Updated on 2024/03/29

写真a

 
SAITO Kazuhide
 
Organization
Academic Assembly Institute of Medicine and Dentistry IGAKU KEIRETU Associate Professor
Graduate School of Medical and Dental Sciences Biological Functions and Medical Control Regenerative and Transplant Medicine Associate Professor
Title
Associate Professor
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Degree

  • 医学博士 ( 1994.3   新潟大学 )

Research Interests

  • General Urology

  • Kidney Transplantation

Research Areas

  • Life Science / Urology

Research History (researchmap)

  • Niigata University   University Medical and Dental Hospital Transplantation Support Center   Chairman

    2020.11

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  • Niigata University   Graduate School of Medical and Dental Sciences Biological Functions and Medical Control   Associate Professor

    2015.6

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  • Niigata University   Graduate School of Medical and Dental Sciences Biomedical Sciences   Associate Professor

    2015.6

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  • Niigata University   Graduate School of Medical and Dental Sciences Biological Functions and Medical Control Regenerative and Transplant Medicine   Associate Professor

    2015.6

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  • Niigata University   Organ Transplantation Center, Niigata University Medical and Dental Hospital   Vice Chairman

    2011.6 - 2020.10

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  • Niigata University   Graduate School of Medical and Dental Sciences Biomedical Sciences   Lecturer

    2003.10 - 2015.5

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  • Niigata University   Graduate School of Medical and Dental Sciences Biological Functions and Medical Control   Lecturer

    2003.10 - 2015.5

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  • Niigata University   University Medical and Dental Hospital   Lecturer

    2003.10 - 2015.5

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  • Niigata University   Lecturer

    1999.7 - 2003.9

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  • Massachusetts General Hospital   Transplantation Unit   Visiting Fellow

    1998.4 - 1998.8

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  • Niigata University   Assistant

    1994.4 - 1999.6

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  • Niigata University

    1990.3

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  • 新潟県厚生連長岡中央綜合病院   泌尿器科   医師

    1989.2 - 1989.8

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  • 恩賜財団新潟県済生会新潟総合病院   泌尿器科   医師

    1987.9 - 1988.1

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Research History

  • Niigata University   Graduate School of Medical and Dental Sciences Biological Functions and Medical Control Regenerative and Transplant Medicine   Associate Professor

    2015.6

  • Niigata University   Graduate School of Medical and Dental Sciences Biomedical Sciences   Associate Professor

    2015.6

  • Niigata University   Graduate School of Medical and Dental Sciences Biological Functions and Medical Control   Associate Professor

    2015.6

  • Niigata University   University Medical and Dental Hospital   Vice Chairman

    2011.4

  • Niigata University   Graduate School of Medical and Dental Sciences Biomedical Sciences   Lecturer

    2003.10 - 2015.5

  • Niigata University   University Medical and Dental Hospital   Lecturer

    2003.10 - 2015.5

  • Niigata University   Graduate School of Medical and Dental Sciences Biological Functions and Medical Control   Lecturer

    2003.10 - 2015.5

  • Niigata University   University Medical Hospital   Lecturer

    1999.7 - 2003.9

  • Niigata University   University Medical Hospital   Research Assistant

    1994.4 - 1999.6

  • Niigata University   University Medical Hospital

    1990.3

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Education

  • Niigata University   Graduate School of Medicine   Department of Urology

    1990.4 - 1994.3

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  • Niigata University   Faculty of Medicine   School of Medicine

    1981.4 - 1987.3

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    Country: Japan

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Professional Memberships

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Studying abroad experiences

  • Massachusetts General Hospital   VisitingFellow

    1998.4 - 1998.8

Qualification acquired

  • 日本移植学会移植認定医

  • 日本臨床腎移植学会腎移植認定医

  • 日本泌尿器科学会泌尿器科指導医

  • Doctor of Medical Science

  • 日本泌尿器科学会泌尿器科専門医

  • Doctor

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Papers

  • Arteriolar hyalinization at 0-hour biopsy predicts long-term graft function in deceased kidney transplantation. International journal

    Masaki Murata, Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Masahiro Ikeda, Masato Akiyama, Naofumi Imai, Ichiei Narita, Kota Takahashi, Yoshihiko Tomita

    International journal of urology : official journal of the Japanese Urological Association   2023.12

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    OBJECTIVES: Regarding the relationship between donor kidney quality and renal graft function after deceased kidney transplantation (KTx) following donation after cardiac death (DCD), the evaluation timing varies depending on the study. Evaluation of histology and changes in long-term renal graft function is limited. METHODS: A retrospective single-center study included 71 recipients who underwent 0-hour biopsy for KTx from DCD. The recipients were divided into two groups to evaluate factors related to renal graft function (study1). The two groups were categorized as stable graft function and poor graft function with the change of estimated glomerular filtration rate (eGFR) after KTx. The recipients were then divided into four groups to assess whether the factors identified in study1 were related to the change in long-term renal graft function (study2). They were categorized as follows: Improved, Stable, Deteriorated, and Primary non-function with the change of eGFR after KTx. RESULTS: In study1, donor age ≥ 50 years (29.5% vs. 65.2%; p = 0.09), banff arteriolar hyalinosis (ah) score (0.66 ± 0.78 vs. 1.2 ± 1.0; p = 0.018), and presence of glomerulosclerosis (43.2% vs. 76.2%; p = 0.017) were significant risk factors for poor long-term graft function. When the recipients were divided into four groups, the severity of ah correlated well with changes in long-term renal function. CONCLUSIONS: We can predict the shift in long-term renal graft function after KTx from DCD according to the severity of ah by 0-hour biopsy.

    DOI: 10.1111/iju.15357

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  • Acquisition of Antibody Against Cytomegalovirus After Kidney Transplantation in Seronegative Recipients. International journal

    Shoko Ishikawa, Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Masahiro Ikeda, Kota Takahashi, Yoshihiko Tomita

    Transplantation proceedings   55 ( 4 )   809 - 814   2023.5

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    BACKGROUND: Cytomegalovirus (CMV) infection is one of the most important infectious diseases affecting recipients of kidney transplantation (KTx). However, the timing of seroconversion for CMV infection in seronegative recipients remains unclear. We evaluated CMV infections in CMV-seronegative recipients and the time to acquire antibodies against CMV. METHODS: We conducted a retrospective study of 228 recipients who underwent KTx between March 1988 and February 2018 at the Niigata University Hospital. The anti-CMV IgG antibody profile before and after transplantation was analyzed. Oral acyclovir or valganciclovir was used as prophylactic therapy for at least 6 months after transplantation. Cytomegalovirus infection was defined as CMV viremia detected using the CMV pp65 antigenemia assay. RESULTS: In this study, 50 cases (21.9%) were CMV-seronegative recipients. Over a median follow-up period of 126.7 months, 68% (34/50) of CMV-seronegative recipients experienced CMV viremia or overt disease symptoms as the first episode of CMV infection. The median duration from transplant to CMV infection was 69.0 days (range, 22-7426). All the recipients who experienced CMV infections acquired seroconversion. The median duration from KTx to seroconversion was 7.2 months (range, 2.8-252.3). Almost all CMV-seronegative recipients could acquire anti-CMV IgG antibodies within 2.5 years. In seronegative recipients whose donors were seronegative, no CMV viremia was found, and none developed anti-CMV IgG antibodies. CONCLUSIONS: In the clinical practice of CMV-seronegative recipients, we should consider that physicians must closely monitor the occurrence of CMV infection up until 2.5 years after KTx.

    DOI: 10.1016/j.transproceed.2023.03.007

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  • Long-term CMV monitoring and chronic rejection in renal transplant recipients. International journal

    Shoko Ishikawa, Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Masahiro Ikeda, Kota Takahashi, Yoshihiko Tomita

    Frontiers in cellular and infection microbiology   13   1190794 - 1190794   2023

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    INTRODUCTION: Cytomegalovirus (CMV) is well established to be an independent risk factor for graft loss after kidney transplantation (KTx). Monitoring for CMV in the chronic phase is not defined in the current guideline. The effects of CMV infection, including asymptomatic CMV viremia, in the chronic phase are unclear. METHODS: We performed a single-center retrospective study to investigate incidence of CMV infection in the chronic phase, defined as more than 1 year after KTx. We included 205 patients who received KTx between April 2004 and December 2017. The CMV pp65 antigenemia assays to detect CMV viremia were continuously performed every 1-3 months. RESULTS: The median duration of the follow-up was 80.6 (13.1-172.1) months. Asymptomatic CMV infection and CMV disease were observed in 30.7% and 2.9% in the chronic phase, respectively. We found that 10-20% of patients had CMV infections in each year after KTx which did not change over 10 years. The history of CMV infection in the early phase (within 1 year after KTx) and chronic rejection were significantly associated with CMV viremia in the chronic phase. CMV viremia in the chronic phase was significantly associated with graft loss. DISCUSSION: This is the first study to examine the incidence of CMV viremia for 10 years post KTx. Preventing latent CMV infection may decrease chronic rejection and graft loss after KTx.

    DOI: 10.3389/fcimb.2023.1190794

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  • Pretransplant BMI Should Be <25 in Japanese Kidney Transplant Recipients: A Single-Center Experience. International journal

    Shoko Ishikawa, Masayuki Tasaki, Masahiro Ikeda, Yuki Nakagawa, Kazuhide Saito, Yoshihiko Tomita

    Transplantation proceedings   2022.12

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    BACKGROUND: The aim of this study was to determine the appropriate body mass index (BMI) in Japanese kidney transplant (KTx) recipients. We analyzed the effects of pre- and post-transplant (Tx) obesity on graft and patient survival, perioperative complications, post-transplant diabetes mellitus (PTDM), and cardiovascular disease (CVD) in Japanese KTx recipients. METHODS: This retrospective study included 269 recipients who underwent KTx from 2008 through 2020 at Niigata University Hospital. Obesity was defined as a body mass index (BMI) ≥25 kg/m2. We examined the association between pre- and post-Tx obesity and graft survival, patient survival, the incidence of PTDM and CVD, and perioperative surgical complications. RESULTS: The graft survival rate was lower in the pre-Tx BMI ≥25 kg/m2 group, although there was no significant difference in patient survival. There was no difference in graft and patient survival between the post-Tx BMI ≥25 kg/m2 group and the <25 kg/m2 group. A pre-Tx BMI ≥25 kg/m2 was an independent risk factor for biopsy-proven allograft rejection. New-onset DM after transplantation was significantly more common in the BMI ≥25 kg/m2 group than in the BMI <25 kg/m2 group (36% vs 13%; P = .002). The incidence of CVD was significantly higher in the post-Tx BMI ≥30 kg/m2 group than in the BMI <30 kg/m2 group (50% vs 11%; P = .023). There were no differences in surgical operating time, intraoperative blood loss, or perioperative complications between the obese and non-obese groups. CONCLUSION: Pre-Tx BMI ≥25 kg/m2 may be a risk factor for allograft rejection and graft loss. Post-Tx BMI should be <25 kg/m2 to reduce the risk for PTDM.

    DOI: 10.1016/j.transproceed.2022.10.058

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  • Hyporesponsiveness against donor's ABO antigens of renal grafts after ABO-incompatible kidney transplantation.

    Masayuki Tasaki, Hiroaki Tateno, Takashi Sato, Hisashi Narimatsu, Kazuhide Saito, Yuki Nakagawa, Toshinari Aoki, Masami Kamimura, Takashi Ushiki, Kota Takahashi, Yoshihiko Tomita

    Clinical and experimental nephrology   27 ( 1 )   89 - 95   2022.10

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    BACKGROUND: ABO antigens expressed on the red blood cells (RBCs) are not identical to those expressed on the renal endothelial cells. The isohemagglutinin assay employing the RBCs is the gold standard for evaluating anti-ABO antibody (Ab) levels. However, it remains unclear whether the anti-ABO Abs detected by the isohemagglutinin assay after ABO-incompatible (ABOi) kidney transplantations (KTx) that are not associated with antibody-mediated rejection can bind to renal graft endothelial cells. METHODS: Ninety plasma samples were collected from patients with stable graft function after ABO-compatible (ABOc) or ABOi KTx. Anti-ABO Ab titers were examined by both the isohemagglutinin assay and the CD31-ABO microarray, which was developed as a mimic of the ABO antigens expressed on the renal endothelial cells. RESULTS: The antibody titers detected by the isohemagglutinin assay and the CD31-ABO microarray after the ABOc KTx relatively correlated with each other. However, the CD31-ABO microarray results showed low antibody levels against donor blood group antigens after ABOi KTx and did not correlate with the isohemagglutinin assay. In contrast, the antibody levels against non-donor blood group antigens after ABOi KTx were comparable to those after the ABOc KTx. Fourteen patients received graft biopsies, and no antibody-mediated rejection was observed in ABOi KTx recipients, except for two patients who had anti-donor-HLA Abs. CONCLUSION: The present study suggested that the anti-ABO Abs detected by the isohemagglutinin assay after ABOi KTx with stable graft function were hyporeactive to the ABO antigen of graft renal endothelial cells.

    DOI: 10.1007/s10157-022-02280-3

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  • 腎血管内皮細胞特異的抗血液型抗体測定法の開発

    田崎 正行, 舘野 浩章, 佐藤 隆, 梶 裕之, 富岡 あづさ, 齋藤 和英, 青木 寿成, 上村 正巳, 牛木 隆志, 吉田 豊, 高橋 公太, 冨田 善彦

    移植   57 ( 総会臨時 )   324 - 324   2022.10

  • Endometrial Cancer After Pancreas-After-Kidney Transplantation: A Case Report and Review of the Literature. International journal

    Takashi Kobayashi, Kohei Miura, Hirosuke Ishikawa, Koji Toge, Yuki Hirose, Kazuyasu Takizawa, Jun Sakata, Toshifumi Wakai, Tatsuya Ishiguro, Risa Kudo, Takayuki Enomoto, Kazuhide Saito, Masayuki Tasaki, Masahiro Ikeda, Yoshihiko Tomita, Yoshiaki Kinoshita

    Transplantation proceedings   54 ( 2 )   560 - 564   2022.3

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    BACKGROUND: As the number of long-term survivors after organ transplantation increases, malignancy has become a problem as a late complication. We herein report a case of endometrial cancer during the follow-up of pancreas transplantation after kidney transplantation. CASE PRESENTATION: A 49-year-old woman was diagnosed with endometrial cancer. The patient had developed type 1 diabetes at 8 years old and started insulin treatment, and at 29 years old, she started hemodialysis for diabetic nephropathy. At 31 years old, she received living donor kidney transplantation and withdrew from dialysis. Hypoglycemia unawareness began to occur frequently from around 36 years old, and at 48 years old, the patient underwent deceased donor pancreas transplantation after kidney transplantation and achieved insulin independence. At 49 years old, she was diagnosed with endometrial cancer. Surgical treatment (total abdominal hysterectomy with left salpingo-oophorectomy) was performed. The pathologic diagnosis was confirmed as stage 1A uterine endometrioid carcinoma grade 1. The postoperative course was uneventful. She was discharged from our hospital on postoperative day 8. There has been no evidence of recurrence and/or metastasis of endometrial cancer for 16 months since the surgery. CONCLUSIONS: Carcinogenesis after pancreas transplantation may be a lethal late complication. It is important to carry out regular screening examinations with carcinogenesis in mind.

    DOI: 10.1016/j.transproceed.2021.12.021

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  • Incisional Hernia Repaired Using Thigh Muscle Fascia After Kidney Transplantation: A Case Report. International journal

    Kohei Miura, Takashi Kobayashi, Hirosuke Ishikawa, Seiji Saito, Yasuo Obata, Koji Toge, Yuki Hirose, Kazuyasu Takizawa, Jun Sakata, Masayuki Tasaki, Kazuhide Saito, Yoriko Nakajima, Ken Matsuda, Yoshihiko Tomita, Toshifumi Wakai

    Transplantation proceedings   54 ( 2 )   533 - 536   2022.3

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    BACKGROUND: Although monofilament mesh-based repair is a safe and effective procedure for incisional hernia (IH) in organ transplant patients, there is no definite evidence of IH treatment for patients with graft rejection and enhanced immunosuppressive therapy. We report a successful case of large IH repair using an autologous thigh muscle fascia sheet in a kidney transplant patient. CASE PRESENTATION: A 69-year-old man had IH from the incision of kidney transplantation, which was performed 6 years ago. He had a large right lower abdominal distension hanging down to the inguinal portion. A computed tomography scan revealed a large IH with a maximum abdominal defect diameter of 15 cm. The hernia sac contained the intestine, colon, and transplanted kidney, which had pulled out along with the retroperitoneum and protruded into the abdominal wall. He had chronic active acute antibody-mediated rejection, which required frequent steroid pulse therapy and additional or adjusted immunosuppressive drugs. After total circumferential exposure of the hernia sac and abdominal fascia, the abdominal wall defect was closed using a horizontal mattress suture. The sutured line was covered with a thigh muscle fascia sheet harvested from the patient's right femur and attached to the closed fascia. He was discharged on postoperative day 13 without any complications, and no IH recurrence was observed 10 months after surgery. CONCLUSIONS: Hernia repair using autologous tissue could be a treatment option for post-transplant IH with a higher risk of infection.

    DOI: 10.1016/j.transproceed.2021.09.076

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  • A case of bronchiolitis obliterans after living-donor renal transplantation. International journal

    Masachika Hayashi, Satoshi Hokari, Nobumasa Aoki, Yasuyoshi Ohshima, Satoshi Watanabe, Toshiyuki Koya, Masayuki Tasaki, Kazuhide Saito, Toshiaki Kikuchi

    Respiratory investigation   59 ( 3 )   367 - 371   2021.5

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    We herein report the case of a 20 year-old-man who developed bronchiolitis obliterans after living-donor renal transplantation. The patient presented with dyspnea on exertion and wheezing two years after renal transplantation, and spirometry showed an obstructive pattern. Surgical lung biopsy revealed subepithelial fibrosis that constricted and obstructed the intrabronchiolar space. Based on these findings, the patient was diagnosed with bronchiolitis obliterans. He was prescribed bronchodilators and azithromycin, and he achieved stable respiratory function for two years. The differential diagnosis of respiratory symptoms after renal transplantation includes opportunistic infection and drug-induced lung injury; however, bronchiolitis obliterans should also be considered.

    DOI: 10.1016/j.resinv.2020.12.003

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  • 腎移植患者における血漿レニンおよびアルドステロン値の検討

    田崎 正行, 齋藤 和英, 中川 由紀, 池田 正博, 高橋 公太, 冨田 善彦

    日本泌尿器科学会雑誌   111 ( 3 )   74 - 81   2020.7

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    (背景)アルドステロンは高血圧のみならず,心機能障害や腎機能障害の原因になるとされる.慢性血液透析患者の中に著明な高アルドステロン血症を呈する症例が存在し,移植腎への影響が懸念される.腎移植後のアルドステロンの長期的な変化や移植患者への影響は不明な点が多い.(対象と方法)当院で1996年から2018年に施行された210名の患者の腎移植前後の血漿レニン活性(PRA)と血漿アルドステロン濃度(PAC)を後方視的に評価した.(結果)腎移植前は60%の症例でPRAは基準値より高値を示し,腎移植後も60%の症例が高レニン血症だった.腎移植後の高レニン血症は,アンギオテンシン受容体阻害薬(ARB)やアンギオテンシン変換酵素阻害薬(ACEI)を使用していた患者で有意に多かった.また,60%の症例で腎移植前のPACが基準値より高かったが,そのほとんどが腎移植後に自然に改善していた.腎移植後のPRA,PACの値と移植腎機能,年齢,収縮期および拡張期血圧に有意な相関はなかった.腎移植後PAC基準範囲内と高値の2群比較を行い,PAC高値群(n=29)は,拡張期血圧が有意に高く,レニン-アンギオテンシン-アルドステロン(RAAS)系阻害薬の使用が有意に少なかった.(結語)腎移植後に高アルドステロン血症が持続する患者にはRAAS系阻害薬の使用を考慮し,長期的な移植腎や心血管系への影響を観察する必要はある.(著者抄録)

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  • Kidney function of Japanese children undergoing kidney transplant with preemptive therapy for cytomegalovirus infection. Reviewed International journal

    Yoshimitsu Gotoh, Seiichiro Shishido, Yuko Hamasaki, Yoshihiko Watarai, Motoshi Hattori, Kenichiro Miura, Kiyonobu Ishizuka, Naoya Fujita, Kazuhide Saito, Yuki Nakagawa, Kiyohiko Hotta, Hiroshi Hataya, Riku Hamada, Hiroyuki Sato, Hirotsugu Kitayama, Kenji Ishikura, Masataka Honda, Osamu Uemura

    Transplant infectious disease : an official journal of the Transplantation Society   22 ( 3 )   e13271   2020.6

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    BACKGROUND: Cytomegalovirus (CMV) infection is one of the major factors that affect morbidity and mortality in kidney transplant (KTx) patients. The rate of CMV seropositivity in children before KTx is lower than that in adults; therefore, pediatric KTx patients have a higher risk of CMV infection. In Japanese pediatric KTx patients, preemptive therapy for CMV infection is a main conventional therapy. This study investigated whether this preemptive treatment would affect kidney function at 2 years post-KTx. METHODS: A total of 163 patients, that is approximately half of the Japanese pediatric KTx patients nationwide, were recruited to participate in our study. We compared the values of the sequential estimated glomerular filtration rate (eGFR) at two years post-KTx and other influencing factors in CMV viremia, CMV disease, and no-infection groups. RESULTS: Cytomegalovirus infection after KTx occurred in 75 patients (46.0%), 38.7% of whom developed CMV disease. The sequential eGFR values post-KTx did not differ significantly between the three groups. CMV infection was not significantly correlated with other factors, other infections (including Epstein-Barr [EB] virus infection), acute rejection (AR), or adverse events. Only prolonged duration of total hospitalization was significantly associated with CMV infection (P = .002). In the multivariate analysis, younger age, CMV infection, and adverse effects were independently significantly related to prolonged total hospitalization. CONCLUSION: Preemptive therapy for CMV infection evidenced by viremia and disease did not significantly influence kidney function in Japanese pediatric KTx patients at two years after the operation.

