• Search Research Projects
  • Search Researchers
  • How to Use
  1. Back to previous page

Trial for extending indication of kidney transplantation

Research Project

Project/Area Number 01440053
Research Category

Grant-in-Aid for General Scientific Research (A)

Allocation TypeSingle-year Grants
Research Field General surgery
Research InstitutionTokyo Women's Medical College

Principal Investigator

OTA Kazuo  Dept. of Surgery. Tokyo Women's Medical College. Professor., 医学部 教授 (40090659)

Co-Investigator(Kenkyū-buntansha) TANABE Kazunari  Dept. of Urology. Tokyo Women's Medical College. Assistant., 医学部, 助手 (80188359)
HAYASAKA Yutaro  Dept. of Surgery. Tokyo Women's Medical College. Assistant Professor., 医学部, 講師 (30120033)
TAKAHASHI Kota  Dept. of Urology. Tokyo Women's Medical College. Associate Professor., 医学部, 助教授 (90101857)
SHIMIZU Masaru  Dept. of Transfusion. Tokyo Women's Medical College. Professor., 医学部, 教授 (20048987)
AGISHI Tetsuzo  Dept. of Surgery. Tokyo Women's Medical College. Professor., 医学部, 教授 (70090660)
NAKAJIMA Kazuo  Dept. of Surgery. Tokyo Women's Medical College. Assistant
OOBA Shinobu  Dept. of Urology. Tokyo Women's Medical College. Assistant.
Project Period (FY) 1989 – 1992
Project Status Completed (Fiscal Year 1992)
Budget Amount *help
¥18,000,000 (Direct Cost: ¥18,000,000)
Fiscal Year 1992: ¥4,300,000 (Direct Cost: ¥4,300,000)
Fiscal Year 1991: ¥4,300,000 (Direct Cost: ¥4,300,000)
Fiscal Year 1990: ¥3,900,000 (Direct Cost: ¥3,900,000)
Fiscal Year 1989: ¥5,500,000 (Direct Cost: ¥5,500,000)
Keywordskidney function / ABO blood type / ABO-incompatibility / preformed antibody / extending indication for kidney transplantation / anti-A, anti-B antibody / rejection / splenectomy / 血漿交換 / 免疫の吸着 / 免疫抑制剤 / deoxyspergualin
Research Abstract

In an effort to extend the opportunity of kidney transplantation, we treated the blood of ABO-incompatible patients or the blood of preformed antibodies-positive patients prior to transplantation by plasma exchange and/or immunoadsorption in order to eliminate anti-A, anti-B antibodies or preformed antibodies. As a result, we successfully widened the opportunities for kidney transplantation. (1) ABO-incompatible kidney transplantation
The patients were 49 chronic renal failure patients who received kidney transplantation at our center between January 1989 and November 1992. Their age range was 35 * 13 (8 to 58 year old). Twentynine patients were male and 20 were female. As for the blood type, eighteen cases were A_1^+-type donor to 0^+ type recipients, A_1^+ to O^-: 1 case, B^+ to O^+:16 cases, B^+ to A_1^+: 4 cases,A_1B^+ to A^+: 6 cases, A_1B^+ to B^+: 2 cases,A_1B^+ to O^+: 1 case, A_1B^- to O^+: 1 case. The number of HLA A.B.DR mismatches were 2.3 * 1.4 and mixed lymphocyete culture … More 1 way stimulation index was 21.1 * 18.9.
Prior to the transplantation, double filtration plasmapheresis and/or immunoadsorption using a Biosynsorb A or B immunoadsorpiton column (Chembiomed. Ltd., Edomonton, Alberta, Canada) were performed. until the serum anti-A and/or anti-B antibody titer lowered to 1:16 or below. A splenectomy was carried out either before or after the kidney transplantation. Initial immunosuppressive therapy was quintuple consisting of ciclosporin(8 mg/kg), azathioprine(2mg/kg), methyprednisolne(125mg/day), prophylactic use of equine antilymphocyte globulin(30mg/kg for 14 days) and deoxyspergulin(5mg/kg for 5 days).
The patient survival rates were 100% at 1-2 months, 98% at 3-6 months, 93% at 7-12 months, 91% at 1-3 years respectively. The graft survival rates were 94% at 1-2 months, 89% at 3-6 months, 81% at 7-12 months. 78% at 1-3 years respectively. Of 49 patients, rejection did not occur in 19 cases(39%) Hyperacute rejection occurred once in 1 case. Accelerated acute rejection occurred once in 4 cases. Acute rejection occured once in 16 cases, twice in 4 cases, 3 times in 2 cases, 4times in 3cases, and 6 times 1 case. Graft loss caused by rejection occurred in 5 cases. Kidney function has been maintained satisfactory in the remaining cases. Unfortunately, there were four deaths by complications. (2) Kidney transplantation in preformed antibodies-positive patients
DEPP and immunoadsorption were done 3 to 9 times prior to the transplantation in order to remove T-cell antibody, The immunosuppressant administration and the transplantation were carried out in a same manner as in the ABO-incompatible cases. Acute rejection occurred once in two cases. Graft loss ocurred in 2 cases due to chronic rejection and in 1 case due to hyeracute rejection respectively. Good kidney function has been maintained in the remaining 5 cases. Less

