吾, 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

日本呼吸器外科学会雑誌 34 ( 3 ) SP4 - 3 2020.8

肺移植から学ぶ呼吸器外科学肺移植から学ぶゲノム医療

杉本誠一郎, 塩谷俊雄, 山本治慎, 田中真, 諏澤憲, 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

日本呼吸器外科学会雑誌 34 ( 3 ) S - 7 2020.8

肺移植の問題点と改善策高度無気肺を合併したドナー肺による移植成績

塩谷俊雄, 杉本誠一郎, 山本治慎, 諏澤憲, 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

日本呼吸器外科学会雑誌 34 ( 3 ) PD1 - 3 2020.8

肺移植から学ぶ呼吸器外科学肺移植から学ぶゲノム医療

杉本誠一郎, 塩谷俊雄, 山本治慎, 田中真, 諏澤憲, 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

日本呼吸器外科学会雑誌 34 ( 3 ) S - 7 2020.8

ロボット支援下肺葉切除術時の肺動脈損傷に対する対応

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

日本呼吸器外科学会雑誌 34 ( 3 ) V1 - 1 2020.8

Pulmonary aspergillosis as a late complication after surgery for locally advanced non-small cell lung cancer treated with induction chemoradiotherapy. Reviewed

Seiichiro Sugimoto, Junichi Soh, Ken Suzawa, Kentaroh Miyoshi, Shinji Otani, Hiromasa Yamamoto, Mikio Okazaki, Masaomi Yamane, Takahiro Oto, Susumu Kanazawa, Katsuyuki Kiura, Shinichi Toyooka

Surgery today 50 ( 8 ) 863 - 871 2020.8

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

PURPOSE: Some long-term survivors after surgery for locally advanced non-small cell lung cancer (NSCLC) treated with induction chemoradiotherapy (trimodality treatment) develop chronic pulmonary aspergillosis (CPA). The aim of our study was to assess the characteristics and outcomes of CPA that develops after trimodality treatment. METHODS: We retrospectively reviewed the data of 187 NSCLC patients who underwent trimodality treatment between 1999 and 2018. RESULTS: Six male ever-smoker patients developed CPA. All 6 patients had undergone extended resection for NSCLC and had a history of either adjuvant chemotherapy (n = 3) or radiation pneumonitis (n = 4). Among the 4 patients with CPA localized in a single lung, 3 patients were treated surgically (completion pneumonectomy or cavernostomy) and 1 patient was treated with antifungal therapy alone. Both treatments led to the improved control of CPA. In contrast, patients with CPA in both lungs were not candidates for surgery, and died of CPA. The survival rates after trimodality treatment in the CPA group and the group without CPA were comparable (10-year survival rate, 50.0% vs. 57.6%, P = 0.59). CONCLUSION: The early diagnosis of CPA localized in a single lung after NSCLC surgery is critical to improving control and survival in patients with CPA.

DOI： 10.1007/s00595-020-01960-5

肺移植の問題点と改善策高度無気肺を合併したドナー肺による移植成績

塩谷俊雄, 杉本誠一郎, 山本治慎, 諏澤憲, 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

日本呼吸器外科学会雑誌 34 ( 3 ) PD1 - 3 2020.8

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

肉腫多発肺転移に対する肺切除術

山本寛斉, 諏澤憲, 三好健太郎, 大谷真二, 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 ) O44 - 7 2020.8

自然気胸後の器質化期膿胸に対する醸膿胸膜切除術明瞭な臓側胸膜外層の同定に基づいた剥離

清水大, 三好健太郎, 松原慧, 山本治慎, 諏澤憲, 大谷真二, 山本寛斎, 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 ) MO59 - 10 2020.8

抗HMGB1抗体による肺虚血再灌流障害の抑制

中田憲太郎, 岡崎幹生, 清水大, 宮内俊作, 荒木恒太, 三浦章博, 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, 大藤剛弘, 豊岡伸一

日本呼吸器外科学会雑誌 34 ( 3 ) O47 - 4 2020.8

右下肺静脈・左心房経由で左心室まで浸潤した小細胞肺癌に対する緊急手術の1例

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

日本呼吸器外科学会雑誌 34 ( 3 ) RV3 - 1 2020.8

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

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

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

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

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

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

SPRED2 deficiency may lead to lung ischemia-reperfusion injury via ERK1/2 signaling pathway activation. Reviewed

Masanori Okada, Masaomi Yamane, Sumiharu Yamamoto, Shinji Otani, Kentaroh Miyoshi, Seiichiro Sugimoto, Akihiro Matsukawa, Shinichi Toyooka, Takahiro Oto, Shinichiro Miyoshi

Surgery today 48 ( 12 ) 1089 - 1095 2018.12

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

PURPOSE: Inflammatory changes during lung ischemia-reperfusion injury (IRI) are related to the activation of the extracellular signal-regulated kinase (ERK)1/2 signaling pathway. Sprouty-related EVH1 (enabled/vasodilator-stimulated phosphoprotein homology 1)-domain-containing proteins (SPREDs) are known inhibitors of ERK1/2 signaling. The role of SPRED2 in lung IRI was examined in a left hilar clamp mouse model. METHODS: C57BL/6 wild-type (WT) and Spred2-/- mice were used in the left hilar clamp model. Experimental groups underwent 30 min of left hilar clamping followed by 1 h of reperfusion. U0126, an ERK1/2 inhibitor, was administered to Spred2-/- mice with reperfused lungs. RESULTS: The partial pressures of oxygen of the Spred2-/- mice after reperfusion were significantly worse than those of WT mice (p < 0.01). Spred2-/- mice displayed more severe injuries than WT mice with increased neutrophil infiltration observed by a histological evaluation and flow cytometry (p < 0.001). This severe inflammation was inhibited by U0126. In addition, the rate of ERK1 activation was significantly higher in the lungs of Spred2-/- mice after reperfusion than in WT mice according to a Western blot analysis (p < 0.05). CONCLUSION: The activation of the ERK1/2 signaling pathway influences the severity of lung IRI, causing inflammation with neutrophil infiltration. SPRED2 may be a promising target for the suppression of lung IRI.