    DOI: 10.1111/tid.13271

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  • ABO血液型不適合腎移植の現状と今後-残された課題- 新潟大学におけるABO血液型不適合腎移植への挑戦

    齋藤 和英, 田崎 正行, 池田 正博, 冨田 善彦, 今井 直史, 伊藤 由美, 成田 一衛, 中川 由紀, 高橋 公太

    日本臨床腎移植学会プログラム・抄録集   53回   140 - 140   2020.2

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  • [PLASMA RENIN ACTIVITY AND ALDOSTERONE IN RENAL TRANSPLANT PATIENTS].

    Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Masahiro Ikeda, Kota Takahashi, Yoshihiko Tomita

    Nihon Hinyokika Gakkai zasshi. The japanese journal of urology   111 ( 3 )   74 - 81   2020

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    (Background) It has become evident in recent year that aldosterone has a pathogenic role in hypertension, heart failure and renal disease. Elevation of aldosterone occurs in a certain fraction of hemodialysis patients, and the adverse effects of hyperaldosteronism could pose a problem after kidney transplantation. Long-term effects of aldosterone level in renal transplant recipients remain unknown. (Materials and methods) All recipients underwent transplantation between 1996 and 2018 in Niigata university hospital were included in the study. Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were retrospectively analyzed in 210 recipients before and after kidney transplantation. (Results) Sixty percent of recipients had higher PRA than normal upper limit before and after transplantation. The use of angiotensin receptor blocker (ARB) or angiotensin-converting-enzyme inhibitor (ACEI) was significantly more frequent in the patients with hyperreninemia than those without one after transplantation. Sixty percent of recipients had higher PAC than normal upper limit before transplantation and it spontaneously decreased to normal level after transplantation in most of them. There was no significant correlation between PAC and blood pressure, recipient age, and renal graft function after transplantation. We divided the patients into two groups, with and without post-transplant hyperaldosteronemia. The patients with post-transplant hyperaldosteronemia (n=29) had higher diastolic blood pressure and less use of renin-angiotensin-aldosterone system (RAAS) inhibitors than those with normal PAC level. (Conclusions) The use of RAAS inhibitors should be considered in post-transplant hyperaldosteronemia patients to control blood pressure and to save their long-term renal graft and heart function.

    DOI: 10.5980/jpnjurol.111.74

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  • Inguinal Herniation After Living Donor Kidney Transplantation: A Case Report. International journal

    Takashi Kobayashi, Kohei Miura, Keita Saito, Masayuki Tasaki, Kazuhide Saito, Jun Sakata, Kazuyasu Takizawa, Tomohiro Katada, Yuki Hirose, Kizuki Yuza, Takuya Ando, Masayuki Nagahashi, Hitoshi Kameyama, Toshifumi Wakai

    Transplantation proceedings   52 ( 6 )   1940 - 1943   2020

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    A 68-year-old male patient received a living donor kidney transplantation 8 years earlier for end-stage kidney disease secondary to IgA nephropathy. His post-transplantation follow-up had been routinely performed with laboratory examinations, ultrasound, and computed tomography (CT). His kidney graft function had been excellent and stable, as shown by a baseline serum creatinine level of 1.0 mg/dL. At referral, regular follow-up ultrasound and CT showed allograft hydroureteronephrosis. He did not have any complaints, but his physical examination revealed right inguinal bulging that was 3.5 × 3.5 cm. Abdominal enhanced CT revealed transplant allograft hydroureteronephrosis due to ipsilateral herniation of ureteroneocystostomy into the right inguinal canal. His serum creatinine level was slightly elevated (1.1 mg/dL). Then, he underwent an open right inguinal hernia repair. Paraperitoneal allograft hydroureteronephrosis and bladder herniation was confirmed at surgery, and hernioplasty with polypropylene mesh reinforcement was successfully performed. The postoperative course was uneventful. He was discharged on the seventh day after surgery. Six weeks after surgery, CT revealed disappearance of allograft hydroureteronephrosis and no sign of inguinal hernia recurrence with the serum creatinine stable at 1.0 mg/dL. Transplant ureteral obstruction due to inguinal hernia is a rare complication after kidney transplantation. However, transplant ureter or bladder herniation should be considered in the differential diagnosis of graft hydroureteronephrosis for preventing allograft loss.

    DOI: 10.1016/j.transproceed.2020.02.131

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  • Analysis of the prevalence of systemic de novo thrombotic microangiopathy after ABO-incompatible kidney transplantation and the associated risk factors. International journal

    Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Naofumi Imai, Yumi Ito, Yutaka Yoshida, Masahiro Ikeda, Shoko Ishikawa, Ichiei Narita, Kota Takahashi, Yoshihiko Tomita

    International journal of urology : official journal of the Japanese Urological Association   26 ( 12 )   1128 - 1137   2019.12

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    OBJECTIVES: To analyze the prevalence of systemic de novo thrombotic microangiopathy in ABO-incompatible kidney transplantation and risk factors associated with this condition. METHODS: A total of 201 patients who received living-donor kidney transplantation (114 patients with ABO-identical kidney transplantation and 87 patients with ABO-incompatible kidney transplantation) were retrospectively analyzed. Systemic de novo thrombotic microangiopathy was diagnosed clinically according to the presence of thrombocytopenia with microangiopathic hemolytic anemia and pathological findings of thrombotic microangiopathy. Anti-A and anti-B antibodies were purified from human plasma, and these antibodies' bindings to human kidney were investigated in vitro. RESULTS: ABO-incompatible kidney transplantation was a significant risk factor of systemic de novo thrombotic microangiopathy (odds ratio 55.9, 95% CI 1.8-8.9, P < 0.001) after transplantation. Multivariate logistic regression analysis showed that non-use of mycophenolate mofetil, pretreatment immunoglobulin G antibody titer ≥64-fold and pretransplant immunoglobulin M antibody titer ≥16-fold were significant risk factors for systemic de novo thrombotic microangiopathy in ABO-incompatible kidney transplantation. Microvascular inflammation of 1-h post-transplant biopsy could be observed more frequently in thrombotic microangiopathy patients than in non-thrombotic microangiopathy patients. Anti-A and anti-B antibodies purified from human plasma showed a strong in vitro reaction against human kidney when the antibody titer was ≥16-fold. CONCLUSIONS: Antibody titer should be decreased to ≤16-fold until the day of ABO-incompatible kidney transplantation by desensitization therapy including mycophenolate mofetil. The 1-h biopsy results might help to diagnose systemic de novo thrombotic microangiopathy.

    DOI: 10.1111/iju.14118

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  • Efficacy and safety of ribavirin therapy for chronic hepatitis E after kidney transplantation. International journal

    Tomoaki Yoshida, Masaaki Takamura, Ryo Goto, Suguru Takeuchi, Atsunori Tsuchiya, Kenya Kamimura, Masayuki Tasaki, Yuki Nakagawa, Kazuhide Saito, Yoshihiko Tomita, Shuji Terai

    Hepatology research : the official journal of the Japan Society of Hepatology   49 ( 10 )   1244 - 1248   2019.10

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    Hepatitis E virus (HEV) infection has been recognized as an acute condition. However, recent reports have shown that immunocompromised patients, such as those receiving solid-organ transplantation, can develop chronic hepatitis with HEV infection. We report two cases of chronic hepatitis E after kidney transplantation (KT) who were successfully treated with ribavirin monotherapy. Several years after KT, both patients had sustained elevations in the levels of liver enzymes for a period of more than 6 months. Both patients had HEV infection, genotype 3a. Histological studies showed infiltration of inflammatory cells without fibrosis. Treatment included ribavirin monotherapy at a dosage of 600 mg daily for 3 months. One month after therapy initiation, HEV-RNA turned to negative, and remained negative at 24 weeks after ribavirin therapy without severe complications. Although the treatment of chronic hepatitis E is not fully established, ribavirin therapy can be a safe and effective treatment for chronic hepatitis E.

    DOI: 10.1111/hepr.13363

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  • 腎移植後TMAの現状と対策 腎移植後におけるThrombotic microangiopathyのリスク因子の検討

    田崎 正行, 齋藤 和英, 中川 由紀, 池田 正博, 今井 直史, 伊藤 由美, 成田 一衛, 高橋 公太, 冨田 善彦

    移植   54 ( 総会臨時 )   187 - 187   2019.9

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  • 腎移植後プロトコール生検施行時期の比較検討

    池田 正博, 田崎 正行, 齋藤 和英, 今井 直史, 伊藤 由美, 中川 由紀, 成田 一衛, 冨田 善彦

    移植   54 ( 総会臨時 )   247 - 247   2019.9

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  • Bortezomib Eliminates Plasma Cells From a Renal Graft in Plasma Cell-Rich Acute Rejection

    Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Masahiro Ikeda, Naofumi Imai, Yumi Ito, Masanori Sudo, Yohei Ikezumi, Takeshi Yamada, Hiroya Hasegawa, Takashi Kobayashi, Kohei Miura, Ichie Narita, Kota Takahashi, Yoshihiko Tomita

    TRANSPLANTATION PROCEEDINGS   51 ( 6 )   1732 - 1738   2019.7

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    Plasma cell-rich acute rejection (PCAR) and antibody-mediated rejection (ABMR), for which a standard treatment has not yet been established, are associated with poor graft survival after kidney transplantation. Here, we report a case series of 3 Japanese patients diagnosed with PCAR accompanied by ABMR. Steroid pulse therapy and rabbit antithymocyte globulin, plasma exchange, intravenous immunoglobulin, and rituximab therapies were sequentially performed in the first case. A graft biopsy after each treatment showed that plasma cell infiltration persisted. Five months after the initiation of rejection therapy, the patient was subjected to bortezomib therapy, which led to the partial elimination of plasma cells from the graft. However, the graft function gradually deteriorated, and hemodialysis treatment was warranted. In the other 2 cases, the patients received the same combination of therapy including bortezomib within a short period. Graft biopsies performed subsequently showed a marked decrease in the number of infiltrated plasma cells, and stabilization of renal graft function was achieved in both cases. Bortezomib, which targets plasma cells, is a potent drug that eliminates infiltrated plasma cells from the graft in PCAR. Thus, in addition to conventional therapy comprising plasma exchange, intravenous immunoglobulin, and rituximab against ABMR, bortezomib may be necessary to administer without any delay to control PCAR.

    DOI: 10.1016/j.transproceed.2019.02.038

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  • 腎移植後におけるThrombotic microangiopathyのリスク因子の検討

    田崎 正行, 齋藤 和英, 中川 由紀, 今井 直史, 伊藤 由美, 成田 一衛, 高橋 公太, 冨田 善彦

    日本泌尿器科学会総会   107回   AOP - 004   2019.4

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  • RESULTS OF TONSILLECTOMY AND STEROID PULSE THERAPY IN 20 CASES OF RECURRENT IgA NEPHROPATHY AFTER KIDNEY TRANSPLANTATION

    Tadokoro Akira, Baba Hironori, Takahashi Nao, Horii Arata, Takahashi Kota, Tomita Yoshihiko, Tasaki Masayuki, Saito Kazuhide, Nakagawa Yuki, Ikeda Masahiro, Ishikawa Shoko, Imai Naofumi, Ito Yumi, Aizawa Naotaka

    The Japanese Journal of Urology   110 ( 2 )   92 - 99   2019

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    <p> (Background) The standard treatment for recurrent immunoglobulin A nephropathy (rIgAN) after kidney transplantation (KTx) has not been established.</p><p> (Methods) The results of treatment consisting of tonsillectomy and steroid pulse therapy in 20 recipients who were diagnosed as rIgAN were retrospectively analyzed.</p><p> (Results) The level of proteinuria significantly decreased from 0.84±0.81 g/day to 0.27±0.31 g/day after treatment (P=0.007). Microscopic hematuria disappeared or improved in 58.3% and 66.6% of recipients 6 and 12 months after treatment, respectively. Serum creatinine levels remained stable for 5 years by the treatment, except for 3 cases of graft loss. Sixteen recipients received renal graft biopsies before and after treatment. Mesangial IgA deposition were dramatically decreased in 7 recipients (43.75%). The degree of mesangial hypercellularity, endocapillary hypercellularity, and crescents formation improved in 3 (18.8%), 6 (37.5%), and 4 (25%) recipients after treatment.</p><p> (Conclusion) Steroid pulse therapy combined with tonsillectomy may be clinically and histopathologically effective treatment for rIgAN after KTx.</p>

    DOI: 10.5980/jpnjurol.110.92

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  • Limited significance of repeated long-term radiological and hormonal examination in nonfunctioning adrenal incidentalomas. International journal

    Masayuki Tasaki, Takashi Kasahara, Itsuhiro Takizawa, Kazuhide Saito, Tsutomu Nishiyama, Yoshihiko Tomita

    International braz j urol : official journal of the Brazilian Society of Urology   45 ( 3 )   503 - 513   2019

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    PURPOSE: The purposes of the present study were to evaluate growth rate of nonfunctioning adrenal incidentalomas (AIs) and their development to hormonal hypersecretion on follow-up. MATERIALS AND METHODS: A retrospective study was conducted from the electronic medical records. A total of 314 patients were diagnosed with adrenal tumors between 2000 and 2016. After excluding patients who had overt adrenal endocrine disorders or whose adrenal tumors were clinically diagnosed as metastatic malignancies, we investigated 108 patients with nonfunctioning AIs including characteristics, the treatment, the way of follow-up and pathology. RESULTS: Fifteen patients received immediate adrenalectomy because of the initial tumor size or patient's preference. Pathological examination revealed malignancy in 2 patients. In the remaining 93 patients, radiological examinations were performed periodically. Tumor enlargement of ≥ 1.0cm was observed in 8.6% of the patients who were followed up as nonfunctioning AIs with a median follow-up period of 61.5 months (range: 4-192). Eleven patients underwent adrenalectomy. On the pathological examinations, all of the tumors, which showed a size increase, were diagnosed as benign tumors. Regarding the followed up patients without adrenalectomy, only 2.4% of the patients had tumor enlargement during the prolonged follow-up. Furthermore, none of the patients developed hormonal hypersecretion or clinical signs such as obesity, glucose intolerance or poorly controlled hypertension. CONCLUSIONS: Tumor enlargement of AIs did not correlate with malignancy. The value of repeat radiological and hormonal examinations may be limited in the long-term follow-up of patients whose AIs are not enlarged.

    DOI: 10.1590/S1677-5538.IBJU.2018.0235

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  • 生体腎移植の適応の検討 DM症例を中心に

    中川 由紀, 田崎 正行, 齋藤 和英, 村田 雅樹, 西山 勉, 高橋 公太, 冨田 善彦

    移植   53 ( 総会臨時 )   510 - 510   2018.9

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  • 長期生着を踏まえて小児腎不全症例の腎移植はいつが理想か? 小児先行的腎移植症例検討から

    中川 由紀, 田崎 正行, 齋藤 和英, 山田 剛史, 長谷川 博也, 村田 雅樹, 西山 勉, 高橋 公太, 冨田 善彦

    移植   53 ( 総会臨時 )   433 - 433   2018.9

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  • 新潟大学泌尿器科における腎移植成績についての検討

    齋藤 和英, 田崎 正行, 中川 由紀, 池田 正博, 高橋 公太, 冨田 善彦

    泌尿器外科   31 ( 臨増 )   821 - 821   2018.6

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  • 当院における腎移植後に発生した移植後リンパ増殖性疾患(PTLD)5症例の検討

    田崎 正行, 齋藤 和英, 中川 由紀, 池田 正博, 高橋 公太, 冨田 善彦

    腎移植・血管外科   29 ( 1 )   15 - 19   2018.5

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    【背景】移植後リンパ増殖性疾患(post-transplant lymphoproliferative desorder:PTLD)は、近年増加傾向にある。【対象と方法】当院で1988-2015年の間に行われた413症例を対象に、PTLDを発症した5症例を後方視的に検討した。【結果】男性3例、女性2例で、移植時の年齢の中央値は51歳、PTLD診断時の年齢の中央値は55歳、腎移植後にPTLDと診断されるまでの期間の中央値は142ヵ月だった。5例のうち1例は死亡、3例は透析再導入となった。死亡した症例を除き、全例で免疫抑制薬の減量・中止が行われ、1例で外科的切除術、1例で化学療法、1例で両者併用が行われた。【結論】5人のPTLDのうち、4人がLate onsetであり、腎移植後の継続的なスクリーニングが必要であると考えられた。(著者抄録)

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  • ABO血液型不適合生体腎移植前に行った二重膜濾過血漿交換施行中に全身膨隆疹を発症した一例

    宮内 大輔, 斎藤 将名, 土田 良樹, 谷江 駿矢, 近藤 友希, 長谷川 進, 西塔 毅, 田崎 正行, 中川 由紀, 齋藤 和英, 蒲澤 秀門, 山本 卓, 成田 一衛

    日本臨床工学技士会会誌   ( 63 )   194 - 194   2018.4

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  • Management of Juvenile Idiopathic Arthritis in ABO-incompatible Kidney Transplantation: A Case Report. International journal

    S Ishikawa, M Tasaki, T Kuroda, D Kobayashi, K Saito, Y Nakagawa, M Ikeda, K Takahashi, Y Tomita

    Transplantation proceedings   50 ( 3 )   869 - 872   2018.4

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    Biologic agents are a beneficial therapy for juvenile idiopathic arthritis (JIA). However, there is a lack of evidence with regard to management of these agents for JIA patients who undergo kidney transplantation (KTx). A 36-year-old woman with JIA who was treated with tocilizumab targeting interleukin-6 (IL-6) receptor underwent ABO-incompatible kidney transplantation (ABOi KTx). To prevent over-immunosuppression, tocilizumab was discontinued before ABOi KTx. Rituximab, tacrolimus, mycophenolate mofetil, everolimus, and methylprednisolone were used for immunosuppression. Clinical remission of joint pain was maintained for over 3 years despite complete discontinuation of tocilizumab. Both serum IL-6 and soluble IL-6 receptor levels were markedly decreased, suggesting that multitargeted immunosuppression for ABOi KTx induced long-term clinical remission of JIA through inhibition of the IL-6 pathway. However, levels of C-reactive protein (CRP) and matrix metalloproteinase-3 (MMP-3) gradually increased thereafter and abatacept was initiated to prevent joint deterioration. These levels decreased without any adverse events. The patient's renal graft function was well maintained.

    DOI: 10.1016/j.transproceed.2017.12.052

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  • IgA腎症に対する腎移植の検討

    田崎 正行, 齋藤 和英, 中川 由紀, 今井 直史, 伊藤 由美, 成田 一衛, 高橋 公太, 冨田 善彦

    日本腎臓学会誌   60 ( 3 )   341 - 341   2018.4

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  • [THE USE OF BORTEZOMIB FOR THE TREATMENT OF CHRONIC ANTIBODY MEDIATED REJECTION AFTER KIDNEY TRANSPLANTATION].

    Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Tomohiro Nobushita, Tsutomu Anraku, Hiroo Kuroki, Naofumi Imai, Yumi Ito, Yoshihiko Tomita

    Nihon Hinyokika Gakkai zasshi. The japanese journal of urology   109 ( 2 )   68 - 73   2018

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    (Backgrounds) The efficacy of bortezomib for chronic antibody mediated rejection (CAMR) after kidney transplantation is still obscure. (Materials and methods) CAMR were persisted in 5 recipients who were treated with plasma exchange, low dose of IVIG, steroid pulse therapy, and rituximab. 1.3 mg/m2 of bortezomib was administered on days 1, 4, 8, 11. Serum creatinine (sCr) levels, anti-HLA antibodies, and histology were analyzed. (Results) Stable sCr levels were obtained in 3 out of 5 recipients. No one lost renal graft function during follow-up periods. Anti-HLA class I antibodies were significantly decreased after bortezomib treatment, however anti-HLA class II antibodies were not changed. Histology showed no improvement at 6 months after bortezomib administration. Two recipients whose sCr levels increased during follow-up had already had interstitial fibrosis and tubular atrophy (IF/TA) in histology before bortezomib treatment. (Conclusions) The use of bortezomib after IF/TA could be detected in histology may not contribute to stabilize renal graft function in CAMR.