Report

(5 results)
  • 1992 Annual Research Report   Final Research Report Summary
  • 1991 Annual Research Report
  • 1990 Annual Research Report
  • 1989 Annual Research Report
  • Research Products

    (39 results)

All Other

All Publications (39 results)

  • [Publications] 太田 和夫 他: "ABO不適合腎移植の1例" 腎と透析. 27. 117-121 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] Hiroshi Kawaguchi etal: "A successful ABO blood type incompatible kidney transplantation" Transplant International. 4. 63-64 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] Tetsuzo Agishi etal: "Immunoadsorption of anti-A on anti-B antibody for successful kidney transplantation between ABO incompatible pains and its limitation" ASAIO Transplantations. 37. 496-498 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] Shinobu Ooba et al: "Two cases of ABO incompatible transplantation using plasmaphnesis and immunoadsorebent." Proceedings of the First Congress of Asian Society of Transplantation. 311-316 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] 高橋 公太 他: "ABO血液型不適合生体腎移植13例の経験" 日本移植学会雑誌. 26. 95-104 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] K.Takahashi et al: "Prophylactio use of a new immunosuppressive agent,transplantation deoxyspergualin,in patients with kidney from ABO-incompatible or preformed antibody-positive donors." Transplantation Proceedings.23. 1078-1082 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] Kota Takahashi,Kazuo Ota: "Nephrology" Springer-Verlag., 1748 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] 高橋 公太: "腎臓学Key Notes" 東京医学社, 353 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1992 Final Research Report Summary
  • [Publications] 高橋 公太,太田 和夫: "腎移植適応拡大の試み-ABO血液型不適合腎移植" 腎と透析. 32. 27-33 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] 川口 洋,高橋 公太,ほか: "こどもに対するABO血液型不適合腎移植" 腎移植・血管外科. 4. 154-160 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] K.Takahashi,K.Ota,etal: "ABO-incompotiblc Kidncy transplantatior in a single Center trial" Transplantation Proc.25. 271-273 (1993)

    • Related Report
      1992 Annual Research Report
  • [Publications] 高橋 公太: "蔵器移植における血液浄化法ABO血液型不適合腎移植" Medicina. 30. (1993)

    • Related Report
      1992 Annual Research Report
  • [Publications] T.Agishi,K.Takahashi,etal.: "Comparative evaluation of immunoadsorption and doublefiltration plaswaphercsis for removal of anti-A or anti-B antibody in ABO-incompatible kidneytransplantation" Transplabt Pro.24. 557-558 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] 阿岸 鉄三: "臓器移植と血液浄化" 人工臓器. 93-100 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] 長沢 俊彦,監修,高橋 公太,他編集: "腎臓学Key Notes ABO血液型不適合腎移植" 東京医学社, 353 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] 阿岸 鉄三,監修: "吸着療法マニュアル" 金原出版, 244 (1992)

    • Related Report
      1992 Annual Research Report
  • [Publications] 太田 和夫 他: "ABO不適合腎移植の1例" 腎と透析. 27. 117-121 (1989)