DOI： 10.1007/s00595-018-1696-x

Donor-derived cell-free DNA is associated with acute rejection and decreased oxygenation in primary graft dysfunction after living donor-lobar lung transplantation. Reviewed International journal

Shin Tanaka, Seiichiro Sugimoto, Takeshi Kurosaki, Kentaroh Miyoshi, Shinji Otani, Ken Suzawa, Shinsuke Hashida, Masaomi Yamane, Takahiro Oto, Shinichi Toyooka

Scientific reports 8 ( 1 ) 15366 - 15366 2018.10

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

Donor-derived cell-free DNA (dd-cf-DNA) has been shown to be an informative biomarker of rejection after lung transplantation (LT) from deceased donors. However, in living-donor lobar LT, because small grafts from blood relatives are implanted with short ischemic times, the detection of dd-cf-DNA might be challenging. Our study was aimed at examining the role of dd-cf-DNA measurement in the diagnosis of primary graft dysfunction and acute rejection early after living-donor lobar LT. Immediately after LT, marked increase of the plasma dd-cf-DNA levels was noted, with the levels subsequently reaching a plateau with the resolution of primary graft dysfunction. Increased plasma levels of dd-cf-DNA were significantly correlated with decreased oxygenation immediately (p = 0.022) and at 72 hours (p = 0.046) after LT. Significantly higher plasma dd-cf-DNA levels were observed in patients with acute rejection (median, 12.0%) than in those with infection (median, 4.2%) (p = 0.028) or in a stable condition (median, 1.1%) (p = 0.001). Thus, measurement of the plasma levels of dd-cf-DNA might be useful to monitor the severity of primary graft dysfunction, and plasma dd-cf-DNA could be a potential biomarker for the diagnosis of acute rejection after LT.

DOI： 10.1038/s41598-018-33848-3

Low-risk donor lungs optimize the post-lung transplant outcome for high lung allocation score patients. Reviewed

Takeshi Kurosaki, Kentaroh Miyoshi, Shinji Otani, Kentaro Imanishi, Seiichiro Sugimoto, Masaomi Yamane, Motomu Kobayashi, Shinichi Toyooka, Takahiro Oto

Surgery today 48 ( 10 ) 928 - 935 2018.10

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

PURPOSE: The lung allocation score (LAS) has been generally recognized as a contributor to the overall survival in lung transplant candidates. However, donor-related risks have never been taken into consideration in previous research that validated the LAS. This study aimed to determine whether or not the role of the LAS as a predictor of the posttransplant outcome is influenced by the quality of the donor lungs. METHODS: We retrospectively reviewed 108 patients who underwent lung transplantation at Okayama University Hospital since 1998. The cohort was divided into two groups based on the lung donor score (DS; ≤ 4/> 4). Correlations between the LAS and posttransplant outcomes were investigated in both groups. RESULTS: In the high-DS group, an elevated LAS was strongly associated with posttransplant PaO2/FiO2 (p = 0.018). However, in the low-DS group, no correlation was found between them. There was no significant difference in the long-term survival according to the LAS in the low-DS group. The LAS effectively predicted the posttransplant outcome only when lungs with DS > 4 were transplanted; the LAS was not reliable if high-quality lungs were transplanted. CONCLUSION: Lung transplantation can be feasible and provides a survival benefit even for high-LAS patients if lungs from a low-risk donor are transplanted.

DOI： 10.1007/s00595-018-1670-7

Favorable survival in lung transplant recipients on preoperative low-dose, as compared to high-dose corticosteroids, after hematopoietic stem cell transplantation. Reviewed

Seiichiro Sugimoto, Kentaroh Miyoshi, Takeshi Kurosaki, Shinji Otani, Masaomi Yamane, Motomu Kobayashi, Takahiro Oto

International journal of hematology 107 ( 6 ) 696 - 702 2018.6

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

Although the number of patients developing pulmonary complications after hematopoietic stem cell transplantation (HSCT) necessitating lung transplantation (LT) is increasing, a little information is available about factors influencing the prognosis after LT in these patients. Corticosteroids represent the first-line therapy for pulmonary complications after HSCT; however, prolonged corticosteroid treatment prior to LT increases the potential risks of LT. In this study, we assessed the effect of preoperative corticosteroid therapy on long-term survival in patients undergoing LT after HSCT. We retrospectively investigated data from 13 patients who had received high-dose corticosteroid therapy and nine who had received low-dose corticosteroid therapy prior to LT for pulmonary complications after HSCT. Other than the preoperative corticosteroid dose, patient clinical characteristics did not differ. The incidence of postoperative complications within the first year after LT was significantly lower in the low-dose corticosteroid group (p = 0.026). Survival after LT was also significantly better in the low-dose corticosteroid group than in the high-dose corticosteroid group (p = 0.034). In recipients of LT after HSCT, preoperative low-dose corticosteroid use, as compared to preoperative high-dose corticosteroid use, could limit the risks of postoperative complications developing within the first year after the LT, leading to improved long-term survival after LT.

DOI： 10.1007/s12185-018-2417-3

Pneumatosis intestinalis after lung transplantation for pulmonary graft-versus-host disease. Reviewed International journal

Kumi Mesaki, Seiichiro Sugimoto, Shinji Otani, Takeshi Kurosaki, Kentaroh Miyoshi, Masaomi Yamane, Takahiro Oto

Journal of thoracic disease 10 ( 1 ) E42-E45 - E45 2018.1

Language：English

Pneumatosis intestinalis, which could complicate a spectrum of clinical conditions ranging from benign to life-threatening, is a rarely encountered complication after lung transplantation (LT). We describe two cases in which PI developed as a complication following LT for pulmonary graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HSCT). In addition to the long-term immunosuppression administered for pulmonary GVHD, the intense immunosuppression needed after LT might increase the risk of PI in lung transplant recipients after HSCT. Conservative therapy should be considered for the treatment of PI developing after LT.

DOI： 10.21037/jtd.2017.11.121

Prolonged Administration of Twice-Daily Bolus Intravenous Tacrolimus in the Early Phase After Lung Transplantation. Reviewed International journal

Yutaka Hirano, Seiichiro Sugimoto, Toshifumi Mano, Takeshi Kurosaki, Kentaroh Miyoshi, Shinji Otani, Masaomi Yamane, Motomu Kobayashi, Shinichiro Miyoshi, Takahiro Oto

Annals of transplantation 22 484 - 492 2017.8

Language：English Publishing type：Research paper (scientific journal) Publisher：INT SCIENTIFIC LITERATURE, INC

BACKGROUND Although administration of tacrolimus, whether by the enteric, sublingual, or continuous intravenous routes, has some limitations, twice-daily bolus intravenous tacrolimus administration has been shown to be beneficial in optimizing efficacy and safety after lung transplantation. However, at present, the duration of bolus intravenous tacrolimus administration is limited, and the effects of prolonged bolus intravenous tacrolimus administration remain unknown. Our study was aimed at assessing the safety and efficacy of prolonged twice-daily bolus intravenous tacrolimus administration in the early phase after lung transplantation. MATERIAL AND METHODS We retrospectively investigated the data of 62 recipients of lung transplantation who had received twice-daily bolus intravenous administration of tacrolimus, followed by oral tacrolimus, after lung transplantation at our institution between January 2011 and October 2015. RESULTS The median duration of bolus intravenous tacrolimus administration was 19 days (4-72 days). The target trough level was achieved in 89% of the patients by day 3. Acute kidney injury occurred in 27% of the patients during bolus intravenous tacrolimus. Two patients (3%) had neurotoxicity, necessitating discontinuation of tacrolimus. Suspected acute rejection requiring steroid pulse therapy occurred in 21% of patients during the follow-up period. Eight patients (13%) developed chronic lung allograft dysfunction during the follow-up period. The 1-year and 5-year survival rates after lung transplantation were 95% and 76%, respectively. CONCLUSIONS These results suggest that prolonged bolus intravenous tacrolimus administration in the early phase after lung transplantation is a safe and effective alternative to enteric, sublingual, or continuous intravenous administration.