    DOI: 10.5980/jpnjurol.109.68

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  • [LONG-TERM OUTCOME OF PEDIATRIC KIDNEY TRANSPLANTATION: A SINGLE-CENTER EXPERIENCES].

    Hiroo Kuroki, Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Yohei Ikezumi, Toshiaki Suzuki, Takeshi Yamada, Hiroya Hasegawa, Kaoru Maruyama, Naofumi Imai, Kota Takahashi, Yoshihiko Tomita

    Nihon Hinyokika Gakkai zasshi. The japanese journal of urology   109 ( 1 )   14 - 19   2018

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    (Background) Long-term care is necessary for normal growth and development of pediatric recipients of kidney transplants. We report on our experience with pediatric kidney transplantation (KTx) during the past 19 years. (Methods) We retrospectively analyzed the data from 26 recipients who received KTx between 1996 and 2014 at Niigata University Hospital (one patient underwent two consecutive KTx during the designated period). All recipients were 16 years old or younger at the time of KTx. (Results) The graft survival rates at 1, 5, and 10 years after transplantation were 96%, 96%, and 88%, respectively. Three recipients lost the renal graft function due to graft thrombosis, antibody mediated rejection and steroid resistant rejection. Drug non-adherence was associated with rejection episodes, which led to the increasing of estimated glomerular filtration rate (eGFR) level. In addition, renal graft function was related to the growth after KTx. Eighteen recipients graduated from high school during follow-up periods and 17 recipients obtained employment. (Conclusion) Interventions promoting adherence should be implemented among pediatric recipients and parents to optimize graft survival and growth after KTx. Successful KTx contributed the high rate of social participation and employment after pediatric KTx.

    DOI: 10.5980/jpnjurol.109.14

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  • 【Onco-nephrology】腎障害患者に対する抗がん薬治療 腎移植がん患者の診断と治療

    田崎 正行, 齋藤 和英, 中川 由紀, 池田 正博, 高橋 公太, 冨田 善彦

    腎と透析   83 ( 5 )   723 - 728   2017.11

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  • B細胞研究の臨床応用 ABO血液型不適合腎移植におけるB細胞の関与

    田崎 正行, 齋藤 和英, 中川 由紀, 池田 正博, 高橋 公太, 冨田 善彦

    移植   52 ( 総会臨時 )   265 - 265   2017.8

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  • 【腎移植-長期生着を目指して】先行的腎移植

    中川 由紀, 齋藤 和英, 冨田 善彦

    腎と透析   83 ( 2 )   162 - 166   2017.8

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  • 献腎登録患者のスクリーニングの必要性の検討

    中川 由紀, 田崎 正行, 齋藤 和英, 高橋 公太, 成田 一衛, 冨田 善彦

    日本透析医学会雑誌   50 ( Suppl.1 )   937 - 937   2017.5

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  • ABO血液型不適合腎移植前の抗体価と抗体関連型拒絶反応の検討

    田崎 正行, 齋藤 和英, 中川 由紀, 今井 直史, 伊藤 由美, 高橋 公太, 冨田 善彦

    泌尿器外科   30 ( 臨増 )   881 - 881   2017.5

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  • 先行的腎移植の現状と課題 移植医の立場より

    中川 由紀, 池田 正博, 田崎 正行, 齋藤 和英, 高橋 公太, 冨田 善彦

    日本泌尿器科学会総会   105回   UP03 - 3   2017.4

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  • 【心停止下献腎移植推進のために】心停止下献腎移植の腎機能に影響する因子

    田崎 正行, 齋藤 和英, 中川 由紀, 池田 正博, 伊藤 由美, 今井 直史, 成田 一衛, 赤澤 宏平, 高橋 公太, 冨田 善彦

    腎移植・血管外科   27 ( 2 )   115 - 122   2017.4

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    移植医療におけるドナー不足は大きな問題であり、高齢者ドナーや心停止後摘出臓器の利用が世界的にも増加している。移植後の腎機能に影響する因子を検討することは以前より行われてきた。当院における59例の心停止下献腎移植の移植腎機能にかかわるレシピエント因子、ドナー因子、graft因子をそれぞれ後方視的に解析した。その結果、UNOSの定義するExpanded criteria donor(ECD)とgraft hyalinosisの程度が移植後腎機能に大きく影響する因子であることが分かった。(著者抄録)

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  • 生体腎移植の適応の検討 DM症例を中心に

    中川 由紀, 池田 正博, 田崎 正行, 齋藤 和英, 高橋 公太, 冨田 善彦

    日本泌尿器科学会総会   105回   OP79 - 1   2017.4

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  • 慢性抗体関連型拒絶反応に対するボルテゾミブの使用経験

    田崎 正行, 齋藤 和英, 中川 由紀, 今井 直史, 伊藤 由美, 冨田 善彦

    日本泌尿器科学会総会   105回   OP79 - 7   2017.4

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  • Acquired Downregulation of Donor-Specific Antibody Production After ABO-Incompatible Kidney Transplantation. International journal

    M Tasaki, K Saito, Y Nakagawa, N Imai, Y Ito, T Aoki, M Kamimura, I Narita, Y Tomita, K Takahashi

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons   17 ( 1 )   115 - 128   2017.1

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    The mechanism of long-term B cell immunity against donor blood group antigens in recipients who undergo ABO-incompatible (ABOi) living-donor kidney transplantation (LKTx) is unknown. To address this question, we evaluated serial anti-A and anti-B antibody titers in 50 adult recipients. Donor-specific antibody titers remained low (≤1:4) in 42 recipients (84%). However, antibodies against nondonor blood group antigens were continuously produced in recipients with blood type O. We stimulated recipients' peripheral blood mononuclear cells in vitro to investigate whether B cells produced antibodies against donor blood group antigens in the absence of graft adsorption in vivo. Antibodies in cell culture supernatant were measured using specific enzyme-linked immunosorbent assays (ELISAs). Thirty-five healthy volunteers and 57 recipients who underwent ABO-compatible LKTx served as controls. Antibody production in vitro against donor blood group antigens by cells from ABOi LKTx patients was lower than in the control groups. Immunoglobulin deposits were undetectable in biopsies of grafts of eight recipients with low antibody titers (≤1:4) after ABOi LKTx. One patient with blood type A1 who received a second ABOi LKTx from a type B donor did not produce B-specific antibodies. These findings suggest diminished donor-specific antibody production function in the setting of adult ABOi LKTx.

    DOI: 10.1111/ajt.13937

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  • [LEIOMYOSARCOMA OF THE OVARIAN VEIN WITH THE RENAL VEIN INVASION: A CASE REPORT].

    Ryo Nakayama, Itsuhiro Takizawa, Ryo Maruyama, Takashi Kasahara, Noboru Hara, Kazuhide Saito, Yoshihiko Tomita

    Nihon Hinyokika Gakkai zasshi. The japanese journal of urology   108 ( 4 )   210 - 214   2017

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    A 56-year-old woman had complained of two year's consecutive left-side abdominal pain. Retroperitoneal tumor was diagnosed and the patient was referred to our institute in December 2014. Laboratory data including endocrinological activity and serological markers were within the normal ranges. Imaging studies showed that the solid tumor measuring 5 cm in diameter was uncovered in the retroperitoneum, between the abdominal aorta and left kidney. The patient underwent surgical removal of the tumor with the left kidney because the mass was highly adhesive to the left ovarian vessels and left renal vein. Histological examination showed proliferating spindle cells in the tumor, and immunoreactivity for desmin and alfa-smooth muscle actin in tumor cells confirmed the diagnosis of leiomyosarcoma originated in left ovarian vein with left renal vein invasion. The patient has been free of disease 21 months after the surgery. Ovarian vein leiomyosarcoma is extremely rare and we have found 18 cases in literature. Furthermore, only three cases of leiomyosarcoma arising from the ovarian vein with the renal vein invasion were reported including our case.

    DOI: 10.5980/jpnjurol.108.210

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  • 【腎と透析診療指針2016】(第18章)腎移植 腎移植の適応 ドナー 死体腎(献腎)

    中川 由紀, 田崎 正行, 齋藤 和英, 高橋 公太, 相川 厚, 菊池 雅美, 冨田 善彦

    腎と透析   80 ( 増刊 )   668 - 671   2016.6

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  • 成功する先行的腎移植のための準備 移植医から腎臓内科医へ 内科医と連携によって成り立つ先行的腎移植

    中川 由紀, 高橋 公太, 田崎 正行, 齋藤 和英, 成田 一衛, 冨田 善彦

    日本腎臓学会誌   58 ( 3 )   248 - 248   2016.5

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  • 腎移植治療の最前線 当科におけるABO不適合腎移植の基礎研究

    田崎 正行, 齋藤 和英, 中川 由紀, 今井 直史, 今井 由美, 高橋 公太, 冨田 善彦

    泌尿器外科   29 ( 臨増 )   867 - 869   2016.5

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  • 先行的腎移植の検討

    中川 由紀, 田崎 正行, 齋藤 和英, 成田 一衛, 高橋 公太, 冨田 善彦

    泌尿器外科   29 ( 臨増 )   908 - 908   2016.5

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  • 内科医と連携によって成り立つ先行的腎移植について

    中川 由紀, 池田 正博, 田崎 正行, 齋藤 和英, 成田 一衛, 高橋 公太, 冨田 善彦

    日本泌尿器科学会総会   104回   OP - 006   2016.4

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  • ハイリスク腎移植への挑戦 高抗体価ABO血液型不適合腎移植への挑戦 血液型糖鎖抗原・抗体の多様性と脱感作療法の意義をふまえて

    齋藤 和英, 中川 由紀, 田崎 正行, 冨田 善彦, 高橋 公太

    日本泌尿器科学会総会   104回   SPS14 - 3   2016.4

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  • 当院における抗体関連型拒絶反応17症例の検討

    黒木 大生, 田崎 正行, 風間 明, 今井 直史, 池田 正博, 中川 由紀, 齋藤 和英, 高橋 公太, 冨田 善彦

    移植   50 ( 総会臨時 )   373 - 373   2015.9

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  • タクロリムス徐放性製剤(グラセプター)の血中濃度測定の簡略化の検討

    塚口 真穂登, 田崎 正行, 田所 央, 黒木 大生, 真砂 俊彦, 中川 由紀, 齋藤 和英, 高橋 公太, 冨田 善彦, 磯貝 和也, 笹原 浩康, 外山 聡

    移植   50 ( 総会臨時 )   412 - 412   2015.9

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  • 献腎登録患者のスクリーニングの必要性の検討

    中川 由紀, 田崎 正行, 池田 正博, 齋藤 和英, 高橋 公太, 成田 一衛, 冨田 善彦

    移植   50 ( 総会臨時 )   318 - 318   2015.9

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  • 生体腎移植2例が長期生着中の家族性巣状分節性糸球体硬化症の1家系

    坪野 俊介, 酒巻 裕一, 山本 卓, 今井 直史, 伊藤 由美, 田崎 正行, 中川 由紀, 齋藤 和英, 後藤 眞, 高橋 公太, 成田 一衛

    日本腎臓学会誌   57 ( 6 )   947 - 947   2015.8

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  • ABO血液型不適合腎移植における術前アフェレーシスの検討

    中川 由紀, 田崎 正行, 齋藤 和英, 冨田 善彦, 高橋 公太

    日本透析医学会雑誌   48 ( Suppl.1 )   485 - 485   2015.5

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  • Trends in ABO-Incompatible Kidney Transplantation Reviewed

    Atsushi Aikawa, Kazuhide Saito, Kota Takahashi

    EXPERIMENTAL AND CLINICAL TRANSPLANTATION   13   18 - 22   2015.4

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    The ABO-incompatible living-donor kidney transplantation was developed in Japan in 1989. Currently, most transplant physicians and surgeons have noted that outcomes are unexpectedly excellent, and no hyperacute rejections have been reported since 2001. In the registry of the Japanese ABO-Incompatible Kidney Transplantation Committee, the data of 2434 ABO-incompatible living-donor kidney transplants were collected from 120 Japanese kidney transplant centers. Overall patient and graft survival rates were 97% and 94% at 1 year, 93% and 86% at 5 years, 90% and 71% at 10 years, and 73% and 52% at 20 years. The patient survival and graft rates in 2001 to 2012 were 93% and 81%, which were significantly better than 83% and 55% reported in 1989 to 2000. The addition of novel immunosuppressive treatments has improved results. Azathioprine has been replaced by mycophenolate mofetil since 2000 to 2001, and basiliximab and rituximab were introduced in 2002 and 2004. The titer of antidonor blood group antibody before transplantation was not correlated with graft survival in 2001 to 2012. De novo antibodies against vascular endothelium of peritubular and glomerular capillaries seemed to be more important than natural antibodies against red blood cells. Therefore, recipients with antidonor blood group antibody titers &lt; 1:128 did not require antibody-removal procedures such as plasmapheresis or immunoadsorption. In particular, children (regardless of their peritoneal dialysis status) do not need to be catheterized for plasmapheresis or immunoadsorption. It is better to avoid the risks of catheterization and antibody removal procedures in children with end-stage renal failure.

    DOI: 10.6002/ect.mesot2014.L24

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  • 新潟大学における糖尿病性腎症に対する腎移植

    池田 正博, 齋藤 和英, 田崎 正行, 中川 由紀, 高橋 公太

    日本泌尿器科学会総会   103回   639 - 639   2015.4

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  • 糖尿病性腎症に対する腎移植 周術期と維持期の管理について

    池田 正博, 田崎 正行, 中川 由紀, 齋藤 和英, 高橋 公太

    今日の移植   28 ( 1 )   91 - 94   2015.2

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  • 【ABO血液型不適合移植の新戦略2015】新潟大学におけるABO不適合腎移植の基礎研究

    田崎 正行, 齋藤 和英, 中川 由紀, 今井 直史, 高橋 公太

    今日の移植   28 ( 1 )   73 - 83   2015.2

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    ABO血液型不適合腎移植におけるaccommodationのメカニズムはいまだに解明されていない。移植腎に発現するABO血液型抗原や、抗ドナー血液型抗体の移植腎血管内皮細胞に対する親和性を解析することが、accommodationのメカニズムの解明につながるのではないかと、近年当科でも基礎研究を行っている。質量分析計を用いた解析により、腎臓に発現するABO血液型糖鎖抗原が結合する蛋白質をほぼすべて同定できた。また、ヒト由来の抗A、抗B抗体を精製し、それらの抗体の赤血球に対する凝集反応と腎臓への結合を解析している。さらに、ヒトリンパ球を培養しin vitroで抗A・抗B抗体が産生される条件を追究し、ABO不適合腎移植後の抗ドナー血液型抗体産生能の解析を行っている。(著者抄録)

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  • 糖尿病合併例の腎移植における免疫抑制療法 糖尿病性腎症の腎移植における免疫抑制療法 新潟大学における治療戦略

    池田 正博, 齋藤 和英, 田崎 正行, 中川 由紀, 高橋 公太

    今日の移植   27 ( 6 )   533 - 537   2014.12

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    糖尿病性腎症の腎移植における免疫抑制療法について検討した。腎移植を施行した374例中、原疾患が糖尿病性腎症(DMN)の23例を対象とした。1型DMNは9例中4例に拒絶反応を認め、3例はデオキシスパガリン(DSG)、1例はDSGに加えSTパルス療法を行った。2型DMNは14例中3例が拒絶反応を認め、DSGで治療した。DMN全体の生存率は、1年100%、5年90%、10年80%、生着率は、1年100%、5年90%、10年72%であった。導入免疫抑制療法は、2001年以降は、膵腎同時移植症例以外はシクロスポリン(CyA)+ミコフェノール酸モフェチル(MMF)+ST+バシリキシマブを導入した。維持免疫抑制療法は10例がSTを中止し、CyA+MMFの2剤で行った。13例はSTを継続した。

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  • Effect of donor-recipient age difference on long-term graft survival in living kidney transplantation Reviewed

    Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Masahiro Ikeda, Naofumi Imai, Ichiei Narita, Kota Takahashi

    INTERNATIONAL UROLOGY AND NEPHROLOGY   46 ( 7 )   1441 - 1446   2014.7

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    We aimed to examine the influence of donor age on living-donor kidney transplantation (KTx), particularly with regard to long-term graft survival in young recipients with aged kidney grafts.
    Between 1988 and 2012, 287 living-donor KTxs were performed in our center. The recipients were divided into 3 groups according to age in years: under 30 (young), 30-49 (middle-aged), and over 50 (old). The data regarding the influence of kidneys from donors aged over 50 years were retrospectively analyzed.
    Graft survival at 1, 5, 10, and 15 years was 94.7, 94.7, 90.2, and 75.2 %, respectively, in young recipients who received grafts from donors aged under 50 years, and 96.4, 91.9, 65.4, and 41.4 %, respectively, in young recipients who received grafts from donors aged over 50 years (P = 0.023). In contrast, there were no significant differences regarding graft survival and donor age in the middle-aged and old recipient groups. Multivariate analysis revealed that young recipient and rejection episode were significant predictors of graft loss in transplantation from older donors. Histological examination revealed significant age-related changes in the grafts before transplant and a significant higher rate of glomerular hypertrophy at the 1-month protocol biopsy in young recipients with aged kidney grafts.
    Kidney grafts from older living donors affected long-term graft survival in young recipients. In addition to the damage from rejection, aged kidney grafts, which have less nephron mass, may have a limited capacity to appropriately respond to increases in physiological or metabolic demands of young recipients, leading to a greater reduction in renal function.

    DOI: 10.1007/s11255-014-0655-8

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  • [Laparoscopic fenestration for a symptomatic lymphocele in renal graft after living-donor kidney transplantation].

    Shoko Ishikawa, Masayuki Tasaki, Naofumi Imai, Masahiro Ikeda, Takashi Kasahara, Mitsuhiro Sekijima, Yusuke Tomita, Yuki Nakagawa, Kazuhide Saito, Tsutomu Nishiyama, Kota Takahashi

    Nihon Hinyokika Gakkai zasshi. The japanese journal of urology   105 ( 3 )   139 - 43   2014.7

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    A 36-year-old female received protocol biopsy at 1 month after living donor kidney transplantation. At 3 months post-transplantation, presence of a growing cystic mass in the kidney graft which had not been detected preoperatively, was demonstrated by ultrasound and computed tomography. The patient had an abdominal pain around the graft. Percutaneous drainage and sclerotherapy with minocyclin were performed twice, but the cystic mass, nevertheless, became enlarged and the abdominal pain recurred again. Laparoscopic fenestration was then performed. Immunohistochemistry of the cystic mass wall showed that it was CD34 (-), EMA (-), Megalin (-), but D2-40 (+). These results suggested that the cystic mass was derived from lymphatic vessels, which developed into lymphocele in the graft. We concluded that lymphatic vessels could have been injured and obstructed by the protocol biopsy. This is the first report of successful laparoscopic fenestration for lymphocele in the kidney graft.

