Masashi Takeda

Mast cell numbers and protease expression patterns in biopsy specimens following renal transplantation from living-related donors predict long-term graft function.

Abstract:  In human kidney transplantation the main cause of declining long‐term graft function is chronic allograft nephropathy (CAN). Recent studies have implicated human mast cells (MC) in chronic inflammation and fibrosis, MC can be subtyped according to protease content: MCT containing tryptase only and MCTC containing both tryptase and chymase. We investigated immunohistochemically whether numbers and subtypes of MC in biopsy specimens 100 d after transplantation could predict subsequent fibrosis and graft dysfunction. The total number of MC/high‐power field at 100 d after transplantation correlated significantly with change in creatinine clearance (ΔCcr), defined as (Ccr at 100 d) − (Ccr at 3 yr) (R = 0.597, p = 0.0021); fibrosis index (FI) at 100 d (R = 0.583, p = 0.0066); and ΔFI, defined as (FI at 3 yr) − (FI at 100 d) (R = 0.406, p < 0.05). The ratio of MCTC to total MC at 100 d also correlated with ΔCcr (R = 0.491, p = 0.0148), FI at 100 d (R = 0.527, p = 0.0081), and ΔFI (R = 0.417, p < 0.05). Thus, increases in number of total MC and the ratio of MCTC to total MC in early biopsy specimens were related to decline of long‐term graft function and fibrosis.

A Twelve-Year Experience with Adrenal Cortical Carcinoma in a Single Institution: Long-Term Survival after Surgical Treatment and Transcatheter Arterial Embolization

Introduction: We retrospectively analyzed 6 cases of adrenal cortical carcinoma (ACC) treated during a 12-year period at a single institution. Patients and Methods: We reviewed the clinical and pathological records and updated the follow-up of the patients treated and observed in our institution between 1995 and 2006. Results: All 6 patients underwent surgery for ACC. The mean age at diagnosis was 53.3 years (range 36–72). The median follow-up was 50.7 months (range 13–132). Three patients were clinically classified as stage II, 2 as stage III and 1 as stage IV with bone metastasis. The 5-year overall survival was 62.5%. Recurrences or metastases occurred in 4 patients. Two patients without reoperation for metastases died, and others with radical treatments such as surgery, chemotherapy, transcatheter arterial embolization and/or radiation remain alive. Conclusions: In our experience, transcatheter arterial embolization was effective against liver metastasis.

Correlation between endothelin expression in early post-transplant biopsy specimens and long-term allograft function in living-related renal transplantation

Abstract:  Objective:  We investigated whether degree of immunohistochemically evident endothelin (ET) expression in early post‐transplant biopsy specimens could predict long‐term allograft function in living‐related renal transplantation.

Posterior approach for retroperitoneal laparoscopic bilateral native nephrectomy in prone position : Initial experience with four cases

Abstract:  Focal segmental glomerulosclerosis (FSGS) is known to recur in some patients after renal transplantation. Recently, laparoscopic nephrectomy has been introduced as a minimally invasive surgery. We present our experience with our first four patients with FSGS who underwent simultaneous bilateral native nephrectomy in the prone position by means of retroperitoneal laparoscopy before renal transplantation. This procedure provided adequate visualization and created enough working space for manipulation. The patients did not need to be repositioned. The mobilized specimens were removed through an incision extending from the first port or by means of morcellation within the sack. Mean operative time was 325 min and mean blood loss was 281 mL. The average time to resumption of oral intake was 1.3 days and all patients started ambulation on postoperative day 1. No major complications were observed. In conclusion, this procedure may become a useful option for native nephrectomy for FSGS patients before transplantation.