DOI： 10.12659/AOT.904225

High Frequency of Acute Adverse Cardiovascular Events After Lung Transplantation in Patients With Pulmonary Arterial Hypertension Receiving Preoperative Long-Term Intravenous Prostacyclin. Reviewed

Satoshi Akagi, Takahiro Oto, Motomu Kobayashi, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Kazufumi Nakamura, Toshihiro Sarashina, Shinichiro Miyoshi, Hiroshi Ito

International heart journal 58 ( 4 ) 557 - 561 2017.8

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

Adverse cardiovascular events after lung transplantation (LT) increase the mortality in patients with pulmonary arterial hypertension (PAH). Long-term intravenous prostacyclin is the usual treatment in severe patients with PAH, but it may increase the risk of hemorrhage due to its antiplatelet aggregation effect or thrombocytopenia. We investigated the impact of length of intravenous prostacyclin therapy on acute adverse cardiovascular events including hemorrhagic complication after LT. We retrospectively compared the incidence of adverse events (death, intrathoracic hematoma and bleeding, cardiac congestion or shock, cerebral infarction and pulmonary embolism) within 30 days after LT between no/short-term (median 0.6 years, n = 13) and long-term (median 3.7 years, n = 15) intravenous prostacyclin groups. There were no differences in the dose of intravenous prostacyclin and pulmonary artery pressure between the two groups. Among 22 adverse events (0.8 ± 1.1 events/patient), 4 events occurred in the no/short-term intravenous prostacyclin group and 18 occurred in the long-term intravenous prostacyclin group. The event rate per patient in the long-term intravenous prostacyclin group (1.2 ± 1.3 events/patient) was significantly higher than that in the no/short-term intravenous prostacyclin group (0.3 ± 0.5 events/patient) (P < 0.05). Intrathoracic hematoma and bleeding was the most frequent adverse event (9 events, 41%). Preoperative long-term intravenous prostacyclin therapy increases acute adverse cardiovascular events after LT in patients with PAH.

DOI： 10.1536/ihj.16-389

Successful Lung Transplantation Using a Deceased Donor Mechanically Ventilated for Ten Months. Reviewed International journal

Shin Tanaka, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Motomu Kobayashi, Takahiro Oto

The Annals of thoracic surgery 104 ( 2 ) e177-e179 - E179 2017.8

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

A successful outcome after lung transplant was achieved using lungs donated from a teenage boy who underwent prolonged mechanical ventilation. The donor experienced hypoxic brain damage and was declared brain dead 324 days after tracheal intubation. At the time of referral, the donor's lungs revealed diffuse radiologic infiltration and atelectasis but excellent function, with a PaO2/FiO2 ratio of 450. The lungs were transplanted to a 10-year-old girl with bronchiolitis obliterans. She developed grade 2 primary graft dysfunction, but recovered quickly. She is doing well and has not experienced any other critical adverse events 12 months after lung transplantation.

DOI： 10.1016/j.athoracsur.2017.03.019

Clinical characteristics of Japanese candidates for lung transplant for interstitial lung disease and risk factors for early death while on the waiting list

Hisao Higo, Takeshi Kurosaki, Eiki Ichihara, Toshio Kubo, Kentaroh Miyoshi, Shinji Otani, Seiichiro Sugimoto, Masaomi Yamane, Nobuaki Miyahara, Katsuyuki Kiura, Shinichiro Miyoshi, Takahiro Oto

RESPIRATORY INVESTIGATION 55 ( 4 ) 264 - 269 2017.7

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

Background: Lung transplants have produced very favorable outcomes for patients with interstitial lung disease (ILD) in Japan. However, because of the severe donor lung shortage, patients must wait approximately 2.5 years before they can undergo transplantation and many candidates die before allocation. We reveal the clinical characteristics of Japanese patients with ILD who are candidates for lung transplants and the risk factors for early death while on the waiting list.Methods: We retrospectively reviewed the clinical data of patients registered in the Japan Organ Transplant Network from Okayama University Hospital who are candidates for cadaveric lung transplants for ILD between 1999 and 2015.Results: Fifty-three patients with ILD were included (24 patients with idiopathic pulmonary fibrosis and 29 others). They had severe pulmonary dysfunction and low exercise tolerability. The median waiting time for transplantation was 462 days, and 22 patients died before allocation. Patients who died before 462 days without undergoing transplantation had more severe dyspnea, shorter 6-minute walk distance (6MWD), and lower performance status than those who waited >= 462 days.Conclusions: Japanese candidates for cadaveric lung transplants for ILD have severe pulmonary dysfunction. Severe dyspnea, short 6MWD, and low performance status are risk factors for early death while on the waiting list. (C) 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

DOI： 10.1016/j.resinv.2017.03.002

Successful Lung Transplantation for Pulmonary Disease Associated With Erdheim-Chester Disease. Reviewed International journal

Kohei Hashimoto, Kentaroh Miyoshi, Hisao Mizutani, Shinji Otani, Seiichiro Sugimoto, Masaomi Yamane, Takahiro Oto

The Annals of thoracic surgery 104 ( 1 ) e13-e15 - E15 2017.7

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

A 53-year-old man with pulmonary fibrosis associated with Erdheim-Chester disease achieved long-term survival after lung transplantation. Major clinical manifestations included lung and bone injuries, and other vital organs were functionally unaffected by the disease. After a careful observation for the disease progression, he underwent bilateral deceased-donor lung transplantation. He has returned to his normal social life and is doing well without recurrence of Erdheim-Chester disease in the lung allograft or progression in other organs 5 years after transplant. Lung transplantation is a potentially reasonable treatment option for Erdheim-Chester disease involving the lungs if the functions of other vital organs remain stable.