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  • ドナーおよびレシピエント年齢が献腎移植の予後に与える影響の検討

    中川 由紀, 池田 正博, 田崎 正行, 齋藤 和英, 高橋 公太

    腎移植・血管外科   25 ( 1 )   33 - 39   2014.6

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    【目的】献腎提供の少ない日本では、長い待機期間を有しないとレシピエントとして選定されることが少ない。そのため高齢者、長期透析患者が選定される事が非常に多い。そこで、このようなマージナルなレシピエントに若年者の提供腎がどのような影響をうけるのか、また高齢者の提供腎が、若年者のレシピエントの予後にどのような影響をうけるのか検討した。【対象と方法】われわれの施設における献腎移植55症例に対してドナー・レシピエントを50歳未満・50歳以上でそれぞれ分類し、その予後を検討した。【結果】10年生着率はG1 84.2%、G2 54.4%、G3 83.3%、G4 53.8%で若年者のレシピエントにおいて若年者ドナー(G1)に比べ高齢者ドナー(G2)では有意に生着率は低かった(P=0.014)。しかし高齢者レシピエントではドナー年齢で生着率に有意差を認めなかった(G3:G4 P=0.409)。【結語】若年者のレシピエントに高齢者の提供腎を移植する事は、その予後を不良とする可能性が高い。余命の長い若年者のレシピエントに対しては、年齢による振り分け選定を検討する必要性がある。(著者抄録)

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  • 【透析・腎移植のすべて】腎移植 特殊な腎移植 ABO血液型不適合腎移植

    田崎 正行, 齋藤 和英, 中川 由紀, 高橋 公太

    腎と透析   76 ( 増刊 )   620 - 624   2014.6

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  • Immune monitoring with a lymphocyte adenosine triphosphate assay in kidney transplant recipients treated with a calcineurin inhibitor. International journal

    Kentaro Sugiyama, Mahoto Tsukaguchi, Akira Toyama, Hiroshi Satoh, Kazuhide Saito, Yuki Nakagawa, Kota Takahashi, Sachiko Tanaka, Kenji Onda, Toshihiko Hirano

    Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation   12 ( 3 )   195 - 9   2014.6

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    OBJECTIVES: The adenosine triphosphate assay using peripheral lymphocytes may be useful to evaluate the risks of acute rejection and infection in kidney transplant patients. We used the adenosine triphosphate assay to evaluate differences between recipients who were treated with cyclosporine- or tacrolimus-based immunosuppressive therapy. MATERIALS AND METHODS: Adenosine triphosphate levels were measured in peripheral CD4+ cells before and after transplant and were correlated with clinical outcomes in 45 kidney transplant recipients. These recipients received immunosuppressive therapy with either cyclosporine (23 patients) or tacrolimus (22 patients). RESULTS: Adenosine triphosphate levels were significantly lower in the cyclosporine- than tacrolimus-based therapy groups from 2 to 6 weeks after transplant. Adenosine triphosphate levels were similar between these groups before and 1 week after transplant. The frequency of cytomegalovirus infection was greater in the recipients who received cyclosporine (17 patients [74%]) than tacrolimus (6 patients [27%]; P ≦ .003). The frequency of acute rejection episodes was similar between the cyclosporine and tacrolimus groups. CONCLUSIONS: These observations suggest that cyclosporine-based immunosuppressive therapy causes excessive immunosuppression compared with tacrolimus-based therapy, evidenced by the lymphocyte adenosine triphosphate levels. The adenosine triphosphate assay using peripheral CD4+ cells may be a useful method for predicting the occurrence of cytomegalovirus infections in kidney transplant recipients.

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  • 献腎移植におけるドナー年齢、レシピエント年齢による予後の検討

    中川 由紀, 池田 正博, 田崎 正行, 齋藤 和英, 高橋 公太

    日本透析医学会雑誌   47 ( Suppl.1 )   647 - 647   2014.5

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  • 献腎移植におけるドナー年齢、レシピエント年齢による予後の検討 1施設症例検討

    中川 由紀, 池田 正博, 田崎 正行, 齋藤 和英, 西山 勉, 高橋 公太

    日本泌尿器科学会総会   102回   431 - 431   2014.4

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  • 【糖尿病性腎症への進歩した腎代替療法-その標準化と個別化】腎移植

    池田 正博, 齋藤 和英, 中川 由紀, 田崎 正行, 高橋 公太

    臨床透析   30 ( 1 )   119 - 126   2014.1

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    腎移植は免疫抑制薬の進歩などにより成績が向上しており,優れた腎代替療法として有用性が確立している.糖尿病性腎症(DM腎症)の慢性腎不全患者は,心血管疾患(CVD)による死亡リスクが高く,透析導入後の予後は非常に悪い.一方,腎移植では透析に比べて生命予後の改善が望める.さらに透析による合併症を避けて腎移植を行うことが,移植腎生着率・生存率の上昇につながる.DM腎症患者ではとくにCVDを含む合併症の評価が重要であり,術前に十分な精査を行う.術後は手術侵襲,免疫抑制薬などにより糖尿病が悪化することが多く,厳密な血糖コントロールが必要となる.またDM腎症の再発が腎生着率を低下させるため,移植後も長期にわたり糖尿病の治療が必要である.(著者抄録)

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  • Obstacles of non-heart-beating donor kidney transplantation in Japan to date and future perspectives Invited Reviewed

    K. Saito, S. Takahara, Y. Nakagawa, T. Yagisawa, M. Naka Mieno, K. Takahashi

    Transplantation Proceedings   45 ( 8 )   2866 - 2870   2013.10

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    In Japan, multiple organ retrieval from brain-dead heart-beating donors has been gradually increasing since the law was adopted in 1997 and amended in 2009. However, almost more than 90% of total deceased donor kidney transplantation (DDKT) in Japan are still obtained from non-heart-beating donors (NHBD). The majority of NHBD are Maastricht categories IV and III. In category IV, we usually place a double balloon arterial and a venous drainage catheter via the femoral vessels after the diagnosis of clinical brain death and acquisition of informed consent from the family. After controlled cardiac arrest, the double balloons are inflated and in situ cold perfusion started as soon as possible to minimize warm ischemic time (WIT), seeking to achieve a zero to within a few minutes WIT in most cases. In category III, it is impossible to place the device prior to cardiac arrest. In these cases, after declaration of cardiac death, cardiopulmonary compression is accompanied by systemic heparinization, immediate laparotomy, and insertion of a cold perfusion catheter at the aortic and caval bifurcations to minimize WIT. NHBD kidney retrieval is critical
    extirpation must be performed as rapidly as possible. The results of NHBD kidney transplantation in Japan are excellent, according to the advancement and utilization of in situ cannulation, organ perfusion, and sophisticated retrieval techniques. The patient and graft survival rates of DDKT at 1, 3, and 5 years in most recent 2001 to 2007 era were 95.4%, 92.2%, 89.1% (n = 945) and 89.2%, 83.7%, 77.8% (n = 919), respectively. © 2013 by Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.transproceed.2013.08.062

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  • ABO不適合腎移植患者の脱感作療法開始時と移植手術直前の免疫抑制薬感受性と個別医療

    杉山 健太郎, 笹原 浩康, 塚口 真穂登, 磯貝 和也, 外山 聡, 佐藤 博, 齋藤 和英, 中川 由紀, 高橋 公太, 田中 祥子, 恩田 健二, 平野 俊彦

    Organ Biology   20 ( 3 )   50 - 50   2013.10

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  • 献腎移植におけるドナー年齢、レシピエント年齢による予後の検討

    中川 由紀, 池田 正博, 田崎 正行, 斎藤 和英, 成田 一衛, 高橋 公太

    移植   48 ( 総会臨時 )   357 - 357   2013.8

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  • 腎臓移植における内科と外科の連携 腎臓移植における内科と外科の連携 先行的腎移植を実施するための腎臓内科との連携

    中川 由紀, 池田 正博, 田崎 正行, 斎藤 和英, 成田 一衛, 高橋 公太

    移植   48 ( 総会臨時 )   241 - 241   2013.8

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  • Profiling of kidney vascular endothelial cell plasma membrane proteins by liquid chromatography-tandem mass spectrometry.

    Zan Liu, Bo Xu, Masaaki Nameta, Ying Zhang, Sameh Magdeldin, Yutaka Yoshida, Keiko Yamamoto, Hidehiko Fujinaka, Eishin Yaoita, Masayuki Tasaki, Yuki Nakagawa, Kazuhide Saito, Kota Takahashi, Tadashi Yamamoto

    Clinical and experimental nephrology   17 ( 3 )   327 - 37   2013.6

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    BACKGROUND: Vascular endothelial cells (VECs) play crucial roles in physiological and pathologic conditions in tissues and organs. Most of these roles are related to VEC plasma membrane proteins. In the kidney, VECs are closely associated with structures and functions; however, plasma membrane proteins in kidney VECs remain to be fully elucidated. METHODS: Rat kidneys were perfused with cationic colloidal silica nanoparticles (CCSN) to label the VEC plasma membrane. The CCSN-labeled plasma membrane fraction was collected by gradient ultracentrifugation. The VEC plasma membrane or whole-kidney lysate proteins were separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis and digested with trypsin in gels for liquid chromatography-tandem mass spectrometry. Enrichment analysis was then performed. RESULTS: The VEC plasma membrane proteins were purified by the CCSN method with high yield (approximately 20 μg from 1 g of rat kidney). By Mascot search, 582 proteins were identified in the VEC plasma membrane fraction, and 1,205 proteins were identified in the kidney lysate. In addition to 16 VEC marker proteins such as integrin beta-1 and intercellular adhesion molecule-2 (ICAM-2), 8 novel proteins such as Deltex 3-like protein and phosphatidylinositol binding clathrin assembly protein (PICALM) were identified. As expected, many key functions of plasma membranes in general and of endothelial cells in particular (i.e., leukocyte adhesion) were significantly overrepresented in the proteome of CCSN-labeled kidney VEC fraction. CONCLUSIONS: The CCSN method is a reliable technique for isolation of VEC plasma membrane from the kidney, and proteomic analysis followed by bioinformatics revealed the characteristics of in vivo VECs in the kidney.

    DOI: 10.1007/s10157-012-0708-1

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  • 抗体関連型拒絶反応の克服に向けて C4d陽性の抗体関連型拒絶反応の1例

    伊藤 由美, 河野 恵美子, 吉田 一浩, 今井 直史, 山崎 裕幸, 中川 由紀, 齋藤 和英, 唐澤 環, 鈴木 俊明, 池住 洋平, 斉藤 昭彦, 高橋 公太, 成田 一衛

    今日の移植   26 ( 2 )   188 - 194   2013.4

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  • 抗体関連型拒絶反応の克服に向けて 腎移植における抗体関連型拒絶反応

    池田 正博, 田崎 正行, 中川 由紀, 齋藤 和英, 高橋 公太

    今日の移植   26 ( 2 )   178 - 181   2013.4

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  • ABO-incompatible kidney transplantation Invited Reviewed

    Kota Takahashi, Kazuhide Saito

    Transplantation Reviews   27 ( 1 )   1 - 8   2013.1

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    Owing to the shortage of deceased donors in Japan, since 1989, we have performed ABO-incompatible kidney transplantation (ABO-IKTx) to expand the indication for living donor kidney transplantation. During the past two decades, about 2000 ABO-IKTxs were performed. Since 2001 the success rate for these kidney transplants has reached 96% for 1-year, 91% for 5-year and 83% for 9-year graft survival, similar to outcomes of ABO-compatible kidney transplantation (ABO-CKTx). This dramatic improvement in results means that ABO-IKTx has become accepted as a therapeutic alternative for end-stage renal failure. Today ABO-IKTx accounts for approximately 30% of all living donor kidney transplantations performed in Japan.We have been making a lot of efforts to elucidate the mechanism of acute antibody-mediated rejection in ABOI-KTx in order to overcome the ABO barrier and to improve the outcome. From careful and precise clinical observations, proteomic analysis of ABO histo-blood group antigens in graft endothelial cells and deep insight into immunology and biology, we have reached the hypothesis that the structural difference of ABO histo-blood group antigens and de novo corresponding antibody production would be the key and keyhole of the development of acute AMR in ABOI-KTx. Preoperative desensitization therapy would be the best solution for the suppression of acute AMR and graft loss, which is now widespread and improves the outcome. © 2013 Elsevier Inc.

    DOI: 10.1016/j.trre.2012.07.003

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  • 腎移植前および移植2、4、6週後における末梢血リンパ球のシクロスポリンおよびタクロリムス感受性の相関性

    杉山 健太郎, 笹原 浩康, 磯貝 和也, 塚口 真穂登, 外山 聡, 佐藤 博, 齋藤 和英, 中川 由紀, 高橋 公太, 田中 祥子, 恩田 健二, 平野 俊彦

    Organ Biology   20 ( 1 )   45 - 51   2013.1

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    移植手術を予定された腎移植患者20名を対象に、移植前、移植2、4、6週後の末梢血単核細胞のカルシニューリン阻害薬感受性測定を行った。移植前測定可能例は17例(男性12例、女性5例、平均43.5歳)、移植2週後では9例(男性7例、女性2例、平均34.7歳)、4週後では9例(男性7例、女性2例、平均32.0歳)、6週後では12例(男性10例、女性2例、平均44.5歳)であった。シクロスポリン/タクロリムスの平均IC50値(ng/mL)は、移植前は439.0/177.6で、Kendall(r=0.468)、Spearman(r=0.612)と両者に有意な相関が認められた。移植2週後では38.8ng/0.24で相関性は認めなかった。移植4週後では399.5/1414.3であり、Kendall(r=0.592)、Spearman(r=0.728)と両者に有意な相関を認め、移植6週後では578.8/251.2で、Kendall(r=0.481)、Spearman(r=0.62)と両者に有意な相関が認められた。移植2週後では移植臓器の挿入や初期の免疫抑制療法による変動の可能性が考えられた。

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J03926&link_issn=&doc_id=20130405220006&doc_link_id=10.11378%2Forganbio.20.45&url=https%3A%2F%2Fdoi.org%2F10.11378%2Forganbio.20.45&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • [The new immunosuppressive drugs for renal transplantation: inhibitors of the mammalian target of rapamycin (mTOR) and anti-thymocyte globulin (Thymoglobulin)].

    Yuki Nakagawa, Masahiro Ikeda, Masayuki Tasaki, Kazuhide Saito, Kota Takahashi

    Nihon Jinzo Gakkai shi   55 ( 2 )   112 - 8   2013

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  • 腎不全治療における内科的マネジメント 移植医の立場から

    中川 由紀, 池田 正博, 田崎 正行, 齋藤 和英, 高橋 公太

    今日の移植   25 ( 5 )   446 - 454   2012.10

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  • Pentraxin-3 expression in acute renal allograft rejection. International journal

    Naofumi Imai, Shinichi Nishi, Kazuhiro Yoshita, Yumi Ito, Yutaka Osawa, Kaori Takahashi, Yuki Nakagawa, Kazuhide Saito, Kota Takahashi, Ichiei Narita

    Clinical transplantation   26 Suppl 24   25 - 31   2012.7

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    Pentraxin-3 (PTX3) is an acute phase reactant produced by a variety of cell types at sites of local inflammation. We examined by immunohistochemistry renal biopsies from patients with acute rejection (n = 10), protocol biopsies without rejection (n = 37), and peri-operative donor biopsies of the same transplant patients (n = 94) for intra-renal expression of PTX3, and its correlation with clinical, laboratory, and histopathologic parameters. PTX3 was mainly expressed in the interstitium of renal allograft. In the non-rejection biopsies (pre- and post-reperfusion and protocol biopsies), PTX3 expression area (PTX3%) was equally maintained at a low level, whereas in the rejection biopsies, PTX3% was significantly higher (p < 0.0001). Treatment of acute rejection resulted in a significant reduction of PTX3% (p < 0.0001). PTX3% positively correlated with the degree of allograft dysfunction and acute rejection scores of Banff classification (2009). This study suggests that PTX3% may be an available histological marker of acute renal allograft rejection.

    DOI: 10.1111/j.1399-0012.2012.01641.x

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  • Final height in a prospective trial of late steroid withdrawal after pediatric renal transplantation treated with cyclosporine and mizoribine Reviewed

    Osamu Motoyama, Akira Hasegawa, Atsushi Aikawa, Seiichirou Shishido, Masataka Honda, Kazuo Tsuzuki, Tsuneo Kinukawa, Motoshi Hattori, Osamu Ogawa, Toshio Yanagihara, Kazuhide Saito, Kota Takahashi, Shinichi Ohshima

    PEDIATRIC TRANSPLANTATION   16 ( 1 )   78 - 82   2012.2

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    A prospective trial of corticosteroid (steroid) withdrawal after pediatric renal transplantation was started in 1990. Fifty-eight recipients with functioning grafts reached their final height. They were transplanted at a mean age of 10.7 yr. Immunosuppressive therapy with CyA, MP, and MZ was started after transplantation. MP was reduced to an alternate-day dose in 49 patients and was withdrawn in 23. Their mean height SDS was -2.4 at the time of transplantation and -2.1 at their final height. Mean final height was 157.9 cm in men and 147.6 cm in women. In 18 patients who had been withdrawn from MP for more than two yr before reaching final height, mean age at transplantation was 8.9 yr. Their mean height SDS of -2.2 at the time of transplantation increased to -1.6 at their final height (p = 0.02), and mean final height was 163.8 cm in men and 147.8 cm in women. The height SDS in all 58 patients was maintained during the immunosuppressive therapy with steroid minimization, and final height SDS increased in recipients older than five yr at transplantation with steroid withdrawal.

    DOI: 10.1111/j.1399-3046.2011.01614.x

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  • Clinical Significance of the Pharmacological Efficacy of Tacrolimus Estimated by the Lymphocyte Immunosuppressant Sensitivity Test (LIST) Before and After Renal Transplantation. International journal

    Kentaro Sugiyama, Kazuya Isogai, Akira Toyama, Hiroshi Satoh, Kazuhide Saito, Yuki Nakagawa, Masayuki Tasaki, Kota Takahashi, Toshihiko Hirano

    Cell medicine   3 ( 1-3 )   81 - 88   2012.1

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    The lymphocyte immunosuppressant sensitivity test (LIST) with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay procedure can predict the pharmacological efficacy of immunosuppressive agents. A previous study reported the pharmacological efficacy of tacrolimus evaluated by LIST just before renal transplantation significantly correlated with the incidence of acute rejection episodes. However, the pharmacological efficacy of tacrolimus has not been estimated after renal transplantation. Therefore, the present study evaluated the pharmacological efficacy of tacrolimus by LIST using the MTT assay procedure before and 1, 3, and 12 months after transplantation in 17 renal transplant recipients that received tacrolimus-based immunosuppressive therapy. The tacrolimus pharmacological efficacies before and after the procedure were also compared with incidence of acute rejection and cytomegalovirus (CMV) infection episodes. The individual values of tacrolimus 50% inhibition of lymphocyte proliferation (IC50) varied widely before transplantation, and the mean value of the IC50 was 126.4 ± 337.7 ng/ml. The patients were divided into two groups according to the tacrolimus IC50 values evaluated before transplantation. The rate of acute rejection episodes in the tacrolimus high-sensitivity group was significantly lower than that in the tacrolimus low-sensitivity group (p = 0.005). The tacrolimus IC50 deviation between patients expanded further at one and three months after surgery. However, the sensitivity deviation almost converged at 1 year after surgery. Moreover, the pharmacological efficacy of tacrolimus evaluated at 1, 3, and 12 months after transplantation did not significantly correlate with the incidence of acute rejection episodes. The pharmacological efficacies of tacrolimus evaluated at both before and after surgery were not significantly correlated with the episodes of CMV infection. These findings suggest that the pharmacological efficacy of tacrolimus evaluated with LIST before surgery is a useful biomarker for predicting the occurrence of acute allograft rejection in renal transplantation.

    DOI: 10.3727/215517912X639360

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  • Comparative study of the cellular pharmacodynamics of tacrolimus in renal transplant recipients treated with and without basiliximab. International journal

    Kentaro Sugiyama, Kazuya Isogai, Satoshi Horisawa, Akira Toyama, Hiroshi Satoh, Kazuhide Saito, Yuki Nakagawa, Masayuki Tasaki, Kota Takahashi, Toshihiko Hirano

    Cell transplantation   21 ( 2-3 )   565 - 70   2012

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    Basiliximab is a recently developed immunosuppressive agent for the prevention of acute allograft rejection in renal transplant recipients. The combination use of basiliximab and a calcineurin inhibitor was suggested to be more effective in comparison to immunosuppressive therapy using calcineurin inhibitor without basiliximab. Cyclosporine has been generally administered with basiliximab for renal transplant recipients. However, in cases of tacrolimus-based immunosuppressive regimen, the clinical efficacy and safety of combined use of tacrolimus and basiliximab remains to be elucidated. This study evaluated the tacrolimus pharmacological efficacy using a lymphocyte immunosuppressant sensitivity test (LIST) with MTT assay procedures in 16 cases of renal transplant recipients treated by tacrolimus without basiliximab and in 13 cases treated by tacrolimus in combination with basiliximab. The rate of acute rejection episodes in the recipients treated with tacrolimus plus basiliximab was 1/13 (7.7%), whereas the rate in the recipients treated with tacrolimus without basiliximab was 6/16 (37.5%). The recipients were divided into two groups according to their peripheral blood mononuclear cell (PBMC) sensitivity to tacrolimus [i.e., including a tacrolimus high sensitivity group (IC(50) <1.0 ng/ml) and a low sensitivity group (IC(50) >1.0 ng/ml). In the recipients treated with tacrolimus without basiliximab, the rate of acute rejection episodes in the tacrolimus high sensitivity group was 1/10 (10.0%), which was significantly lower than the rate in the low sensitivity group of 5/6 (83.3%; p = 0.008). The incidence of cytomegalovirus infection was not significantly different between the tacrolimus high and the low sensitivity groups of the recipients treated with tacrolimus with and without basiliximab. Therefore, in the case of selected tacrolimus-based immunosuppressive therapy for renal transplant recipients, the tacrolimus pharmacological efficacy should be evaluated using LIST at a time just before the transplant procedure in order to accurately predict allograft rejection. The data also suggested that low tacrolimus sensitivity recipients should be treated with tacrolimus-based immunosuppressive therapy in combination with basiliximab.