    • Related Report
      1991 Annual Research Report
  • [Publications] 阿岸 鉄三 他: "ABO血液型不適合者間腎移植に対する免疫吸着処置" 人工臓器. 20. 318-323 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] Tetsuzo Agishi,et al.: "Immunoadsorption of antiーA or antiーB antibody for successful kidney transplantation between ABO incompatible pains and its limitation." ASATO Transactions. 37. 496-498 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] 高橋 公太 他: "ABO血液型不適合間生体腎移植13例の経験" 日本移植学会雑誌. 26. 95-104 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] Kota Takahashi,et al.: "Prophylactic use of a new immunosuppressive agent,deoxyspergualin,in patients with kidney transplantation from ABOーincompatible or preformed antibodyーpositive donors." Transplantation Proceedings. 23. 1078-1082 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] 高橋 公太 他: "腎移植適応拡大の試みーABO血液型不適合腎移植" 腎と透析. 32. 27-33 (1992)

    • Related Report
      1991 Annual Research Report
  • [Publications] Kota Takahashi,et al.: "Therapeutic Plasmapheresis X." EXAO Press,Cleveland, 200 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] 太田 和夫,阿岸 鉄三 監修;高橋 公太 編集: "ABO血液型不適合腎移植" 日本医学館, 121 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] 太田 和夫,他: "ABO不適合腎移植の1例" 腎と透析. 27. 117 (1989)

    • Related Report
      1990 Annual Research Report
  • [Publications] 阿岸 鉄三,他: "ABO血液型不適合者間腎移植に対する免疫吸着処置" 人工臓器. 21. (1991)

    • Related Report
      1990 Annual Research Report
  • [Publications] 高橋 公太,他: "ABO血液型不適合間腎移植" 腎移植・血管外科雑誌. 2. 105-122 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] 高橋 公太,他: "腎移植適応拡大のための血液浄化法ーABO血液型不適合例と既存抗体陽性例の生体腎移植" 日本外科学会雑誌. 91. 1272-1276 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] 高橋 公太,他: "ABO血液型不適合間生体腎移植13例の経験" 日本移植学会雑誌. 26. 95-104 (1991)

    • Related Report
      1990 Annual Research Report
  • [Publications] K.Takahashi,etal: "Prophylactic use of a new immunosuppressive.agent,deoxyspergualin,in patients with kidney transplantation from ABOーincompatible or preformed antibodyーpositive donors." Transplantation Proceedings. 23. 1078-1082 (1991)

    • Related Report
      1990 Annual Research Report
  • [Publications] K.Takahashi,etal: "Therapheutci Plasmapheresis IX" ESAO Press,Cleveland, 200 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] 阿岸 鉄三(編・著),他: "ABO血液型不適合者間移植" 日本医学館, 300 (1991)

    • Related Report
      1990 Annual Research Report
  • [Publications] 太田和夫: "ABO不適合腎移植の1例" 腎と透析. 27. 117-121 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] 高橋公太: "腎移植の現状と将来の展望" 日本臨床免疫学会会誌. 12. 464-467 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] 高橋公太: "腎移植の現状と展望" 治療. 72. 741-747 (1990)

    • Related Report
      1989 Annual Research Report
  • [Publications] K.Takahashi: "Use of a novel immunosuppressive agent,deoxyspergualin,on rejections in kidney transplant recipients." Transplant Proc.(1990)

    • Related Report
      1989 Annual Research Report
  • [Publications] 阿岸鉄三: "腎移植における体外免疫調節" Transplantation Now. 2. 135-141 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] K.Takahashi,T.Agishi,K.Ota.: "Extracorporeal plasma treatment for Extending Indication of kidney transplantation:ABO incompatible and preformed antibody-positive kidney transplantation." ISAO Press, (1990)

    • Related Report
      1989 Annual Research Report
  • [Publications] 田辺一成,高橋公太,阿岸鉄三: "腎移植前処置としての免疫吸着 体外免疫調節" 日本メディカルセンタ-, 289 (1990)

    • Related Report
      1989 Annual Research Report

URL: 

Published: 1989-04-01   Modified: 2016-04-21  

Information User Guide FAQ News Terms of Use Attribution of KAKENHI

Powered by NII kakenhi