DOI： 10.1016/j.athoracsur.2017.02.020

Lung retransplantation in an adult 13 years after single lobar transplant in childhood Reviewed

Seiichiro Sugimoto*,Shinji Otani*,Takashi Ohki,Takeshi Kurosaki*,Kentaroh Miyoshi *,Masaomi Yamane*,Shinichiro Miyoshi*,Takahiro Oto*

General Thoracic and Cardiovascular Surgery, Japanese Journal of Thoracic and Cardiovascular Surgery, [Zasshi] [Journal]. Nihon Kyobu Geka Gakkai, Journal of the Japanese Association for Thoracic Surgery 1 - 3 2017.1

Visualization of bronchial circulation at bronchial anastomotic site using bronchial fluorescein angiography technique Reviewed

Norichika Iga,Kentaroh Miyoshi*,Katsuyoshi Takata,Yutaka Hirano,Yusuke Konishi,Shinji Otani*,Seiichiro Sugimoto*,Masaomi Yamane*,Shinichiro Miyoshi*,Takahiro Oto*

Interactive Cardiovascular and Thoracic Surgery 23 ( 5 ) 716 - 721 2016.11

腸型肺腺癌の1切除例

清水大, 三好健太郎, 目崎久美, 枝園和彦, 杉本誠一郎, 山本寛斉, 宗淳一, 豊岡伸一, 大藤剛宏, 三好新一郎

肺癌 56 ( 6 ) 682 - 682 2016.11

Overview of Clinical Issues after Lung Transplantation Reviewed

Kentaroh Miyoshi*,Takahiro Oto*

Japanese Journal of Thoracic Surgery, Kyobu geka. The Japanese journal of thoracic surgery 69 ( 11 ) 915 - 918 2016.10

Pulmonary artery patch for an inadequate donor atrial cuff in the absence of donor pericardium in lung transplantation Reviewed

Seiichiro Sugimoto*,Masaomi Yamane*,Kentaroh Miyoshi*,Takeshi Kurosaki*,Shinji Otani*,Shinichiro Miyoshi*,Takahiro Oto*

Japanese Journal of Surgery, Surgery Today, The Japanese Journal of Surgery 1 - 3 2016.6

Lung transplantation for diffuse panbronchiolitis Reviewed

Seiichiro Sugimoto*,Kentaroh Miyoshi*,Masaomi Yamane*,Takahiro Oto*

Interactive Cardiovascular and Thoracic Surgery 22 ( 5 ) 679 - 681 2016.5

Therapeutic Effect of Sirolimus for Lymphangioleiomyomatosis Remaining in the Abdominopelvic Region After Lung Transplantation: A Case Report Reviewed

T. Ito, M. Suno, K. Sakamoto, Y. Yoshizaki, K. Yamamoto, R. Nakanishi, Y. Hirano, M. Irie, T. Kurosaki, S. Otani, M. Yamane, S. Sugimoto, K. Miyoshi, T. Oto

Transplantation Proceedings 48 ( 1 ) 271 - 274 2016.1

Balloon-expandable metallic stents for airway diseases Reviewed

Takashi Ohki,Seiichiro Sugimoto*,Takeshi Kurosaki*,Shinji Otani*,Kentaroh Miyoshi*,Masaomi Yamane*,Shinichiro Miyoshi*,Takahiro Oto*

Acta Medica Okayama, Acta. Medica Okayama, Acta medicinae Okayama, Acta medica Okayama 70 ( 5 ) 421 - 424 2016.1

A neutrophil elastase inhibitor improves lung function during ex vivo lung perfusion. Reviewed

Masaaki Harada, Takahiro Oto, Shinji Otani, Kentaroh Miyoshi, Masanori Okada, Norichika Iga, Hitoshi Nishikawa, Seiichiro Sugimoto, Masaomi Yamane, Shinichiro Miyoshi

General thoracic and cardiovascular surgery 63 ( 12 ) 645 - 51 2015.12

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

OBJECTIVE: Ex vivo lung perfusion (EVLP) has been used not only for graft evaluation but also for graft reconditioning prior to lung transplantation. Inflammatory cells such as neutrophils may cause additional graft injury during EVLP. Neutrophil elastase inhibitors protect lungs against neutrophil-induced lung injury, such as acute respiratory distress syndrome. This study aimed to investigate the effect of a neutrophil elastase inhibitor during EVLP. METHODS: EVLP was performed for 4 h in bilateral pig lungs that had previously experienced warm ischemia for 2 h with or without a neutrophil elastase inhibitor (treated and control groups, respectively; n = 6). Following EVLP, the left lung was transplanted into a recipient pig, and this was followed by observation for 4 h. Pulmonary functions were observed both during EVLP and during the early post-transplant stage. RESULTS: During EVLP, decreases in neutrophil elastase levels (P < 0.001), the wet-dry weight ratio (P < 0.05), and pulmonary vascular resistance (P < 0.01) and increases in the PaO2/FiO2 ratio (P < 0.01) and pulmonary compliance (P < 0.05) were observed in the treated group. After transplantation, decreased pulmonary vascular resistance (P < 0.05) was observed in the treated group. CONCLUSIONS: A neutrophil elastase inhibitor attenuated the inflammatory response during EVLP and may decrease the incidence of lung reperfusion injury after transplantation.

DOI： 10.1007/s11748-015-0585-0

Extended sleeve lobectomy after induction chemoradiotherapy for non-small cell lung cancer. Reviewed

Shinichi Toyooka, Junichi Soh, Hiromasa Yamamoto, Masaomi Yamane, Shigeru Hattori, Kazuhiko Shien, Kentaroh Miyoshi, Seiichiro Sugimoto, Takahiro Oto, Shinichiro Miyoshi

Surgery today 45 ( 9 ) 1121 - 6 2015.9

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

PURPOSE: Extended sleeve lobectomy is a challenging surgery. While induction chemoradiotherapy (ChRT) followed by surgery is one of the therapeutic strategies used for locally advanced non-small cell lung cancer (NSCLC), ChRT can impair the anastomotic healing potential. We herein present our experience with cases who underwent an extended sleeve lobectomy after induction ChRT. METHODS: The medical records of patients who underwent a surgery for NSCLC after ChRT were reviewed. RESULTS: Between December 2007 and January 2013, nine patients underwent an extended sleeve lobectomy; the left lingular division and lower lobe in four patients, the right upper lobe and trachea in one patient, the carina and trachea in one patient, the right middle and lower lobes in one patient, the right upper and middle lobes and carina in one patient and the right upper lobe and superior segment of the lower lobe in one patient. While no postoperative 90-day deaths occurred, one case developed a bronchopleural fistula on postoperative day (POD) 25 and one case developed a bronchovascular fistula on POD 163. No cases of local recurrence developed. CONCLUSIONS: Our experience suggests that an extended sleeve lobectomy after induction ChRT is feasible, but careful patient selection and perioperative management are mandatory.