    DOI: 10.3727/096368911X605493

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  • 抗血液型抗体価が高いABO血液型不適合腎移植の3症例

    中川 由紀, 田崎 正行, 斎藤 和英, 高橋 公太

    腎移植・血管外科   23 ( 1 )   21 - 27   2011.12

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    ABO血液型不適合腎移植では、抗血液型抗体によって抗体関連型拒絶反応(AMR:antibody mediated rejection)を引き起こす可能性があるため、抗血液型抗体価が高い症例は、いままでは移植困難とされてきた。今回我々は、抗血液型抗体価が高い症例に対し脱感作療法、抗体除去療法を行うことでAMRを発症することなく経過良好な血液型不適合腎移植を3症例経験したので報告する。(著者抄録)

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  • 移植腎動脈狭窄により腎機能の発現が遷延した献腎移植例

    池田 正博, 鳥羽 智貴, 瀧澤 逸大, 中川 由紀, 齋藤 和英, 高橋 公太, 吉村 宣彦, 堀 祐郎, 高野 徹

    腎移植・血管外科   23 ( 1 )   49 - 54   2011.12

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    症例は65歳男性。IgA腎症のため末期腎不全となり血液透析療法に導入された。透析歴15年で献腎移植を受けたが、術後腎機能発現が遅れ、透析は術後18日目まで必要であった。術後2ヵ月より降圧薬抵抗性の高血圧や頭痛が出現し、体重増加、血清クレアチニンの上昇を認めた。造影CT検査で、移植腎動脈狭窄(Transplant renal artery stenosis:TRAS)が疑われたため、血管造影検査で診断を確定し、直ちに経皮経管的血管形成術(Percutaneous transluminal angioplasty:PTA)を施行した。その後は、速やかに血圧、体重増加、腎機能の改善がみられた。しかしPTA3ヵ月後に、再び体重増加を認め、TRAS拡張部の再狭窄の診断で、再度PTAが必要であった。TRASについて、若干の文献的考察を含め報告する。(著者抄録)

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  • The case of BK virus infection in which it was difficult to differentiate from acute rejection. International journal

    Yumi Ito, Shinichi Nishi, Naofumi Imai, Kazuhiro Yoshita, Kazuhide Saito, Yuki Nakagawa, Kota Takahashi, Ichiei Narita

    Clinical transplantation   25 Suppl 23   44 - 8   2011.7

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    BK virus (BKV) nephropathy is one of the major causes of allograft dysfunction or graft loss in kidney transplant recipients. Early diagnosis and timely reduction in immunosuppressant is important for proper treatment. We report a 35-yr-old male case of cadaveric renal transplantation with BK viral related tubulointerstitial nephritis complicated by acute rejection. The diagnostic biopsy showed severe inflammatory infiltrates, tubulitis, and peritubular capillaritis. Discontinuation of mycophenolate mofetil, prednisone pulse therapy, and r-globulin was successful in relieving allograft dysfunction.

    DOI: 10.1111/j.1399-0012.2011.01481.x

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  • ABO血液型不適合・抗ドナー抗体陽性腎移植の治療戦略 ABO血液型不適合腎移植の治療戦略

    田崎 正行, 池田 正博, 中川 由紀, 齋藤 和英, 成田 一衛, 高橋 公太

    今日の移植   24 ( 2 )   191 - 196   2011.4

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  • ABO血液型不適合・抗ドナー抗体陽性腎移植の治療戦略 腎移植における抗ドナー抗体陽性症例の治療戦略

    中川 由紀, 池田 正博, 田崎 正行, 齋藤 和英, 成田 一衛, 高橋 公太

    今日の移植   24 ( 2 )   197 - 204   2011.4

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  • 【AKIとCKDのすべて】CKD 特殊な条件におけるCKD 腎移植におけるドナーとレシピエント 腎移植後の管理

    田崎 正行, 中川 由紀, 齋藤 和英, 高橋 公太

    腎と透析   69 ( 増刊 )   209 - 213   2010.12

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  • Detection of allogeneic blood group A and B enzyme activities in patients with ABO incompatible kidney transplantation Reviewed

    Masayuki Tasaki, Tamiko Nakajima, Naofumi Imai, Yuki Nakagawa, Kazuhide Saito, Kota Takahashi, Shin Yazawa

    GLYCOBIOLOGY   20 ( 10 )   1251 - 1258   2010.10

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    The phenomenon of accommodation in recipients of blood group ABO incompatible kidney transplantation (iKTx), in which grafts survive despite the presence of blood group A or B antigen in the graft and the presence of corresponding antibodies in the recipient&apos;s blood, is not uncommon. alpha 1,3-N-Acetylgalactosaminyltransferase and alpha 1,3galactosyltransferase associated with the synthesis of blood group A and B antigen (A and B enzymes), respectively, were measured by a highly specific enzyme-linked immunosorbent assay in the sera and transplanted tissues of patients who underwent an ABO iKTx. Allogeneic A and B enzymes were present in the sera and tissues as well as A and B antigens in the tissues for a long period, which hitherto have never been seen in recipients prior to an iKTx. However, activities of these enzymes in the sera after an iKTx decreased in patients who experienced a serious acute antibody-mediated rejection and disappeared in patients who had an unrepairable rejection, leading to graft loss without establishment of accommodation. Our observations on the presence of allogeneic A and B enzymes in the recipients&apos; sera should have implications in decision making for a successful iKTx.

    DOI: 10.1093/glycob/cwq086

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  • 腎移植後のサイトメガロウイルス感染(CMV)に対するバルガンシクロビル経口投与薬の投与量の検討

    中川 由紀, 池田 正博, 田崎 正行, 斎藤 和英, 成田 一成, 高橋 公太

    移植   45 ( 総会臨時 )   252 - 252   2010.10

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  • ABO血液型不適合腎移植患者におけるA/B型糖転移酵素活性測定の検討

    田崎 正行, 矢澤 伸, 中島 たみ子, 今井 直史, 中川 由紀, 齋藤 和英, 高橋 公太

    Organ Biology   17 ( 2 )   164 - 164   2010.10

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  • The pharmacological efficacy of mycophenolic acid before and after renal transplantation as estimated by the lymphocyte immunosuppressant sensitivity test (LIST). International journal

    Kentaro Sugiyama, Kazuya Isogai, Satoshi Horisawa, Akira Toyama, Hiroshi Satoh, Kazuhide Saito, Yuki Nakagawa, Masayuki Tasaki, Kota Takahashi, Toshihiko Hirano

    Immunopharmacology and immunotoxicology   32 ( 3 )   430 - 6   2010.9

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    The lymphocyte immunosuppressant sensitivity test (LIST) can predict the pharmacological efficacy of immunosuppressive agents. We herein estimated the mycophenolic acid efficacy using LIST before and 1, 3, and 12 months after the operation in 15 renal transplant recipients. The pharmacological efficacy of mycophenolic acid as assessed before transplantation showed small individual variations, whereas the variability greatly increased at 1 and 3 months after transplantation. Furthermore, the individual IC50 variation among these subjects at 1-year after operation was closely similar to that observed before surgery. No significant implications of these individual differences in the mycophenolic acid sensitivity were noted in regard to the clinical courses of these recipients.

    DOI: 10.3109/08923970903490478

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  • Preemptive kidney transplantation 腎臓内科医からみたpreemptive kidney transplantation

    後藤 眞, 西 慎一, 成田 一衛, 中川 由紀, 齋藤 和英, 高橋 公太

    今日の移植   23 ( 5 )   637 - 641   2010.9

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  • Preemptive kidney transplantation 移植医からみたpreemptive kidney transplantation

    中川 由紀, 田崎 正行, 齋藤 和英, 高橋 公太

    今日の移植   23 ( 5 )   627 - 631   2010.9

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  • 腎移植2010 適応の現状と展望 ABO血液型不適合腎移植の現状と展望

    中川 由紀, 齋藤 和英, 成田 一衛, 西 慎一, 高橋 公太

    日本腎臓学会誌   52 ( 6 )   661 - 661   2010.8

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  • Two distinct FSGS lesions caused by distinct etiology confirmed in a single patient in pre- and post-transplantation. International journal

    Yumi Ito, Shinichi Nishi, Naofumi Imai, Ichiei Narita, Fumitake Gejyo, Kazuhide Saito, Yuki Nakagawa, Masayuki Tasaki, Kota Takahashi

    Clinical transplantation   24 Suppl 22   54 - 9   2010.7

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    At the age of three yr, a male patient had surgical treatment for bilateral vesicoureteral reflux (VUR), and at the age of 19 yr, he developed nephrotic syndrome because of focal segmental glomerulosclerosis (FSGS). His renal function deteriorated despite treatment with temocapril and aspirin, and dialysis treatment was started when he was 19. After nine yr of dialysis, he received a living kidney transplantation from his 58-yr-old father, who had a long history of hypertension. A graft biopsy before perfusion showed moderate arteriolosclerosis. As urine protein increased to 2.15 g/d at 16 months after kidney transplantation, the graft biopsy was performed again. FSGS lesion with severe arteriosclerosis was recognized under light microscope, while the effacement of podocyte foot processes was seldom observed. The alteration of calcineurin inhibitor from cyclosporine to tacrolimus, combined with the new administration of angiotensin receptor antagonist (valsartan) and aldosterone receptor blocker, successfully decreased the amount of urine protein to 0.8 g/d within two wk. We considered that the present case showed two distinct types of FSGS lesions--one because of VUR and the other because of cyclosporine arteriolopathy--in each native kidney and transplanted kidney.

    DOI: 10.1111/j.1399-0012.2010.01267.x

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  • Successful treatment of nonocclusive mesenteric ischemia that developed during the peritransplant period following ABO-incompatible kidney transplantation.

    Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Noboru Hara, Akifumi Kuwabara, Shintaro Komukai, Manabu Ohashi, Haruhiko Okamoto, Toshiki Tanikawa, Tsutomu Nishiyama, Kota Takahashi

    Clinical and experimental nephrology   14 ( 2 )   199 - 202   2010.4

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    Nonocclusive mesenteric ischemia (NOMI) is an infrequent and fatal disorder. We describe a 54-year-old man who developed NOMI during the peritransplant period following ABO-incompatible living-donor kidney transplantation, but who was successfully treated with his renal graft function unimpaired. Abdominal pain appeared on the sixth postoperative day (POD), and emergency surgery was performed on POD 8. Discontinuous segmental necrosis extended throughout the small intestine, and the necrotic segments were entirely removed. He thereafter had ischemia of the ascending colon, which was treated with colectomy, and prostaglandin E1 delivered through the related artery prevented advanced necrosis. Temporary colostomy was closed 20 months after surgery. He maintains excellent graft function at present without secondary disorder. There has been no ABO-incompatible kidney transplant recipient complicated with NOMI. However, patients with end-stage renal disease are at the highest risk for this lethal condition, and physicians and urologists should correctly recognize its diagnostics and therapeutics.

    DOI: 10.1007/s10157-009-0232-0

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  • 知的障害者の腎移植 精神発達遅滞患者における生体腎移植

    池田 正博, 田崎 正行, 中川 由紀, 齋藤 和英, 高橋 公太, 西 愼一, 下条 文武, 鈴木 俊明, 唐沢 環, 内山 聖

    今日の移植   23 ( 2 )   234 - 238   2010.4

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  • 腎移植後のサイトメガロウイルス感染(CMV)に対するバルガンシクロビル経口投与薬の治療効果

    中川 由紀, 田崎 正行, 斎藤 和英, 谷川 俊貴, 西山 勉, 高橋 公太

    日本泌尿器科学会雑誌   101 ( 2 )   326 - 326   2010.2

  • ABO不適合腎移植患者におけるA/B糖転移酵素活性測定

    田崎 正行, 矢澤 伸, 中島 たみ子, 今井 直史, 中川 由紀, 齋藤 和英, 高橋 公太

    日本泌尿器科学会雑誌   101 ( 2 )   324 - 324   2010.2

  • 総排泄腔遺残を伴う慢性腎不全患児の二次献腎移植 母親をドナーとする一次生体腎移植と腎静脈血栓症

    中川 由紀, 田崎 正行, 齋藤 和英, 高橋 公太

    今日の移植   22 ( 5 )   562 - 565   2009.10

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  • 総排泄腔遺残を伴う慢性腎不全患児の二次献腎移植 11歳の小児ドナーからの二次献腎移植

    田崎 正行, 齋藤 和英, 中川 由紀, 金子 公亮, 安楽 力, 谷川 俊貴, 西山 勉, 高橋 公太

    今日の移植   22 ( 5 )   566 - 570   2009.10

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  • ABO血液型不適合腎移植におけるBiosynsorb抗体吸着療法の復活

    中川 由紀, 斎藤 和英, 高橋 公太, 下条 文武, 長谷川 進, 西 慎一

    日本透析医学会雑誌   42 ( Suppl.1 )   519 - 519   2009.5

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  • Identification and characterization of major proteins carrying ABO blood group antigens in the human kidney. International journal

    Masayuki Tasaki, Yutaka Yoshida, Masahito Miyamoto, Masaaki Nameta, Lino M Cuellar, Bo Xu, Ying Zhang, Eishin Yaoita, Yuki Nakagawa, Kazuhide Saito, Tadashi Yamamoto, Kota Takahashi

    Transplantation   87 ( 8 )   1125 - 33   2009.4

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    BACKGROUND: It is generally admitted that ABO(H) blood group antigens are linked to lipids and proteins. Although glycolipids carrying ABO antigens have been well characterized in human kidneys, glycoproteins carrying ABO antigens are largely unknown, and their molecular properties remain to be elucidated. METHODS: All the blood group A antigen-linked proteins in human kidney could be solubilized and captured on immobilized Helix pomatia lectin that recognizes A antigens. These proteins were separated on SDS-PAGE gels. The gel pieces containing protein bands immunoreactive with anti-A antibody were excised, in-gel digested with trypsin, and analyzed by nanoLC tandem mass spectrometer. Protein candidates that carry ABO antigens were confirmed by immunoprecipitation and double-labeled immunofluorescense microscopy. RESULTS: All the glycoproteins carrying ABO antigens were found to be Asn-linked glycoproteins, and presented as multiple bands on SDS-PAGE with molecular masses ranging from 60 to 270 kDa. The protein bands were subjected for mass spectrometric analysis, which identified 121 distinct proteins with high confidence. Of the identified proteins, 55 N-glycosylated, membrane proteins were selected as glycoprotein candidates that carry ABO antigens. Among them, most abundantly expressed proteins as estimated by the number of peptide matches in the MS spectrometric analysis, such as platelet endothelial cell adhesion molecule 1, plasmalemmal vesicle-associated protein, and von Willebrand factor, were further characterized. CONCLUSIONS: Several glycoproteins were identified that represented major glycoproteins carrying ABO antigens in the human kidney, which exhibited distinct features in localization to most of vascular endothelial cells.

    DOI: 10.1097/TP.0b013e31819e0054

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  • 【リツキシマブによる抗体抑制 腎移植を中心に】ABO血液型不適合腎移植におけるリツキシマブによる抗体抑制

    齋藤 和英, 中川 由紀, 田崎 正行, 高橋 公太

    今日の移植   22 ( 2 )   171 - 179   2009.3

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    ABO血液型不適合腎移植においては、抗A抗B抗体による抗体関連型急性拒絶反応による移植腎喪失を防ぐことが最大の課題であり悲願であった。近年、B細胞表面に発現する機能分子であるCD20に対するヒトマウスキメラ型モノクローナル抗体であるリツキシマブを脱感作療法に用いることにより、多くの症例で脾摘を行うことなく安全に抗体関連型急性拒絶反応を回避し、"免疫学的順応"を誘導することが可能となった。(著者抄録)

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  • OP-271 ABO血液型不適合腎移植におけるBiosynsorb抗体吸着療法の復活(腎移植3,一般演題口演,第97回日本泌尿器科学会総会)

    中川 由紀, 田崎 正行, 齋藤 和英, 谷川 俊貴, 西山 勉, 長谷川 進, 西 慎一, 下条 文武

    日本泌尿器科学会雑誌   100 ( 2 )   256 - 256   2009

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    DOI: 10.5980/jpnjurol.100.256_3

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  • Pharmacodynamic parameters of immunosuppressive drugs are not correlated with age, duration of dialysis, percentage of lymphocytes or lymphocyte stimulation index in renal transplant recipients.

    Kentaro Sugiyama, Kazuya Isogai, Akira Toyama, Hiroshi Satoh, Kazuhide Saito, Yuki Nakagawa, Masayuki Tasaki, Kota Takahashi, Noriko Saito, Toshihiko Hirano

    Biological & pharmaceutical bulletin   31 ( 11 )   2146 - 9   2008.11

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    The lymphocyte immunosuppressant-sensitivity test (LIST) has been reported extensively as being able to estimate the pharmacological efficacy of immunosuppressive drugs in individual patients. This study measured the IC50 values for 6 drugs, cyclosporine, tacrolimus, methylprednisolone, 6-mercaptopurine, mycophenolic acid, and mizoribine, against mitogen-induced proliferation of peripheral-blood lymphocytes in 29 renal transplant recipients. We also examined relationship between the IC50 values and 4 factors; age, duration of dialysis, percentage of lymphocytes in total white blood cells, and blastogenesis stimulation index by mitogen. There were no significant correlations between the IC50 values and these factors, except that the tacrolimus IC50 value was correlated weakly with the stimulation index (p<0.05, r=-0.429). It was concluded that the pharmacological efficacy of immunosuppressive drugs cannot be inferred from the patient characteristics or their laboratory data. LIST is an effective method to elucidate the pharmacodynamic properties of immunosuppressive agents in individual renal transplant recipients without being influenced by the recipient clinical data.

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  • 【移植患者のマネジメント 知っておきたい内科学的トピックス】腎移植後高血圧

    西 慎一, 齋藤 和英, 中川 由紀, 高橋 公太, 下条 文武

    今日の移植   21 ( 5 )   467 - 474   2008.10

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    移植後高血圧(PTHT)は、頻度の高い内科的合併症である。その臨床的特徴は、慢性腎臓病患者の高血圧に順ずる。つまり、夜間高血圧、早朝高血圧を特徴とする。PTHTはグラフト腎機能のみでなく、レシピエントの生命予後を左右する。したがって、降圧療法は充分なされるべきである。ただし、PTHTには免疫抑制薬の副作用が関与しており、免疫抑制薬の変更あるいは減量という手段が治療手段の一つであることが特異な点である。(著者抄録)

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  • ヒト腎皮質に発現するABO血液型糖鎖抗原を持つタンパク質解析

    田崎 正行, 吉田 豊, 諏訪 通博, 中川 由紀, 斎藤 和英, 山本 格, 高橋 公太

    移植   43 ( 総会臨時 )   279 - 279   2008.9

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  • Two cases of kidney transplantation from the same non-heart beating deceased donor after long cold-ischemic time more than 24 h

    Shinichi Nishi, Naofumi Imai, Yuki Nakagawa, Kazuhide Saito, Kota Takahashi, Fumitake Gejyo

    CLINICAL TRANSPLANTATION   22   72 - 75   2008.7

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    We present here two cases of kidney transplantation from a non-heart beating deceased donor after long cold-ischemic time (CIT) more than 24 h. The donor was a young male who died of severe subarachnoid hemorrhage. Grafts were transplanted into two different patients one after another in our hospital. Their total ischemic times were 24 and 43 h because they were the fourth and fifth candidates on the waiting list. Although the anuric phase continued for more than three wk in both cases, finally their grafts functioned well with the nadir serum creatinine of 2.2 and 1.8 mg/dL, respectively. We evaluated protocol biopsies after 50 d from the transplantation. Both biopsy specimens revealed diffuse interstitial fibrosis, particularly more severe in the second recipient. The expression of 8-OHdG, one of the histochemical markers of oxidative stress, was more strongly expressed in the biopsy specimens of pre-perfusion and protocol biopsy in the same case. From these results, it was suspected that the interstitial fibrosis was induced by oxidative stress derived from the longer CIT and the following reperfusion.

    DOI: 10.1111/j.1399-0012.2008.00854.x

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  • 献腎移植レシピエント選択基準の変化から移植はどうかわったか

    中川 由紀, 斎藤 和英, 高橋 公太, 西 慎一, 下条 文武

    日本透析医学会雑誌   41 ( Suppl.1 )   409 - 409   2008.5

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  • 腎移植の現状と技術の進歩 ABO血液型不適合腎移植の進歩と今後の展望

    齋藤 和英, 中川 由紀, 高橋 公太, 西 慎一

    日本透析医学会雑誌   41 ( Suppl.1 )   307 - 307   2008.5

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  • Renal cell carcinomas arising from the allograft and bilateral native kidneys. International journal

    Tomohiro Nobushita, Noboru Hara, Yuki Nakagawa, Kazuhide Saito, Tsutomu Nishiyama, Kota Takahashi

    International journal of urology : official journal of the Japanese Urological Association   15 ( 2 )   175 - 7   2008.2

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    We present the case of a young lady who developed renal cell carcinomas (RCC) in the allograft and bilateral native kidneys metachronously within one year. She received a living donor kidney transplantation from her father. A solid tumor of 4 cm in diameter was uncovered first in the allograft kidney 103 months after transplantation, and was treated with graftectomy. Six months after graftectomy, a right renal tumor measuring 3.5 cm and left renal tumors emerged in the native kidneys. She underwent laparoscopic right and left radical nephrectomy in separate sessions. The pathological diagnosis in the allograft and right renal tumors was clear cell RCC with eosinophilic cytoplasm and that in the left kidney was clear cell carcinoma. Fluorescence in situ hybridization and human leukocyte antigen typing showed that each tumor was most probably primary disease. She was free of disease 18 months postoperatively. This is the first report on RCC arising both in the allograft and bilateral native kidneys.