DOI： 10.1007/s00595-014-1025-y

局所進行非小細胞肺癌に対する根治的放射線化学療法後手術の治療成績

宗淳一, 豊岡伸一, 諏澤憲, 岡田真典, 牧佑歩, 伊賀徳周, 三好健太郎, 山本寛斉, 杉本誠一郎, 山根正修, 大藤剛宏, 伊達洋至, 三好新一郎

日本呼吸器外科学会雑誌 29 ( 3 ) RO2 - 2 2015.4

局所進行性肺癌に対する胸骨正中切開アプローチの利用可能性(Feasibility of median sternotomy approach for locally advanced lung cancer)

佐藤博紀, 豊岡伸一, 岡田真典, 伊賀徳周, 牧佑歩, 三好健太郎, 山本寛斉, 杉本誠一郎, 宗淳一, 山根正修, 大藤剛宏, 三好新一郎

日本呼吸器外科学会雑誌 29 ( 3 ) O39 - 1 2015.4

Living related donor middle lobe lung transplant in a pediatric patient. Reviewed International journal

Takahiro Oto, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane

The Journal of thoracic and cardiovascular surgery 149 ( 3 ) e42-4 - E44 2015.3

Use of Extended-Criteria Lungs on a Lobe-by-Lobe Basis Through Ex Vivo Lung Perfusion Assessment. Reviewed International journal

Kentaroh Miyoshi, Takahiro Oto, Yusuke Konishi, Yutaka Hirano, Masanori Okada, Norichika Iga, Shin Hirayama, Seiichiro Sugimoto, Masaomi Yamane, Motomu Kobayashi, Shinichiro Miyoshi

The Annals of thoracic surgery 99 ( 5 ) 1819 - 21 2015

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

Initially rejected and extended-criteria lungs were partially used through an ex vivo lung perfusion (EVLP) assessment that was first clinically applied in Asia. The truly injured lobe (left lower lobe) was identified during 89-minute normothermic EVLP and was excised, and the remaining lobes were successfully transplanted into a patient with lymphangioleiomyomatosis. The lung lobes showed heterogeneous changes on the ex vivo rig, and a brief duration of EVLP helped differentiate lung quality on a lobe-by-lobe basis.

DOI： 10.1016/j.athoracsur.2014.06.115

Validity of using lobe-specific regional lymph node stations to assist navigation during lymph node dissection in early stage non-small cell lung cancer patients. Reviewed

Shinichiro Miyoshi, Kazuhiko Shien, Shinichi Toyooka, Kentaroh Miyoshi, Hiromasa Yamamoto, Seiichiro Sugimoto, Junichi Soh, Makio Hayama, Masaomi Yamane, Takahiro Oto

Surgery today 44 ( 11 ) 2028 - 36 2014.11

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

PURPOSE: The validity of our proposed lobe-specific regional lymph node stations (LSRLNS) was evaluated as a method for navigation during lymphadenectomy in patients with early stage non-small cell lung cancer (NSCLC). METHODS: A total of 725 NSCLC patients with c-T2N1M0 or less extensive disease who had undergone a curative operation with complete mediastinal lymph node dissection (MLND) were studied. The LSRLNS were #2, #3, #4 and #10 for the right upper lobe, #11i, #11s, #7 and #8 for the right lower lobe, #4, #5 and #6 for the left superior division, #11, #5 and #7 for the left lingular division and #11, #7 and #8 for the left lower lobe. RESULTS: If the LSRLNS were used for pathological examinations during surgery, 599 p-N0 and 39 p-N1 patients diagnosed with no metastasis would have been subjected to a selective MLND, while 20 p-N1 and 65 p-N2 patients who had a diagnosis of metastasis would have been navigated to a complete MLND. Two p-N2 patients with a diagnosis of no metastasis would have inappropriately undergone a selective MLND, resulting in the false negative rate at 0.3 %. CONCLUSION: Intra-operative pathological examination using our LSRLNS may accurately reveal the status of metastasis, and appropriately lead to a selective or complete MLND in patients with c-T2N1M0 or less extensive disease.

DOI： 10.1007/s00595-013-0772-5

肺移植前後のリハビリテーションに関する諸問題肺移植患者の理学療法と当院での現状

萩山明和, 築山尚司, 福田智美, 岩井賢司, 三好健太郎, 杉本誠一郎, 大藤剛宏

日本移植学会総会プログラム抄録集 50回 272 - 272 2014.8

Detection of airway ischaemic damage after lung transplantation by using autofluorescence imaging bronchoscopy. Reviewed International journal

Norichika Iga, Takahiro Oto, Masanori Okada, Masaaki Harada, Hitoshi Nishikawa, Kentaroh Miyoshi, Shinji Otani, Seiichiro Sugimoto, Masaomi Yamane, Shinichi Toyooka, Shinichiro Miyoshi

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 45 ( 3 ) 509 - 13 2014.3

Language：English Publishing type：Research paper (scientific journal) Publisher：OXFORD UNIV PRESS INC

OBJECTIVES: Airway complications related to ischaemia are a major cause of morbidity after lung transplantation. Early detection of airway ischaemia and optimal management of the anastomotic site could reduce the risk of airway complications. Autofluorescence imaging (AFI) bronchoscopy has been increasingly recognized as an effective technique for detecting abnormal mucosal thickening. The aim of this study was to investigate whether AFI bronchoscopy can facilitate the detection of airway ischaemic damage in lung transplant patients. METHODS: Twenty Landrace pigs were used to create a tracheal autotransplantation model. A four-ring length of trachea was excised and implanted orthotopically. The tracheal autograft was observed on postoperative days 0, 2, 4 and 7 with AFI bronchoscopy. The extent and origin of graft autofluorescence were examined using histology and measured according to fluorescence intensity. RESULTS: The lesions on the tracheal autografts appeared as bright green fluorescence on AFI bronchoscopy. On confocal fluorescence microscopy, high-intensity green fluorescence was observed in the elastin fibre layer of the submucosa. The fluorescence intensity of elastin was significantly higher in the graft showing fluorescence than the graft that did not show fluorescence and that at the control site. CONCLUSIONS: Bright green fluorescence was seen in an elastin fibre layer in the submucosa, which was likely a result of epithelial sloughing. There is a close relationship between the bright green fluorescence pattern observed using AFI bronchoscopy and airway ischaemic damage. We conclude that AFI bronchoscopy may detect airway ischaemic damage after lung transplantation.

DOI： 10.1093/ejcts/ezt437

[The role of 18F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) in liposarcoma of the chest wall]. Reviewed

Haruchika Yamamoto, Seiichiro Sugimoto, Kentaroh Miyoshi, Hiromasa Yamamoto, Junichi Soh, Masaomi Yamane, Shinichi Toyooka, Takahiro Oto, Shinichiro Miyoshi

Kyobu geka. The Japanese journal of thoracic surgery 67 ( 1 ) 4 - 8 2014.1

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

18F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT)imaging is valuable in biopsy guidance, response assessment, grading, follow-up and prognostication for soft-tissue sarcoma. In liposarcoma, the maximum standardized uptake value (SUVmax) on PET/CT scan is correlated with the histological subtypes. We briefly review the role of FDG PET/CT in liposarcoma, and describe a case of chest wall liposarcoma treated based on the assessment with PET/CT. A 76-year-old man, with a 10-cm tumor at the thoracic outlet of the right chest wall, underwent the complete resection of the tumor according to the assessment with PET/CT that showed high FDG uptakeonly in the central area of the tumor with SUVmax of 5.89, but low uptake in the peripheral area. In accordance with the PET/CT findings, pathological examination revealed dedifferentiated liposarcoma in the central area and well-differentiated liposarcoma in the peripheral area. Pretherapy PET/CT should be performed for the appropriate treatment of liposarcoma.

多数の具体的達成・評価項目票使用による診療参加型臨床実習の導入

山根正修, 杉本誠一郎, 宗淳一, 万代康弘, 三好健太郎, 山本寛斉, 豊岡伸一, 大藤剛宏, 三好新一郎

医学教育 44 ( Suppl. ) 110 - 110 2013.7

微小乳頭状肺腺癌におけるEGFR、K-ras、EML4-ALKの変異の様式(EGFR, K-ras and EML4-ALK mutational profile of lung adenocarcinomas with micropapillary component)

古川公之, 宗淳一, 豊岡伸一, 枝園和彦, 三好健太郎, 山本寛斉, 杉本誠一郎, 山根正修, 大藤剛宏, 三好新一郎

肺癌 52 ( 5 ) 671 - 671 2012.10

まれなEGFR変異を有する肺腺癌の1例

木村紘爾, 山根正修, 豊岡伸一, 古川公之, 難波圭, 三好健太郎, 山本寛斉, 宗淳一, 大藤剛宏, 三好新一郎

肺癌 52 ( 5 ) 650 - 650 2012.10

Intrathoracic irrigation with arbekacin for methicillin-resistant Staphylococcus aureus empyema following lung resection. Reviewed International journal

Tsuyoshi Ueno, Shinichi Toyooka, Junichi Soh, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Takahiro Oto, Shinichiro Miyoshi

Interactive cardiovascular and thoracic surgery 15 ( 3 ) 437 - 41 2012.9

Language：English Publishing type：Research paper (scientific journal) Publisher：OXFORD UNIV PRESS

OBJECTIVES: Empyema is a well-known complication following lung resection. In particular, empyema caused by methicillin-resistant Staphylococcus aureus (MRSA) is difficult to treat. Here, we present our experience of MRSA empyema treated with local irrigation using arbekacin. METHODS: Six patients consisted of 4 males and 2 females with an average age of 65.7 years. They developed MRSA empyema following lung resection and were treated at our institution between 2007 and 2011. Cases comprised four primary and one metastatic lung cancer, and 1 patient was a living lung transplantation donor. The surgical procedure consisted of four lobectomies, one segmentectomy and one wedge resection. After diagnosis of MRSA empyema, anti-MRSA drugs were administered intravenously in all cases. In addition, arbekacin irrigation at a dose of 100 mg dissolved in saline was performed after irrigation with saline only. RESULTS: The average number of postoperative days for the diagnosis of MRSA empyema was 13 (range 4-19). The period of irrigation ranged from 6 to 46 days. Arbekacin irrigation did not induce nephrotoxicity or other complications, and no bacteria resistant to arbekacin was detected in the thoracic cavity. We re-operated on 1 case because he had pulmonary fistula and severe wound infection. At the time of removing the thoracic catheter, MRSA in the pleural effusion disappeared completely in 3 patients. The period until MRSA concentration in the pleural effusion became negative after starting arbekacin irrigation ranged from 4 to 9 days. In the remaining cases, in which MRSA did not disappear, the catheter was removed because of no inflammatory reaction after stopping irrigation and clamping the catheters. All patients were discharged from our institution without thoracic catheterization and no patients had relapsed during the follow-up period ranging from 6 to 44 months. CONCLUSIONS: Irrigation of the thoracic cavity with arbekacin proved to be an effective, safe and readily available method for treating MRSA empyema following lung resection.

DOI： 10.1093/icvts/ivs285

血清中microRNA34b/cメチル化同定による悪性胸膜中皮腫高感度スクリーニング法

村岡孝幸, 宗淳一, 豊岡伸一, 枝園和彦, 古川公之, 牧佑歩, 上野剛, 山本寛斉, 青江啓介, 藤本伸一, 岸本卓巳, 大槻剛巳, 三好健太郎, 杉本誠一郎, 山根正修, 大藤剛宏, 三好新一郎

日本呼吸器外科学会雑誌 26 ( 3 ) RS06 - 03 2012.4

Elevation of antidonor immunoglobulin M levels precedes acute lung transplant rejection. Reviewed International journal

Kentaroh Miyoshi, Yoshifumi Sano, Masaomi Yamane, Shinichi Toyooka, Takahiro Oto, Shinichiro Miyoshi

The Annals of thoracic surgery 92 ( 4 ) 1233 - 8 2011.10

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

BACKGROUND: No useful noninvasive biomarker exists for diagnosing acute rejection after lung transplantation (LTx). In this study, antidonor T-cell antibodies were monitored daily in living-donor lobar LTx recipients to determine whether they are correlated with the onset of steroid-responsive typical acute rejection. METHODS: Ten nonsensitized patients who underwent bilateral living-donor lobar LTxs donated from 2 persons were analyzed. In 5 patients, unilateral acute rejection developed during the first 14 days after LTx and responded to subsequent pulse steroid therapies. The other patients experienced no rejection episodes during the period. Immunoreactivity against T cells from each lobe of the donors was monitored daily by detecting antidonor immunoglobulin (Ig) M and IgG using flow cytometry crossmatching for 14 days after LTx. RESULTS: There was a remarkable increase in IgM levels against rejected grafts around the onset of acute rejection, but this increase was not observed against nonrejected grafts. The mean IgM levels against rejected grafts 14 days after transplantation was significantly higher than that against nonrejected grafts in the acute rejection group (p = 0.009) and the no rejection group (p = 0.010). In the acute rejection group, the IgM level against rejected grafts became significantly higher than those against nonrejected grafts 2 days before the clinical onset of acute rejection. These trends were statistically marginal or not detected for IgG levels. CONCLUSIONS: Significant immunoreactivity of IgM, but not IgG, preceded the clinical onset of acute rejection. Antidonor IgM monitoring can contribute to the early detection of steroid-responsive acute rejection.