    DOI: 10.1111/j.1442-2042.2007.01941.x

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  • 各種移植における免疫抑制療法の実際 バシリキシマブを用いたABO血液型不適合腎移植

    中川 由紀, 齋藤 和英, 西 慎一, 谷川 俊貴, 西山 勉, 下条 文武, 高橋 公太

    今日の移植   20 ( 6 )   585 - 587   2007.11

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  • ABO血液型不適合腎移植における脱感作療法 Rituximab至適投与量についての検討

    齋藤 和英, 中川 由紀, 諏訪 通博, 田崎 正行, 谷川 俊貴, 西山 勉, 高橋 公太

    移植   42 ( 総会臨時 )   204 - 204   2007.10

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  • 献腎移植10年の変化 レシピエント選択基準の変更によって

    中川 由紀, 田崎 正行, 斎藤 和英, 谷川 俊貴, 西山 勉, 高橋 公太, 西 慎一, 下条 文武

    移植   42 ( 総会臨時 )   275 - 275   2007.10

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  • C4d deposition on peritubular capillary (PTC) in the protocol biopsy of ABO-incompatible kidney transplantation under the treatment with anti-CD20 antibody and without splenectomy

    Naofumi Imai, Shinichi Nishi, Mitsuhiro Ueno, Yuki Nakagawa, Kazuhide Saito, Kota Takahashi, Fumitake Gejyo

    CLINICAL TRANSPLANTATION   21   2 - 7   2007.7

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    For the desensitization of A/B antigens, we had developed and reported a new potent immunosuppressive treatment, which is the pre-prescription of anti-CD20 monoclonal antibody with mycophenolate mofetil and low-dose steroid. Using this kind of desensitization therapy, splenectomy is not required at the kidney transplantation. Complement C4d deposition on peritubular capillary (PTC) in graft biopsy has been reported as a relatively reliable marker for humoral rejection. However, the C4d deposition was often observed in the graft biopsy of ABO-incompatible kidney transplantation even with no rejection findings. The aim of this study was to examine the effect of this treatment on C4d deposition on PTC. Baseline and protocol graft biopsies obtained from 12 recipients of ABO incompatible kidney transplants were evaluated by light and immunofluorescence microscopy. To elucidate the involvement of classical and/or lectin pathway of complement cascades in C4d deposition, we examined the deposition of the initial activating proteins on PTC, IgG and IgM in the classical pathway and mannose-binding lectin (MBL), H-ficolin, L-ficolin, MBL-associated serine protease (MASP)-1 and MASP-2 in the lectin pathway. Three out of nine available baseline biopsy specimens showed diffuse C4d and IgM deposition on PTC. In the protocol biopsy, nine of 12 specimens revealed diffuse C4d deposition on PTC. Five of them had positive deposition of IgM and H-ficolin on PTC, whereas the other initial proteins were not detected in all specimens. Apart from one case, the histological findings of the protocol biopsies were normal or borderline changes. Our study suggested that although the new treatment with anti-CD20 antibody treatment and without splenectomy was clinically effective, it did not perfectly inhibit C4d deposition on PTC. It also confirmed the dual activation of both classical and lectin pathways in the process of C4d deposition on PTC in ABO-incompatible transplantation.

    DOI: 10.1111/j.1399-0012.2007.00709.x

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  • ABO血液型不適合腎移植における脾摘群、非脾摘群での検討

    中川 由紀, 斎藤 和英, 西 慎一, 下条 文武, 高橋 公太

    日本透析医学会雑誌   40 ( Suppl.1 )   505 - 505   2007.5

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  • 脾摘をおこなわないABO血液型不適合腎移植脱感作療法におけるrituximab減量の試み

    齋藤 和英, 中川 由紀, 熊谷 直樹, 諏訪 通博, 信下 智弘, 谷川 俊貴, 西山 勉, 高橋 公太, 西 慎一

    移植   42 ( 2 )   190 - 190   2007.4

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  • 【ドナーアクションプログラムへの取り組み】献腎摘出マニュアル

    中川 由紀, 齋藤 和英, 谷川 俊貴, 西山 勉, 高橋 公太, 上野 光博, 成田 一衛, 下条 文武, 西 慎一, 秋山 政人

    今日の移植   20 ( 2 )   138 - 142   2007.3

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  • 腎移植 最近の話題 ABO血液型不適合腎移植の展望

    齋藤 和英, 中川 由紀, 諏訪 通博, 熊谷 直樹, 田崎 正行, 谷川 俊貴, 西山 勉, 高橋 公太

    日本泌尿器科学会雑誌   98 ( 2 )   152 - 152   2007.2

  • Diet therapy after kidney transplantation: a comparative debate between Japan and western countries. International journal

    Shinichi Nishi, Fumitake Gejyo, Kazuhide Saito, Yuki Nakagawa, Kota Takahashi

    Contributions to nephrology   155   82 - 89   2007

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    Kidney transplantation has a powerful influence on the nutritional status of patients with end-stage renal disease. How to control diet varies in different races and periods after kidney transplantation. In general, malnutrition in patients with end-stage renal disease slowly recovers after kidney transplantation; however, several dietary interventions are required throughout the post transplant course. While hyperalimentation is warranted to control the hypercatabolic state immediately following the transplant operation, dietary restriction of protein, salt and calories is recommended to prevent life-style related diseases, which affect patient and graft survival. No consensus on dietary control in kidney transplant recipients has been reached yet. Herein, we present the nutritional status of Japanese kidney allograft recipients, discuss some unresolved nutritional problems and review the recent literature.

    DOI: 10.1159/000101001

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  • 【腎移植 質の時代へ】腎移植患者における生活習慣病

    西 慎一, 下条 文武, 中川 由紀, 齋藤 和英, 高橋 公太

    腎と透析   61 ( 4 )   534 - 537   2006.10

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  • Immunohistochemical evidence of activated lectin pathway in kidney allografts with peritubular capillary C4d deposition Reviewed

    Naofumi Imai, Shinichi Nishi, Bassam Alchi, Mitsuhiro Ueno, Sachiko Fukase, Masaaki Arakawa, Kazuhide Saito, Kota Takahashi, Fumitake Gejyo

    NEPHROLOGY DIALYSIS TRANSPLANTATION   21 ( 9 )   2589 - 2595   2006.9

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    Background. Complement 4d (C4d) deposition in the peritubular capillary (PTC) in the kidney allograft is a useful diagnostic marker for humoral rejection. C4d is produced not only by the classical pathway but also by the lectin pathway of the complement activation cascade. We have recently reported the in situ role of the later phase of the complement cascade in renal allografts with C4d deposition; however, the initial process prior to C4d deposition is yet to be resolved.
    Methods. To clarify the early phases of the complement activation cascade, we evaluated the deposition of initial proteins of the above two pathways; IgG, IgM, mannose-binding lectin (MBL), H-ficolin, L-ficolin, MBL-associated serine protease (MASP)-1 and MASP-2 in kidney allografts with PTC C4d deposition.
    Results. Sixty kidney allograft specimens were divided into two groups on the basis of the presence of C4d deposition in PTC. The C4d-positive group (n = 18) included nine ABO-identical and nine ABO-incompatible cases, and the C4d-negative group (n = 42) had 34 ABO-identical and eight ABO-compatible (but not identical) cases. In the C4d-positive group, 16 of 18 cases showed diffuse H-ficolin and IgM deposition in PTC. In contrast, H-ficolin and IgM were not detected in PTC in the C4d-negative group. Other initial proteins were not detected in all cases.
    Conclusions. Our study suggested for the first time that the lectin pathway activated by H-ficolin may be involved in C4d deposition on PTC in the kidney allograft.

    DOI: 10.1093/ndt/gfl210

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  • ABO-incompatible kidney transplantation in Japan Reviewed

    Kazuhide Saito, Kota Takahashi

    International Congress Series   1292   35 - 41   2006.7

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    Up to 2005, the number of patients on dialysis therapy exceeded more than 250,000 in Japan
    however, only 200 deceased and 800 living kidney transplants have been performed annually. We have been making continuous efforts in ABO-incompatible kidney transplantation since 1989 to expand the opportunities for living kidney transplantation in Japan. From the Japanese registry, we have reviewed the long-term patient and graft outcome of ABO-incompatible kidney transplantation. This survey focused on 685 patients who received ABO-incompatible kidney grafts from January 1989 to December 2004 in whom monitoring follow-up could be achieved in 75 institutions. The overall patient survival rates at 1, 3, 5 and 10 years after transplantation were 94%, 91%, 87% and 82%, with overall graft survival rates of 87%, 83%, 76% and 57%, respectively. The graft survival rate was significantly higher in patients aged 29 and younger compared with those aged 30 and older. Especially in children aged 15 and younger, they have shown excellent graft survival rate. The patients with anticoagulation therapy showed significantly higher graft survival rate than those without anticoagulation. There were no significant differences between A- and B-incompatibility with respect to clinical outcomes. There were also no significant difference in numbers of HLA mismatches, induction and maintenance calcinurine inhibitors (ciclosporine vs. tacrolimus) and donor/recipient relationships with respect to the outcomes. A result of most recent 245 cases since 2001 had dramatically improved with 1-year graft survival is 96% and there is a significant difference between the groups in 2001 onwards and before. This study confirms that the outcome of ABO-incompatible living kidney transplantation in Japan is excellent and is similar to that in ABO-compatible cases. ABO-incompatible kidney transplantation has already become one of a standard, safety and effective treatment choice for end-stage renal disease. © 2006.

    DOI: 10.1016/j.ics.2006.05.004

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  • 腎移植後早期に再発した難治性ネフローゼ症候群の2例

    中川 由紀, 斉藤 和英, 西 慎一, 下条 文武, 高橋 公太

    日本透析医学会雑誌   39 ( Suppl.1 )   950 - 950   2006.5

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  • Present status of ABO-incompatible kidney transplantation in Japan Reviewed

    Kota Takahashi, Kazuhide Saito

    Xenotransplantation   13 ( 2 )   118 - 122   2006.3

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    Background: We have been making continuous efforts in ABO-incompatible kidney transplantation since 1989 to expand the opportunities for kidney transplantation from living donors in Japan. Patients and method: From the Japanese registry, we reviewed the long-term patient and graft survival of ABO-incompatible kidney transplantation. This survey focused on 564 patients who received ABO-incompatible kidney grafts from January 1989 to December 2003 in whom monitoring follow-up could be achieved in 60 institutions all over Japan. The mean age of 367 (65%) male and 197 (35%) female patients at surgery was 34.5 yr. Pre-operative anti-A/B antibody (Ab) removal and splenectomy (n=553, 98%) were routinely performed combined with triple or quadruple immunosuppression using calcinurine inhibitor (CNI), anti-metabolites and steroids with or without deoxyspurgualin (DSG) or anti-lymphocyte Abs. Results: The overall patient survival rate at 1, 3, 5 and 10 yr after transplantation was 94, 91, 88 and 81%, with overall graft survival rates of 86, 82, 74 and 53%, respectively. The graft survival rate was significantly higher in patients aged 29 and younger compared with those aged 30 and older. Children aged 15 or younger in particular have shown excellent graft survival rates at 1, 3, 5 and 10 yr of 90, 90, 86 and 76%, respectively. Patients with anticoagulation therapy (n=285) showed a significantly higher graft survival rate than those without anticoagulation (n=213), with 10-yr graft survival rates of 59 vs. 48%. There were no significant differences between A and B incompatibility with respect to clinical outcomes. There were also no significant difference in numbers of human leukocyte antigen mismatches, induction and maintenance CNI (cyclosporin A (CYA) vs. tacrolimus) and donor/recipient relationships with respect to the outcomes. We divided the patients into five groups according to the transplanted year periods. The outcome of the most recent 124 cases since 2001 had dramatically improved, with 2-yr graft survival of 94%, and there is a significant difference between the groups in 2001 onwards and the other four groups. Conclusion: This study confirms that the long-term outcome of ABO-incompatible living kidney transplantation is excellent and is similar to that of ABO-compatible cases. Recent data show that short-term graft survival has also improved. ABO-incompatible kidney transplantation is a radical, but safe and effective, treatment choice for end-stage renal disease. © Blackwell Munksgaard, 2006.

    DOI: 10.1111/j.1399-3089.2006.00278.x

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  • Pinpoint targeted immunosuppression: anti-CD20/MMF desensitization with anti-CD25 in successful ABO-incompatible kidney transplantation without splenectomy. International journal

    Kazuhide Saito, Yuki Nakagawa, Michihiro Suwa, Naoki Kumagai, Toshiki Tanikawa, Tsutomu Nishiyama, Mitsuhiro Ueno, Fumitake Gejyo, Shin-ichi Nishi, Kota Takahashi

    Xenotransplantation   13 ( 2 )   111 - 7   2006.3

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    BACKGROUND: In Japan, ABO-incompatible (ABO-I) kidney transplantation began in 1989; these transplantations have flourished because of the lack of cadaveric donors, and more than 600 cases were performed up to 2004. Splenectomy has been considered to be necessary for successful ABO-I kidney transplantation, and the majority of pre-conditioning protocols include splenectomy in Japan. However, we have lost some grafts due to antibody-mediated rejection (AMR) accompanying explosive elevation of anti-A/B antibody (Ab) titer even though the patients had a low pre-operative Ab titer. PATIENTS AND METHODS: We utilized two doses of anti-CD20, rituximab, simply combined with mycophenolate mofetil (MMF)/low-dose steroid desensitization started 1 month before surgery in ABO-I kidney transplantation. Two sessions of pre-operative Ab removal by double filtration plasmapheresis or plasma exchange were carried out. We performed six ABO-I kidney transplantations without splenectomy. Anti-A/B Ab titers were more than 16 to 32 times before treatment. We did not plan any post-operative repeated Ab removal or intravenous immunoglobulin G (IVIG). RESULTS: Pre-operative anti-A/B Ab titers were successfully reduced to less than eight times in all cases. Except for one case in which we had to remove the graft due to aspiration pneumonia and methicillin-resistant staphylococcus epidermidis (MRSE) sepsis, the other five cases did not experience antibody-mediated rejection (AMR). An additional session of post-operative Ab removal and/or IVIG was not necessary. In all patients, B cells (CD19+, CD20+, CD21+) and activated T cells (CD25+) were selectively suppressed, although CD3+, CD4+ and CD8+ cell populations remained stable, thus we call our protocol "pinpoint targeted immunosuppression." Plasma immunoglobulin level was also successfully suppressed, especially after 6 weeks of surgery. CONCLUSION: Anti-CD20/MMF desensitization is safe and allows successful ABO-I kidney transplantation without splenectomy.

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  • リツキシマブを用いたABO血液型不適合腎移植

    中川 由紀, 齋藤 和英, 西山 勉, 西 慎一, 下条 文武, 高橋 公太

    移植   40 ( 総会臨時 )   274 - 274   2005.10

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  • [ABO-incompatible kidney transplantation].

    Yuki Nakagawa, Kazuhide Saito, Kota Takahashi

    Nihon rinsho. Japanese journal of clinical medicine   63 Suppl 4   700 - 5   2005.4

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  • ABO不適合腎移植におけるRituximabを用いた脾摘回避の試み

    齋藤 和英, 中川 由紀, 諏訪 通博, 原 昇, 西山 勉, 高橋 公太, 深瀬 幸子, 上野 光博, 下条 文武, 西 慎一

    移植   40 ( 2 )   188 - 188   2005.4

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  • 新潟大学における腎移植統計

    諏訪 通博, 斉藤 和英, 中川 由紀, 谷川 俊貴, 高橋 公太, 西 慎一, 下条 文武

    移植   39 ( 総会臨時 )   323 - 323   2004.7

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  • 生体腎移植後,アスペルギルス肺炎にノカルジア肺炎を続発し,呼吸不全に到った一例

    阿部 真樹, 田崎 正行, 諏訪 通博, 擣木 立, 中川 由紀, 齋藤 和英, 高橋 公太, 小原 竜軌, 成田 淳一, 大井 秀美

    移植   39 ( 3 )   338 - 338   2004.6

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  • 抗ドナー抗体陽性,ABO不適合二次移植においてバシリキシマブを用いた一例

    擣木 立, 阿部 真樹, 田崎 正行, 齋藤 和英, 高橋 公太, 西 慎一, 伊藤 洋輔, 下条 文武

    移植   39 ( 3 )   319 - 320   2004.6

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  • CAPD患者の腎移植後管理

    中川 由紀, 齋藤 和英, 熊谷 直樹, 谷川 俊貴, 西山 勉, 高橋 公太, 西 慎一, 下条 文武

    日本透析医学会雑誌   37 ( Suppl.1 )   816 - 816   2004.5

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  • 新規免疫抑制剤Basiliximabを用いた腎移植12症例の検討

    齋藤 和英, 中川 由紀, 若月 秀光, 擣木 立, 諏訪 通博, 阿部 真樹, 清水 淳, 田崎 正行, 滝澤 逸大, 村山 慎一郎, 谷川 俊貴, 高橋 公太

    日本泌尿器科学会雑誌   94 ( 2 )   202 - 202   2003.2

  • 生体腎移植後,アスペルギルス肺炎にノカルジア肺炎を続発した1例

    阿部 真樹, 田崎 正行, 諏訪 通博, 擣木 立, 中川 由紀, 齋藤 和英, 高橋 公太, 小原 竜軌, 成田 淳一, 大井 秀美

    今日の移植   15 ( 6 )   656 - 659   2002.11

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    52歳女.妊娠中毒症の後に慢性腎不全となり34歳で血液透析を導入した.血液型一致,HLA1MMの伯母をドナーとする生体腎移植を希望し,陳旧性肺結核再燃予防目的の3剤併用療法を6ヵ月施行した.全経過を通じて白血球減少症が認められたことが,アスペルギルス,ノカルジア感染症のrisk factorとなっていた.組織適合性が良好であること,感染症予防の為に免疫抑制療法は代謝拮抗薬を外していたにも拘わらずアスペルギルス感染症が発症し,治療の過程でノカルジア感染症も認められた.感染症のrisk factorが存在する場合は胸部CT等による厳重な管理が必要である

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  • 新潟大学グループにおけるABO不適合腎移植 免疫抑制療法の変遷を中心に

    諏訪 通博, 齋藤 和英, 谷川 俊貴, 中川 由紀, 冨田 善彦, 西 慎一, 下条 文武, 玉木 信, 木全 直樹, 今井 智之

    泌尿器外科   15 ( 臨増 )   493 - 493   2002.5

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  • The clinical significance of antibody to vascular endothelial cells after renal transplantation. International journal

    Yuki Nakagawa, Kazuhide Saito, Testuo Morioka, Yoshihiko Tomita, Kota Takahashi, Takashi Oite

    Clinical transplantation   16 Suppl 8   51 - 7   2002

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    Vascular endothelial cells (ECs) are considered to be a primary target for injury in allograft rejection. However, the relationship between serum antibody activity to ECs and rejection episodes has not been examined extensively in renal transplantation. Twenty-two renal transplant recipients were included in this study. Serum antibody activity to vascular endothelial cells (AECA) was measured using a cellular enzyme-linked immunosorbent assay (ELISA) in which human umbilical vein endothelial cells (HUVEC) and human glomerular endothelial cells (HGEC) were preincubated with TNF-alpha used as target cells. Serum samples were obtained just before transplantation and once a week during the immediate 1-3-month post-transplantation period. There was a significant correlation between the presence of AECA against HGEC and rejection episodes (P < 0.05). Patients with multi-episodes of rejection showed significantly higher frequencies of AECA than patients with mono-episodic rejection (P < 0.0005). It should be noted that patients suffering from multi-episodes of rejection revealed higher AECA titres before transplantation. These findings imply that the HGEC-ELISA could be used as a prospective, informative test to identify patients with a higher risk of acute rejection in renal transplantation.