DOI： 10.1016/j.athoracsur.2011.04.090

Early effects of the ex vivo evaluation system on graft function after swine lung transplantation. Reviewed International journal

Shinji Otani, Takahiro Oto, Tomokazu Kakishita, Kentaroh Miyoshi, Shiro Hori, Masaomi Yamane, Shinichi Toyooka, Shinichiro Miyoshi

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 40 ( 4 ) 956 - 61 2011.10

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE BV

OBJECTIVES: Ex vivo lung evaluation (ex vivo) has been developed as a useful method by which to assess lungs from donation-after-cardiac death (DCD) donors prior to transplant. However, the safety of the ex vivo circulation itself with respect to grafts has not been fully investigated. The aim of this study is to evaluate the effects of the ex vivo circuit using a swine lung transplant model. METHODS: Lungs with or without 2-h warm ischemia were used. To assess post-transplant graft function, the left lung was transplanted after 2-h ex vivo or cold preservation; blood gas analysis of the left pulmonary vein (partial pressure of oxygen, PO(2)) was performed during the 6-h post-transplant follow-up period. Data were compared between the ex vivo (+) and ex vivo (-) groups. RESULTS: Partial pressure of oxygen/ inspired oxygen fraction (PO(2)/FiO(2)) in the ex vivo (-) group was significantly greater than that in the ex vivo (+) group until 3h after transplant. The PO(2)/FiO(2) levels in both groups then increased and became similar at 6 h after transplant, regardless of whether ischemic or non-ischemic lungs (p<0.001 and p=0.004, respectively) were used. CONCLUSIONS: Negative effects of the ex vivo system were limited and seen only in the immediate post-transplant period. Therefore, in DCD swine lung transplantation, the ex vivo system appears to be safe.

DOI： 10.1016/j.ejcts.2010.12.071

A novel technique for identification of the lung intersegmental plane using dye injection into the segmental pulmonary artery. Reviewed International journal

Seiichiro Sugimoto, Takahiro Oto, Kentaroh Miyoshi, Shinichiro Miyoshi

The Journal of thoracic and cardiovascular surgery 141 ( 5 ) 1325 - 7 2011.5

Effect of donor pre-mortem hypoxia and hypotension on graft function and start of warm ischemia in donation after cardiac death lung transplantation. Reviewed International journal

Kentaroh Miyoshi, Takahiro Oto, Shinji Otani, Shin Tanaka, Masaaki Harada, Tomokazu Kakishita, Shiro Hori, Naohisa Waki, Masaomi Yamane, Shinichiro Miyoshi

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 30 ( 4 ) 445 - 51 2011.4

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

BACKGROUND: The start of warm ischemic time (WIT) of donor lungs in donation after cardiac death (DCD) is not clearly defined. We investigated the effect of donor pre-mortem hypotension and hypoxia to determine which physiologic factor is the determinant of WIT onset in controlled DCD lung transplantation. METHODS: Twenty mechanically-ventilated donor pigs were placed in 4 groups (n = 5 each) and exposed to each of the pseudo-agonal conditions for 60 minutes: (1) control group, no intervention and optimum ventilation, followed by cardiac arrest; (2) hypotension (HT) group, controlled cardiac tamponade reducing systolic blood pressure to <50 mm Hg, followed by cardiac arrest; (3) hypoventilation (HV) group, ventilation with room air at 5 breaths/min, followed by cardiac arrest; (4) non-circulation (NC) group, initial cardiac arrest, followed by a 60-minute standoff time. The lung graft was retrieved and the left lung was transplanted to the recipient. Graft function was evaluated for 4 hours after contralateral pulmonary artery ligation. The reperfusion injury was evaluated based on tissue cytokine expression, wet weight-to-dry weight ratio, and histology at the end of the reperfusion period. RESULTS: Impaired post-transplant graft function was seen in the HV group, which had significantly poorer oxygenation during the reperfusion period than the other groups (p < 0.001). The HV group also had higher tissue levels of interleukin-8 (p < 0.05), a higher wet weight-to-dry weight ratio (p < 0.05), and histologic findings of graft tissue injury than the control group. The difference in these parameters among the control, HT, and NC groups was not significant. CONCLUSIONS: Only pre-mortem hypoxia provoked by hypoventilation significantly impaired lung graft function in DCD lung transplantation. Ventilatory rather than circulatory deterioration can trigger the onset of warm ischemia.

DOI： 10.1016/j.healun.2010.11.010

Suppression of inflammatory cytokines during ex vivo lung perfusion with an adsorbent membrane. Reviewed International journal

Tomokazu Kakishita, Takahiro Oto, Shiro Hori, Kentaroh Miyoshi, Shinji Otani, Sumiharu Yamamoto, Naohisa Waki, Osamu Yoshida, Mikio Okazaki, Masaomi Yamane, Shinichi Toyooka, Yoshifumi Sano, Shinichiro Miyoshi

The Annals of thoracic surgery 89 ( 6 ) 1773 - 9 2010.6

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

BACKGROUND: Lung grafts can be perfused ex vivo for 2 hours without edema formation; however, prolonged ex vivo lung perfusion (EVLP) eventually induces lung injury. This study evaluated the change in proinflammatory cytokines of the perfusate during EVLP and investigated the effect of cytokine removal using an adsorbent membrane. METHODS: Porcine heart-lung blocks were harvested after electrically induced cardiac arrest and underwent 12-hour EVLP with an adsorbent membrane (membrane group: n = 5) and without an adsorbent membrane (control group: n = 6). RESULTS: In the control group, both tumor necrosis factor-alpha and interleukin 8 levels were elevated in the perfusate 2 hours after perfusion. Although tumor necrosis factor-alpha and interleukin 8 levels were significantly lower in the membrane group than in the control group during the EVLP period, there was no significant difference in oxygenation, pulmonary vascular resistance, edema formation, or myeloperoxidase activity between the two groups. CONCLUSIONS: Tumor necrosis factor-alpha and interleukin 8 levels of the perfusate were elevated during EVLP. Although adverse effects of these inflammatory cytokines were anticipated, removal of inflammatory cytokines by the adsorbent membrane did not improve lung function during prolonged EVLP. Factors other than the cytokines may play a major role in causing lung injury during EVLP. Further research is needed to investigate the real mechanism of lung graft injury during prolonged EVLP and to establish longer EVLP duration for graft treatment. This strategy could contribute to the salvage of potentially damaged lungs, especially from cardiac death donors, and to expansion of the donor pool.