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  • 非免疫学的因子としての移植腎血行動態におよぼすACEI/ARBの効果

    齋藤 和英, 中川 由紀, 擣木 立, 諏訪 通博, 谷川 俊貴, 冨田 善彦, 高橋 公太, 齋藤 徳子, 成田 一衛, 西 慎一, 下条 文武

    日本泌尿器科学会雑誌   93 ( 2 )   225 - 225   2002

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    DOI: 10.5980/jpnjurol.93.225_3

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  • 腎移植におけるタクロリムスの体内薬物動態についての考察

    齋藤 和英, 諏訪 通博, 中川 由紀, 谷川 俊貴, 冨田 善彦, 高橋 公太

    日本泌尿器科学会雑誌   93 ( 2 )   224 - 224   2002

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    DOI: 10.5980/jpnjurol.93.224_2

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  • 心停止後小児ドナーから小児への献腎移植の3例

    齋藤 和英, 若月 俊二, 谷川 俊貴, 中川 由紀, 西 慎一, 今井 智之, 柳原 俊雄, 高橋 公太

    移植   36 ( 総会臨時 )   187 - 187   2001.12

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  • 移植後10日でgraft lossに至ったB不適合生体腎移植の一例

    齋藤 和英, 中川 由紀, 谷川 俊貴, 水澤 隆樹, 宮島 憲生, 小松 集一, 上野 光博, 長 賢治, 西 慎一, 冨田 善彦

    移植   36 ( 4 )   250 - 251   2001.8

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  • 腎不全生涯治療からみた慢性腎不全患児の管理 参加者と考える問題提起症例 下大静脈・腸骨静脈完全閉塞に対し,卵巣静脈を用いて静脈吻合を行った小児献腎移植の1例

    齋藤 和英, 金井 利雄, 中川 由紀, 谷川 俊貴, 冨田 善彦, 高橋 公太, 西 慎一, 恵 以盛, 若杉 三奈子, 上野 光博, 荒川 正昭

    日本小児腎不全学会雑誌   21   38 - 39   2001.8

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  • ウイルス感染症 その予防と治療 小児と移植後のウイルス感染症 腎移植におけるサイトメガロウイルス感染症例 予防的治療とモニタリング,治癒判定

    齋藤 和英, 中川 由紀, 谷川 俊貴, 冨田 善彦, 高橋 公太, 西 慎一, 下条 文武

    日本小児腎不全学会雑誌   21   14 - 15   2001.8

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  • Efficacy of tacrolimus in ABO-incompatible kidney transplantation: clinicopathological aspect of humoral rejection. International journal

    K Saito, Y Nakagawa, T Tanikawa, K Sonda, S Nishi, Y Yamaguchi, M Arakawa, K Takahashi

    Transplantation proceedings   31 ( 7 )   2851 - 2   1999.11

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  • Recurrence of IgA nephropathy 17 months after renal transplantation in the allograft transmitted thin basement membrane disease (TBMD) from donor Reviewed

    Y Nakagawa, K Saito, S Nishi, Bilim, V, T Tanikawa, M Ueno, H Shimada, Y Osawa, M Arakawa, K Takahashi

    CLINICAL TRANSPLANTATION   13   59 - 62   1999

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    Recurrence of IgA nephropathy (IgAN) following renal transplantation has been described in 40-50% of such patients and it usually has a good outcome. We present the case of a 20-yr-old woman with IgAN who developed end-stage renal failure in 1995. In November 1996, she received a kidney from a living-related donor and was treated with tacrolimus, azathioprine and steroids. Zero- and one-hour biopsies were performed, which revealed minor glomerular abnormalities in light microscopy, thin basement membrane disease (TBMD) in electron microscopy. Eight months later she developed microscopic hematuria and proteinuria; however, the graft function was normal. Renal biopsy revealed an IgAN that is thought to be due to recurrence of the original disease.

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  • Tacrolimus therapy for ABO-incompatible kidney transplantation. International journal

    K Takahashi, K Saito, K Sonda, Y Nakagawa, A Katagiri, Y Tomita, T Tanigawa, M Takeda

    Transplantation proceedings   30 ( 4 )   1219 - 20   1998.6

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  • 移植後3ヵ月後に出現した中等度蛋白尿が消失した1例

    赤岩 靖久, 柄沢 良, 西 慎一, 上野 光博, 成田 一衛, 荒川 正昭, 齋藤 和英, 高橋 公太

    移植   33 ( 3 )   239 - 239   1998.6

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  • タクロリムスを用いた腎移植症例の検討 : 第86回日本泌尿器科学会総会

    齋藤 和英, 木村 元彦, 中川 由紀, 谷川 俊貴, 武田 正之, 高橋 公太

    日本泌尿器科学会雑誌   89 ( 2 )   325 - 325   1998

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    DOI: 10.5980/jpnjurol.89.325_3

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  • 移植後腎生検で糸球体内に多量の泡沫細胞を認めたABO不適合腎移植の1症例

    赤岩 靖久, 大澤 豊, 岡 一雅, 柄沢 良, 島田 久基, 上野 光博, 西 慎一, 鈴木 芳樹, 荒川 正昭, 中川 由紀, 谷川 俊貴, 齋藤 和英, 高橋 公太

    今日の移植   10 ( Suppl. )   82 - 87   1997.12

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    症例は34歳男である.移植後早期からtransplant glomerulopathyを呈し,糸球体内に多量の泡沫細胞を認めたABO不適合腎移植について,文献的考察を加えて報告した.これらはABO不適合腎移植に伴った所見である可能性が考えられた

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  • Possible significance of VLA‐4 (α β1) for hematogenous metastasis of renal‐cell cancer Reviewed

    Yoshihiko Tomita, Toshihiro Saito, Kazuhide Saito, Takashi Oite, Fujio Shimizu, Shotaro Sato

    International Journal of Cancer   60 ( 6 )   753 - 758   1995

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    Very late antigen‐4 (VLA‐4) composed of α and β, a member of the β ‐integrin subfamily, facilitates cell‐to‐cell interaction with vascular celladhesion molecule‐1 (VCAM‐1) on endothelial cells (EC). Attachment of bloodborne tumor cells to EC is a crucial step for hematogenous metastasis, and VLA‐4‐positive tumor cells can attach to EC by binding to VCAM‐1. Renalcell cancer (RCC) reveals proportionally greater percentages of metastases than other carcinomas at initial diagnosis. We investigated whether VLA‐4 is expressed on RCC, and how such expression on RCC correlates with the metastatic potential of RCC. Immunohistochemical staining on 66 primary and 4 metastatic RCC showed that 4 out of 4 metastatic and 5 out of 8 primary RCC from patients with lung and /or brain metastases expressed α4 and β1 chains. On the other hand, 13 of 58 RCC without metastases expressed α4 chain. α4 and β expressions were also detected on 5 out of 5 human RCC cell lines, ACHN,KRC/Y, A498, Caki1 and Caki2, by flowcytometric analysis. Reversetranscriptasepolymerasechainreaction (RT‐PCR), followed by Southernblot hybridization with cDNA probe for a α4 chain, also confirmed mRNA production in 4 out of 5 RCC cell lines. Furthermore, adhesion of α4‐positive RCC cell lines to human umbilicalvein endothelial cells (HUVEC) was augmented by treatment of HUVEC with tumor necrosis factor‐α (TNF‐α). This adhesion was inhibited by anti‐α4 or anti‐VCAM‐1 antibodies, suggesting that VLA‐4‐VCAM‐1 interaction was involved in the adhesion between RCC cells and HUVEC. Taken together, VLA‐4 on RCC cells might play a crucial role in their hematogenous metastasis. © 1995 Wiley‐Liss. Inc. Copyright © 1995 Wiley‐Liss, Inc., A Wiley Company

    DOI: 10.1002/ijc.2910600604

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  • Modulation of human mesangial cell behaviour by extracellular matrix components - The possible role of interstitial type III collagen Reviewed

    K. Saito, F. Shimizu, T. Sato, T. Oite

    Clinical and Experimental Immunology   91 ( 3 )   510 - 515   1993

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    We have investigated the effects of various extracellular matrix (ECM) components on the behaviour of human mesangial cells (HMC) in a gel culture system using a modified MTT assay method. When cultured on a reconstituted basement membrane, Matrigel (M gel), HMC aggregated and formed isolated colonies initially, then extended an array of cell processes to form a dendritic network structure and proliferated very slowly as the culture period progressed. On type I collagen gel (CI gel), however, HMC developed elongated bipolar shapes, migrated into the gel, and showed rapid cell growth. Next, separate ECM components, such as type III and IV collagens, laminin, heparin and heparan sulphate, were incorporated into CI gel and HMC proliferation was assessed. Although attachment of HMC to each gel did not differ significantly, HMC proliferation was inhibited markedly on gels containing type III collagen, heparin and heparan sulphate
    type IV collagen suppressed HMC proliferation slightly
    and laminin had no significant effect. These data suggest that interstitial type I and III collagens, which are often observed in diseased glomeruli, as well as the basement membrane components, may play important roles in the regulation of HMC proliferation under pathophysiological conditions in vivo. We conclude that HMC behaviour is affected by the surrounding ECM constituents, which appear to function as a refined modulator.

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  • 腎移植後の尿路結石発生率と治療についての検討

    田崎正行, 風間明, 齋藤和英, 池田正博, 冨田善彦

    日本泌尿器内視鏡・ロボティクス学会(Web)   37th   2023

  • 肥満患者に対する腎移植の検討 BMIは25未満とすべきか

    石川 晶子, 田崎 正行, 池田 正博, 中川 由紀, 齋藤 和英, 冨田 善彦

    日本臨床腎移植学会プログラム・抄録集   55回   206 - 206   2022.2

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  • 鼠径部膀胱ヘルニアのため移植腎に水腎症をきたした1例

    池田 正博, 田崎 正行, 齋藤 和英, 冨田 善彦, 小林 隆, 若井 俊文

    日本臨床腎移植学会プログラム・抄録集   53回   249 - 249   2020.2

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  • 腎移植発展に向けての活動〜次世代を担う若手移植医の取り組みと課題〜 地方大学における泌尿器科医としての腎移植医療

    田崎 正行, 齋藤 和英, 冨田 善彦

    日本臨床腎移植学会プログラム・抄録集   53回   149 - 149   2020.2

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  • ANALYSIS OF THE PREVALENCE OF SYSTEMIC DE NOVO THROMBOTIC MICROANGIOPATHY AFTER ABO-INCOMPATIBLE KIDNEY TRANSPLANTATION AND THE ASSOCIATED RISK FACTORS: A RETROSPECTIVE STUDY

    Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Naofumi Imai, Yumi Ito, Yutaka Yoshida, Ichiei Narita, Kota Takahashi, Yoshihiko Tomita

    TRANSPLANT INTERNATIONAL   32   323 - 323   2019.10

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  • Desensitization therapy for ABO incompatible kidney transplantation

    6 ( 2 )   139 - 145   2018.12

  • Acquired down-regulation of B cell function after ABO-incompatible kidney transplantation

    Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Naofumi Imai, Yumi Ito, Kota Takahashi, Yoshihiko Tomita

    INTERNATIONAL JOURNAL OF UROLOGY   25   184 - 184   2018.10

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  • Is it Really Necessary to Remove anti-A/B Antibodies in ABO-Incompatible Kidney Transplantation?

    Yuki Nakagawa, Kazuhide Saito, Masayuki Tasaki, Kota Takahashi, Yoshihiko Tomita

    TRANSPLANTATION   102   S472 - S472   2018.7

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    DOI: 10.1097/01.tp.0000543276.46991.4b

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  • Bortezomib Eliminates Plasma Cells from the Renal Graft in Plasma Cell-Rich Acute Rejection

    Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Masahiro Ikeda, Naofumi Imai, Yumi Ito, Takeshi Yamada, Hiroya Hasegawa, Kota Takahashi, Yoshihiko Tomita

    TRANSPLANTATION   102   S479 - S479   2018.7

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    DOI: 10.1097/01.tp.0000543287.07980.0b

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  • Long-Term Outcome of Kidney Transplantation for IgA Nephropathy: A Single-Center Experiences

    Akira Tadokoro, Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Masahiro Ikeda, Naofumi Imai, Yumi Ito, Kota Takahashi, Yoshihiko Tomita

    TRANSPLANTATION   102   S579 - S579   2018.7

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    DOI: 10.1097/01.tp.0000543456.88760.cc

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  • The Examination of Hepatitis E after Renal Transplantation

    Yuki Nakagawa, Kazuhide Saito, Masayuki Tasaki, Kota Takahashi, Yohei Owada, Yukio Ohshiro, Nobuhiro Ohkohchi, Hiroaki Okamoto, Yoshihiko Tomita

    TRANSPLANTATION   102   S662 - S662   2018.7

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    DOI: 10.1097/01.tp.0000543594.62792.27

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  • 新潟大学における腎移植の成績と悪性腫瘍についての検討

    齋藤 和英, 田崎 正行, 中川 由紀, 池田 正博, 冨田 善彦, 高橋 公太

    腎と透析   84 ( 別冊 腎不全外科2018 )   115 - 118   2018.6

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    腎移植の成績と悪性腫瘍の発生について検討した。1988〜2015年末に当施設で腎移植を実施した416例(生体腎移植320例、献腎移植96例)を対象とした。レシピエントの移植時年齢中央値は38.5歳、男性272例、女性144例、ドナー年齢の中央値は55.0歳であった。1・5・10・15・20年後の患者生存率は生体腎99.4、97.8、95.6、93.4、82.0%、献腎97.1、92.6、87.4、84.1、84.1%、死亡症例は24例(5.8%)であった。全416例中29例(7%)に32件の悪性腫瘍が発生した。悪性腫瘍あり群29例と非悪性腫瘍群387例を比較検討したところ、移植時年齢、性別、透析期間、生体腎移植の比率、ABO血液型不適合の比率、ドナー年齢に有意差は認められなかった。しかし、癌なし群は癌あり群と比較して有意差をもって生存・生着率が良好であった。

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  • 献腎移植における廃用性萎縮膀胱への腎移植の検討

    中川由紀, 中川由紀, 池田正博, 田崎正行, 齋藤和英, 高橋公太, 冨田善彦

    日本臨床腎移植学会プログラム・抄録集   51st   2018

  • マージナルドナーからの献腎移植:提供意思を生かすには?

    齋藤和英, 中川由紀, 田崎正行, 冨田善彦, 伊藤由美, 今井直史, 成田一衛

    日本臨床腎移植学会プログラム・抄録集   51st   2018

  • IS IT REALLY NECESSARY TO REMOVE ANTI-A/B ANTIBODIES IN ABO-INCOMPATIBLE KIDNEY TRANSPLANTATION?

    Yuki Nakagawa, Yuki Nakagawa, Kazuhide Saito, Masayuki Tasaki, Kota Takahashi, Yoshihiko Tomita

    TRANSPLANT INTERNATIONAL   30   81 - 81   2017.9

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  • RE-EVALUATING CUT-OFF POINTS FOR THE EXPANSION OF DECEASED DONOR CRITERIA FOR KIDNEY TRANSPLANTATION IN JAPAN

    Yuki Nakagawa, Kazuhide Saito, Masahiro Ikeda, Masayuki Tasaki, Atsushi Aikawa, Kota Takahashi, Yoshihiko Tomita

    TRANSPLANT INTERNATIONAL   30   293 - 293   2017.9

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  • PRE-TRANSPLANT ANTIBODY REMOVAL CAN BE AVOIDED IN ABO INCOMPATIBLE KIDNEY TRANSPLANTATION.

    Masayuki Tasaki, Yuki Nakagawa, Kazuhide Saito, Naofumi Imai, Yumi Ito, Vladimir Bilim, Kota Takahashi, Yoshihiko Tomita

    JOURNAL OF UROLOGY   197 ( 4 )   E74 - E74   2017.4

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    DOI: 10.1016/j.juro.2017.02.251

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  • ARTERIOLAR HYALINIZATION PREDICTS CLINICAL OUTCOME IN RENAL TRANSPLANTATION FROM DONORS AFTER CARDIAC DEATH.

    Masayuki Tasaki, Kazuhide Saito, Yuki Nakagawa, Naofumi Imai, Yumi Ito, Masato Akiyama, Kota Takahashi, Yoshihiko Tomita

    JOURNAL OF UROLOGY   197 ( 4 )   E995 - E995   2017.4

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    DOI: 10.1016/j.juro.2017.02.2169

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  • The examination of the breaking point of expanded criteria deceased donor in Japan

    Yuki Nakagawa, Masayuki Tasaki, Kazuhide Saito, Kota Takahashi, Atushi Aikawa, Masami Kikuchi, Yoshihiko Tomita

    TRANSPLANTATION   100 ( 7 )   S723 - S724   2016.7

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  • Clinical and pathological evaluations of combination therapy for active antibody mediated rejection in renal transplantation; a single-center experience

    Masayuki Tasaki, Akira Kazama, Kazuhide Saito, Yuki Nakagawa, Naofumi Imai, Yumi Ito, Masahiro Ikeda, Hiroo Kuroki, Kota Takahashi, Yoshihiko Tomita

    TRANSPLANTATION   100 ( 7 )   S616 - S616   2016.7

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  • 当院におけるタクロリムス徐放性製剤(グラセプター)の管理

    塚口真穂登, 田崎正行, 磯貝和也, 田所央, 黒木大生, 真砂俊彦, 中川由紀, 齋藤和英, 冨田善彦, 高橋公太, 笹原浩康, 外山聡

    日本臨床腎移植学会プログラム・抄録集   49th   2016

  • 泌尿器科処方のすべて すぐに使える実践ガイド 11 併存疾患:血液系 貧血

    中川由紀, 齋藤和英, 冨田善彦

    臨床泌尿器科   70 ( 4 )   2016

  • 【糖尿病と腎疾患2015】 移植 腎移植と糖尿病 腎移植後の糖尿病(PTDM)の治療と管理

    細島 康宏, 石川 友美, 池田 正博, 齋藤 和英, 成田 一衛, 斎藤 亮彦

    腎と透析   78 ( 増刊 )   396 - 401   2015.6

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  • DESENSITIZATION WITH RITUXIMAB IN ABO INCOMPATIBLE KIDNEY TRANSPLANTATION IN JAPAN

    Kazuhide Saito, Kota Takahashi

    NEPHROLOGY DIALYSIS TRANSPLANTATION   30   2015.5

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    DOI: 10.1093/ndt/gfv185.46

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  • 我が国における献腎移植ドナーの基準と限界点の検討

    中川 由紀, 池田 正博, 田崎 正行, 齋藤 和英, 相川 厚, 菊池 雅美, 高橋 公太

    日本泌尿器科学会総会   103回   587 - 587   2015.4

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  • 当科におけるABO血液型不適合移植の基礎研究

    田崎正行, 齋藤和英, 中川由紀, 今井直史, 高橋公太, 冨田善彦

    日本泌尿器科学会東部総会プログラム・抄録集   80th   2015

  • マージナルドナーの基準と限界点 我が国における献腎移植ドナーの基準と限界点の検討

    中川 由紀, 斎藤 和英, 池田 正博, 田崎 正行, 高橋 公太

    日本移植学会総会プログラム抄録集   50回   209 - 209   2014.8

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  • 新潟大学泌尿器科における腹腔鏡下ドナー腎採取術 100例の検討

    笠原 隆, 新井 啓, 瀧澤 逸大, 田崎 正行, 小松 集一, 星井 達彦, 斉藤 和英, 西山 勉, 高橋 公太

    新潟医学会雑誌   128 ( 8 )   408 - 408   2014.8

  • 7 生体腎移植患者に対する持続血糖測定(CGM)を用いた血糖評価(Ⅰ.一般演題, 第97回新潟内分泌代謝同好会)

    128 ( 2 )   93 - 93   2014.2

  • 10 移植後高カルシウム血症に対しPEITが効果的であった4症例(Ⅰ.一般演題, 第97回新潟内分泌代謝同好会)

    128 ( 2 )   94 - 95   2014.2

  • 新潟大学における腹腔鏡下ドナー腎採取術100例の検討

    瀧澤 逸大, 笠原 隆, 新井 啓, 田崎 正行, 小松 集一, 星井 達彦, 齋藤 和英, 西山 勉, 高橋 公太

    Japanese Journal of Endourology   26 ( 3 )   260 - 260   2013.11

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  • iABO KT in Japan: The present status of ABO-incompatible kidney transplantation in Japan - Lessons from more than 2,500 transplants during 24 years

    Kota Takahashi, Kazuhide Saito

    XENOTRANSPLANTATION   20 ( 5 )   315 - 315   2013.9

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    DOI: 10.1111/xen.12060_2

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  • Examination of ABO-incompatible kidney transplantation without methods of removing anti-ABO antibodies pretransplant

    Yuki Nakagawa, Masayuki Tasaki, Kazuhide Saito, Kota Takahashi

    XENOTRANSPLANTATION   20 ( 5 )   321 - 321   2013.9

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    DOI: 10.1111/xen.12060_19

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  • 新潟大学におけるエベロリムスの使用経験

    池田 正博, 中川 由紀, 齋藤 和英, 高橋 公太, 成田 一衛

    移植   47 ( 総会臨時 )   336 - 336   2012.9

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  • 腎移植レシピエントにおけるペントラキシン3(PTX3)の血漿中濃度

    今井直史, 西慎一, 吉田一浩, 高橋香, 伊藤由美, 大澤豊, 中川由紀, 齋藤和英, 高橋公太, 成田一衛

    日本臨床腎移植学会プログラム・抄録集   45th   2012

  • 著明なメサンギウム細胞増殖と管内細胞増多を認めた抗体関連型拒絶反応の一例

    伊藤由美, 河野恵美子, 吉田一浩, 今井直史, 成田一衛, 山崎裕幸, 中川由紀, 齋藤和英, 高橋公太, 唐澤環, 鈴木俊明, 池住洋平, 齋藤昭彦

    移植腎病理研究会学術集会プログラム・抄録   16th (Web)   2012

  • CLINICAL PHARMACOKINETICS OF VALGANCICLOVIR IN RENAL TRANSPLANT RECIPIENTS WITH OR WITHOUT RENAL IMPAIRMENT

    Yuki Nakagawa, Kazuhide Saito, Kota Takahashi

    TRANSPLANT INTERNATIONAL   24   175 - 176   2011.9

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  • THE CLINICAL STUDY OF IMMUNOSUPPRESSION PROTOCOL IN ABO-INCOMPATIBLE KIDNEY TRANSPLANTATION

    Yuki Nakagawa, Kazuhide Saito, Kota Takahashi

    TRANSPLANT INTERNATIONAL   24   36 - 37   2011.9

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  • ABO INCOMPATIBLE PEDIATRIC KIDNEY TRANSPLANTATION IN JAPAN

    Atsushi Aikawa, Kota Takahashi, Kazuhide Saito

    PEDIATRIC TRANSPLANTATION   15   43 - 43   2011.8

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  • 移植腎におけるpenraxin 3の発現

    今井直史, 吉田一浩, 伊藤由美, 成田一衛, 西慎一, 大澤豊, 中川由紀, 齋藤和英, 高橋公太

    移植腎病理研究会学術集会プログラム・抄録   15th (Web)   2011

  • Mechanism of Acute Antibody-Mediated Rejection in ABO-Incompatible Kidney Transplantation: Which Anti-A/Anti-B Antibodies are Responsible, Natural or de Novo?