DOI： 10.1016/j.athoracsur.2010.02.077

肺移植後急性拒絶反応と抗ドナー特異的抗体価の推移急性拒絶発症を予見できるか

三好健太郎, 佐野由文, 岡崎幹生, 山根正修, 豊岡伸一, 大藤剛宏, 三好新一郎

日本呼吸器外科学会雑誌 24 ( 3 ) 416 - 416 2010.4

Extracorporeal membrane oxygenation bridging to living-donor lobar lung transplantation. Reviewed International journal

Kentaroh Miyoshi, Takahiro Oto, Mikio Okazaki, Masaomi Yamane, Shinichi Toyooka, Keiji Goto, Yoshifumi Sano, Shunji Sano, Shinichiro Miyoshi

The Annals of thoracic surgery 88 ( 5 ) e56-7 - E57 2009.11

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

A 21-year-old man with pulmonary fibrosis and a 27-year-old woman with idiopathic pulmonary hypertension, who were in pulmonary hypertensive crisis, were successfully treated by using venoarterial extracorporeal membrane oxygenation, followed by living-donor lobar lung transplantation. In both of the patients, bridging time of extracorporeal membrane oxygenation to lung transplantation was 2 days, and both could be weaned from cardiopulmonary support immediately after transplantation in the operating room. No major complications were seen, including primary graft dysfunction. The cardiopulmonary functions of these patients markedly improved after living-donor lobar lung transplantation.

DOI： 10.1016/j.athoracsur.2009.07.089

肺高血圧症crisisに対するVA-ECMOをbridgeとした両側生体肺移植

三好健太郎, 大藤剛宏, 岡崎幹生, 山根正修, 豊岡伸一, 佐野由文, 三好新一郎

移植 44 ( 総会臨時 ) 316 - 316 2009.9

Clinical outcomes of short hook wire and suture marking system in thoracoscopic resection for pulmonary nodules Reviewed

Kentaroh Miyoshi, Shinichi Toyooka, Hideo Gobara, Takahiro Oto, Hidefumi Mimura, Yoshifumi Sano, Susumu Kanazawa, Hiroshi Date

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY 36 ( 2 ) 378 - 382 2009.8

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE BV

Objective: The short hook wire and suture marking system is a device for localization of small pulmonary nodules in thoracoscopic resection. We and other authors have shown the feasibility of the marking procedure. In this study, we reviewed our recent experience to examine the problems for resecting procedure using the device and determine if the system negatively impacts the survival rates for lung cancers. Methods: Between November 1996 and March 2007, a total of 125 pulmonary nodular lesions in 108 patients were intended for thoracoscopic resection after localization with computed tomography-guided short hook wire and suture placement. We reviewed the major problems during surgery among all cases and prognosis in 64 patients with primary lung cancer. Results: One hundred and seventeen lesions (93.6%) were successfully resected by intitial resection with no major complication. However, we experienced missing events, the major problem during surgery, which was defined as temporarily missing lesions or hook wires. Eight missing events (6.4%) consisting of five unresected lesions and three remaining hook wires occurred after initial wedge resection. All the missing lesions and one remaining hook wire were recovered by additional resection. No specific factors of lesions, including location, diameter, distance from the pleural surface, and opacification were related to incidence of the 'missing event'. Five-year survival of patients with stage IA lung cancer was 90.0% with no local recurrence. Conclusions: Our localization method assured a consistent quality of resection regardless of the lesion characteristics and a reasonable prognosis for patients with primary lung cancer. The short hook wire and suture system provides acceptable utility in thoracoscopic surgery. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

DOI： 10.1016/j.ejcts.2009.03.039

生体肺移植後Calcineurin inhibitor起因性薬物性肝障害と、白血球貪食症候群

大藤剛宏, 山根正修, 三好健太郎, 大谷真二, 柿下大一, 堀志郎, 脇直久, 山本澄治, 吉田修, 岡崎恵, 岡崎幹生, 豊岡伸一, 佐野由文

移植 44 ( 3 ) 266 - 267 2009.6

生体肺移植ドナー手術の認容性について岡山大学病院における93例の経験より

佐野由文, 大藤剛宏, 山根正修, 岡崎幹生, 三好健太郎, 吉田修, 大谷真二, 山本澄治, 柿下大一, 岡崎恵, 豊岡伸一

移植 44 ( 3 ) 270 - 271 2009.6

VA-ECMOをbridgeとした両側生体肺移植

三好健太郎, 大藤剛宏, 大谷真二, 山本澄治, 柿下大一, 堀志郎, 脇直久, 岡崎幹生, 山根正修, 豊岡伸一, 岡崎恵, 佐野由文

移植 44 ( 3 ) 271 - 271 2009.6

当科非小細胞肺癌切除例におけるIASLC提案新TNM分類の検討

三好健太郎, 豊岡伸一, 岡崎幹生, 山根正修, 大藤剛宏, 佐野由文

日本呼吸器外科学会雑誌 23 ( 3 ) 419 - 419 2009.4

肺・気管移植の基礎と臨床生体肺移植におけるLung Allocation Scoreの有用性について

大藤剛宏, 山根正修, 大谷真二, 柿下大一, 堀志郎, 脇直久, 吉田修, 山本澄治, 三好健太郎, 岡崎幹生, 豊岡伸一, 佐野由文

日本呼吸器外科学会雑誌 23 ( 3 ) 351 - 351 2009.4

Sirolimus ameliorated post lung transplant chylothorax in lymphangioleiomyomatosis. Reviewed

Ohara T, Oto T, Miyoshi K, Tao H, Yamane M, Toyooka S, Okazaki M, Date H, Sano Y

The Annals of thoracic surgery 86 ( 6 ) e7 - 8 2008.12

肺リンパ脈管筋腫症による生体肺移植後の難治性胸腹水に対するSirolimusの投与経験

大原利章, 佐野由文, 三好健太郎, 田尾裕之, 山根正修, 豊岡伸一, 大藤剛宏, 岡崎恵, 伊達洋至

移植 42 ( 総会臨時 ) 240 - 240 2007.10

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