    Kota Takahashi, Kazuhide Saito, Yuki Nakagawa, Masayuki Tasaki, Noboru Hara, Naofumi Imai

    TRANSPLANTATION   89 ( 5 )   635 - 637   2010.3

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    DOI: 10.1097/TP.0b013e3181c89307

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  • THE RETURN OF BIOSYNSORB ANTIGEN-SPECIFIC IMMUNOADSORPTION IN ABO-INCOMPATIBLE KIDNEY TRANSPLANTATION

    Yuki Nakagawa, Kazuhide Saito, Kota Takahashi

    TRANSPLANT INTERNATIONAL   22   186 - 186   2009.8

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  • 下大静脈閉塞した小児に対し腎移植を施行した2症例

    中川由紀, 田崎正行, 斎藤和英, 高橋公太, 西慎一, 下条文武

    日本臨床腎移植学会プログラム・抄録集   42nd   2009

  • The study of rituximab dose in ABO-incompatible kidney transplantation

    Yuki Nakagawa, Kazuhide Saito, Kota Takahashi

    TRANSPLANT INTERNATIONAL   20   119 - 119   2007.9

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  • 腎動脈狭窄を原因とする腎移植後高血圧に対し、経皮的腎動脈拡張術が奏効した12歳男児例

    鈴木 俊明, 池住 洋平, 目黒 茂樹, 唐澤 環, 中川 由紀, 斎藤 和英, 高橋 公太, 内山 聖

    小児高血圧研究会誌   4 ( 1 )   49 - 52   2007.6

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  • 移植直後に尿蛋白が増加し,1回の血漿交換と3回のLDL吸着で消失した献腎移植の一例

    新谷茂樹, 忰田亮平, 大森健太郎, 近藤大介, 成田一衛, 下条文武, 西慎一, 武田啓介, 中川由紀, 斉藤和英, 高橋公太

    日本臨床腎移植学会プログラム・抄録集   40th   2007

  • "Pin-point'' targeted immunosuppression anti-CD20/MMF desensitization combined with anti-CD25 in successful ABO-incompatible kidney transplantation without splenectomy

    K Saito, Y Nakagawa, M Suwa, N Kumagai, T Tanikawa, T Nishiyama, M Ueno, S Nishi, F Gejyo, K Takahashi

    XENOTRANSPLANTATION   12 ( 5 )   358 - 358   2005.9

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  • Perioperative Management of ABO-Incompatible Kidney Transplantation : Focused on Double Filtration Plasmapheresis (DFPP)

    Nakagawa Yuki, Saito Kazuhide, Tanikawa Toshiki, Nishi Shiniti, Ueno Mituhiro, Gejyo Fumitake, Takahashi Kota

    24 ( 2 )   199 - 203   2005

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    DFPP (double filtration plasmapheresis) is used in patients with ABO-incompatible kidney transplants for depletion of anti A/B antibodies. However, there are some problems and complications. We investigated those complications and took preventive measures against complications. Before transplantation, patients with ABO-incompatible kidney transplants receive DFPP for depletion of anti A/B antibodies, under a continuous hematocrit (Hct) monitoring. In these patients, blood volume (BV) fell gradually with an increase in the volume of replacement fluid. The corrected concentration of serum albumin decreased during treatment, indicating that albumin loss occurred during treatment. We speculated that the decrease in BV was induced by the fall in oncotic pressure caused by albumin loss, and often resulted in a fall in blood pressure. We changed the concentration of replacement fluid of DFPP from 8.5% to 12.5%. The 12.5% replacement fluid is more effective and safe than the 8.5%, and does not lead to a decrease in BV. After transplantation, when there is humoral rejection with anti A/B antibody rebound, patients receive DFPP for elimination of anti A/B antibody. Basiliximab (BXM : Simulect) is a chimeric anti-CD 25 monoclonal antibody frequently used recently in kidney transplantation and is easily eliminated by DFPP. We reported a case whose Basiliximab concentration was dramatically decreased by DFPP for elimination of anti A/B antibodies after kidney transplantation.

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    Other Link: http://id.nii.ac.jp/1141/00150610/

  • 腎移植における尿路再建術式の検討

    齋藤 和英, 中川 由紀, 擣木 立, 熊谷 直樹, 諏訪 通博, 谷川 俊貴, 西山 勉, 高橋 公太

    移植   39 ( 総会臨時 )   207 - 207   2004.7

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  • 最近5年間の新潟大学における腎移植の成績

    米山 健志, 斉藤 和英, 谷川 俊貴, 中川 由紀, 冨田 善彦, 高橋 公太

    移植   36 ( 4 )   275 - 275   2001.8

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

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Awards

  • Ota Kazuo Memorial Prize

    2017.7   Japanese Society of Renal Failure Surgery  

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  • 平成26年度 文部科学大臣表彰 科学技術賞(理解増進部門)

    2014.4   文部科学省  

    高橋公太, 齋藤和英, 中川由紀, 秋山政人

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    Award type:International academic award (Japan or overseas)  Country:Japan

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  • 平成25年度 厚生労働大臣表彰 臓器移植対策推進功労者(移植医療対策功労者)

    2013.11   厚生労働省  

    齋藤和英

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    Country:Japan

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  • Clinical Research Award by Japan Society for Clinical Renal Transplantation

    2013.3  

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    Award type:International academic award (Japan or overseas)  Country:Japan

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  • 平成6年度 新潟県医師会 学術研究助成

    1994.11   新潟県医師会   腎細胞癌の血行性転移のメカニズムに関する基礎的研究

    齋藤和英

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    Country:Japan

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Research Projects

  • ABO血液型不適合腎移植における糖鎖アレイを用いた新規血液型抗体測定法の臨床応用

    Grant number:21K09369

    2021.4 - 2024.3

    System name:科学研究費助成事業

    Research category:基盤研究(C)

    Awarding organization:日本学術振興会

    田崎 正行, 齋藤 和英, 舘野 浩章, 牛木 隆志

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    Grant amount:\4160000 ( Direct Cost: \3200000 、 Indirect Cost:\960000 )

    ABO血液型不適合腎移植は免疫学の常識を覆し、高い成功率と長期移植腎生着が可能となり、わが国における生体腎移植の30%を占め、慢性腎不全の治療に多大な貢献をしている。しかし、未だに制御不能の抗体関連型拒絶反応により、移植後早期に移植腎を摘出せざるを得ない症例があり、この問題を解決することが急務であった。これまで、われわれはABO血液型不適合腎移植後の抗体関連型拒絶反応を予測する新しい検査法の開発に努めてきた。
    本研究の目的は、『われわれが開発した腎特異的ABO糖タンパクアレイを用いて、ABO血液型不適合腎移植前に抗体関連型拒絶反応発症の高リスク患者を識別することが可能であるかを検証し、実臨床へ応用をめざす』ことである。
    これまで、腎血管内皮細胞上のABO抗原が結合する中心的なCD31をリコンビナントで作成し、ABO糖鎖抗原を遺伝子導入して発現させ、アレイとして固相化したものを新規抗ABO抗体測定法として報告した。これは、従来の赤血球を用いた抗ABO抗体測定結果よりも、正確にABO不適合腎移植後の抗体関連型拒絶反応を予測できる結果だった。しかし、より多くの検体を解析し、実臨床で応用可能かを追求する必要がある。
    本研究は、多施設共同研究としていかにサンプルを収集するかが重要である。新潟大学以外に14施設の病院に協力を依頼し、倫理委員会で承認を受け各施設で研究開始のための施設承認をしていただいた。施設ごとに研究開始の処理をしていただける時間がまちまちであり、完了までに時間を要した。
    検体採取用のチューブとフリーズボックスを当大学で準備し、各施設に送付し、検体収集を開始していただいている。また、これまで開発したCD31-ABOアレイの検量線を設定するために抗体を購入し検討を開始した。

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  • Immunological accommodation, Treg/Breg and co-stimulatory signal in ABO-incompatible kidney transplantation

    Grant number:20K09573

    2020.4 - 2023.3

    System name:Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)

    Research category:Grant-in-Aid for Scientific Research (C)

    Awarding organization:Japan Society for the Promotion of Science

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    Grant amount:\4290000 ( Direct Cost: \3300000 、 Indirect Cost:\990000 )

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  • Development of glycoconjugate microarray for the prediction of antibody mediated rejection in ABO incompatible kidney transplant

    Grant number:17K11195

    2017.4 - 2021.3

    System name:Grants-in-Aid for Scientific Research

    Research category:Grant-in-Aid for Scientific Research (C)

    Awarding organization:Japan Society for the Promotion of Science

    Tasaki Masayuki

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    Grant amount:\4550000 ( Direct Cost: \3500000 、 Indirect Cost:\1050000 )

    It is important to examine about antibody titer against donor ABO blood group antigen before ABO-incompatible kidney transplantation in order to control acute antibody mediated rejection. However, the results of existing method using red blood cells is not often corelated to clinical outcomes. In the present study, we developed the novel method to examine antibody titer against ABO blood group antigens specifically expressed on kidney endothelial cells. This method showed significant predictive value of acute antibody mediated rejection after ABO-incompatible kidney transplantation.

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  • ADAMTS13, vWF and Immunological accommodation in renal injury after ABO-incompatible kidney transplantation

    Grant number:26462457

    2014.4 - 2018.3

    System name:Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)

    Research category:Grant-in-Aid for Scientific Research (C)

    Awarding organization:Japan Society for the Promotion of Science

    Saito Kazuhide

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    Grant amount:\4810000 ( Direct Cost: \3700000 、 Indirect Cost:\1110000 )

    It has been still unknown that the establishment and maintenance mechanism of immunological accommodation after ABO-incompatible kidney transplantation.
    Even now, antibody mediated rejection(AMR) and/or thrombotic microangiopathy(TMA) sometimes occurs in several cases. We have focused on the graft factor in which kidney endothelium express the blood type carbohydrate antigen with specific anchor proteins such as PECAM-1, vWF,ADAMTS-13 that is quite different from RBCs, which play a critical role in prevention of AMR and/orTMA and induction of accommodation. On the other hand, we have also found the recipient factor in which the donor-blood type specific inhibition of antibody production. We have approved it both in vivo and in vitro study. B cells derived from the patients have revealed that the immunological unresponsiveness, so-called B cell anergy against donor blood type antigen, which might be the real feature of the accommodation after ABO-incompatible kidney transplantation,

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  • ABO血液型不適合腎移植におけるADAMTS13、vWFと免疫学的順応

    2014.4 - 2017.3

    System name:科学研究費助成事業

    Research category:基盤研究(C)

    Awarding organization:日本学術振興会

    齋藤和英

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    Authorship:Principal investigator  Grant type:Competitive

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  • 腎移植後急性拒絶反応の新規診断法の開発

    2012.4 - 2016.3

    System name:科学研究費助成事業

    Research category:基盤研究(C)

    Awarding organization:日本学術振興会

    西 愼一

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  • How is immunological accommodation induced in ABO incompatible kidney transplantation?

    Grant number:24249078

    2012.4 - 2015.3

    System name:Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (A)

    Research category:Grant-in-Aid for Scientific Research (A)

    Awarding organization:Japan Society for the Promotion of Science

    TAKAHASHI KOTA, SAITO Kazuhide, NARITA Ichiei, YAMAMOTO Tadashi, IMAI Naofumi, NAKAGAWA Yuki

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    Grant type:Competitive

    Grant amount:\43420000 ( Direct Cost: \33400000 、 Indirect Cost:\10020000 )

    We have publidhed many articles and books on elucidation of the mechanism of induction of "immunological accommodation" in ABO-incompatible kidney transplantation. In the manuscript, we have reviewed the history of ABO incompatible kidney transplantation worldwide and in Japan, our pioneership and destination in the role and importance of " desensitization therapy" in the field. The most ultimate goal is the elucidation of the induction mechanism of immunological accommodation in which we have clarified the variety of ABO carbohydrate antigens and antibodies in biomimicry to those of bacteria, RBC and vascular endothelial cells that closely related to the immunological accommodation induction in ABO incompatible kidney transplantation. Our hypothesis and evidence verified by clinical and experimental approach may lead to the improved patient and graft survival not only in kidney but also in other organ transplantation fields.

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  • Mechanism of the immunological accmmodation in ABO incompatible kidney transplantation

    2011.4 - 2015.3

    System name:Grant-in-Aid for Scientific Research

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    Grant type:Competitive

    ABO incompatible kidney transplantation was contraindication a quarter century ago. We had developed the desensitization therapy which induce the imunological accommodation that enable the same success rate as ABO compatible cases and overcome the immunological barrier. Hoerver, the underlying mechanism of accommodation induction is still unclear. We are tryng to reveal the mechanism using carbohydrate array assay system based on the variation and organ specific ABO blood type antigenicity.

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  • 移植医療の社会的基盤に関する研究:Donor Action Program(DAP)の検証

    2008.4 - 2013.3

    System name:厚生労働科学研究費補助金

    Awarding organization:厚生労働省

    篠崎尚史

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    Grant type:Competitive

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  • 移植医療の社会基盤整備に関する研究:新潟県におけるDonor Action Program(DAP)の検証

    2005.4 - 2008.3

    System name:厚生労働科学研究費補助金

    Awarding organization:厚生労働省

    島崎修次

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    Grant type:Competitive

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  • 骨髄細胞移植による移植腎再生治療の試み

    2004.4 - 2007.3

    System name:科学研究費助成事業

    Research category:挑戦的萌芽研究

    Awarding organization:日本学術振興会

    高橋公太

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    Grant type:Competitive

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  • レシピエント骨髄細胞移植によるドナー腎血管内皮細胞再生と血管内皮細胞キメラ誘導:液性拒絶反応・慢性移植腎障害の回避への挑戦

    2003.4 - 2007.3

    System name:科学研究費助成事業

    Research category:基盤研究(B)

    Awarding organization:日本学術振興会

    齋藤和英

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    Authorship:Principal investigator  Grant type:Competitive

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  • レシピエント骨髄細胞移植によるドナー腎血管内皮細胞再生と血管内皮細胞キメラ誘導

    2003.4 - 2007.3

    System name:科学研究費助成事業

    Research category:基盤研究(B)

    Awarding organization:日本学術振興会

    齋藤和英

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    Authorship:Principal investigator  Grant type:Competitive

    Grant amount:\12600000 ( Direct Cost: \12600000 )

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  • Restoration of renal microcirculation by eNOS gene transfection for overcoming the antibody-mediated rejection and achievement of long-term renal allograft survival

    Grant number:15390487

    2003 - 2006

    System name:Grants-in-Aid for Scientific Research

    Research category:Grant-in-Aid for Scientific Research (B)

    Awarding organization:Japan Society for the Promotion of Science

    TAKAHASHI Kota, SAITO Kazuhide, OITE Takashi

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    Grant amount:\12500000 ( Direct Cost: \12500000 )

    1. From the clinicopathological observation of antibody-mediated rejection in living donor ABO-incompatible kidney transplantation and ischemia-reperfusion injury in deceased donor kidney transplantation, We had analyzed and evaluated the process of the microcirculation injury and microvascular endothelial cell damage.
    2. We had established the GFP(+) to (-) rat bone marrow transplantation model and evaluated the role of The bone marrow derived endothelial progenitor cells in the regeneration of the injured microvascular Cells in renal ischemia-reperfusion injury.
    3. We have revealed that the bone marrow derived endothelial cells have migrated and recovered the injured endothelial cells in renal ischemia-reperfusion injury.
    It was approved not only by static immunohinstopathological method but also by dynamic direct observation by real-time phase contrast microscopy.
    4. We have also established in vitro eNOS gene transfection into cultured vascular endothelial cells, However, transplantation and restoration of injured endothelial cells by eNOS transfectant endothelial cells in "in vivo" experimental model could not be established.
    5.These result will be useful for the clinical renal preservation and regeneration therapy for antibody-mediated rejection in ABO-incompatible kidney transplantation and ischemia-reperfusion injury in deceased donor kidney transplantation.

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  • アデノウイルスベクターを用いたアポトーシス抑制分子発現による移植腎拒絶回避の試み

    2002.4 - 2004.3

    System name:科学研究費助成事業

    Research category:挑戦的萌芽研究

    Awarding organization:日本学術振興会

    高橋公太

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    Grant type:Competitive

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  • 臓器移植の社会基盤に向けての研究:新潟県におけるドナー・アクション・プログラムの導入

    2000.4 - 2005.3

    System name:厚生労働科学研究費補助金

    Awarding organization:厚生労働省

    大島伸一

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    Grant type:Competitive

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  • ABO血液型不適合腎移植の急性拒絶反応制御に関する研究

    1999.4 - 2002.3

    System name:科学研究費助成事業

    Research category:基盤研究(B)

    Awarding organization:日本学術振興会

    高橋公太

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    Grant type:Competitive

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  • 臓器移植の基盤整備に関する臨床的研究:腎移植におけるドナー・レシピエントの年齢差の問題点

    1999.4 - 2000.3

    System name:厚生労働科学研究費補助金

    Awarding organization:厚生労働省

    長澤俊彦

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    Grant type:Competitive

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  • 腎移植におけるドナー・レシピエントの年齢差の問題点:小児ドナーから小児レシピエントへの献腎移植の選択基準

    1998.4 - 1999.3

    System name:厚生労働科学研究費補助金

    Awarding organization:厚生労働省

    長澤俊彦

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    Grant type:Competitive

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  • 臓器移植の基盤整備に関する臨床的研究:腎移植におけるドナー・レシピエントの年齢差の問題点ー小児献腎移植の現況と予後

    1998.4 - 1999.3

    System name:厚生労働科学研究費補助金

    Awarding organization:厚生労働省

    長澤俊彦

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    Grant type:Competitive

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  • 脳死ドナーからの多臓器摘出ならびに多臓器移植に関する研究・腎移植神移植における免疫寛容誘導機構の研究

    1998.4 - 1998.8

    System name:ヒューマンサイエンス財団海外日本人研究者派遣事業

    Awarding organization:財団法人ヒューマンサイエンス振興財団

    齋藤和英

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    Authorship:Principal investigator  Grant type:Competitive

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  • 腎細胞癌細胞の増殖および腫瘍血管の新生における一酸化窒素の役割

    1997.4 - 1999.3

    System name:科学研究費助成事業

    Research category:基盤研究(C)

    Awarding organization:日本学術振興会

    齋藤和英

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    Authorship:Principal investigator  Grant type:Competitive

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  • 腎細胞癌の血行性転移に関する基礎的研究―腎細胞癌の血管内皮細胞への接着・浸潤・増殖におけるVLA4/VCAM-1経路の役割について

    1995.4 - 1996.3

    System name:科学研究費助成事業

    Research category:奨励研究

    Awarding organization:日本学術振興会

    齋藤和英

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    Authorship:Principal investigator  Grant type:Competitive

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