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  • 1. Friman, Styrbjörn
    et al.
    Foss, Aksel
    Isoniemi, Helena
    Olausson, Michael
    Höckerstedt, Krister
    Yamamoto, Shinji
    Karlsen, Tom Hemming
    Rizell, Magnus
    Ericzon, Bo-Göran
    Liver transplantation for cholangiocarcinoma: Selection is essential for acceptable results2011Ingår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, Vol. 46, nr 3, s. 370-375Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and aims. Cholangiocarcinoma (CCA) is considered a contraindication for liver transplantation by most liver transplant centers. The aim of this study has been to report our results as well as to explore factors that influence patient survival after liver transplantation for CCA. Patients. All transplant patients with CCA in Norway, Sweden and Finland during 1984–2005 were included (n = 53). Thirty-three patients (62%) had intrahepatic CCA. Twenty-one patients (40%) had a more advanced tumor (>TNM stage 2). Thirty-four of the 53 recipients (64%) had primary sclerosing cholangitis (PSC). Results. Patients with TNM stage ≤2 transplanted after 1995 had a 5-year survival rate of 48%. The overall 5-year patient survival rate was 25%. There was no difference in survival between patients with extrahepatic and intrahepatic CCA. The 5-year survival rate among patients with TNM stage ≤2 was 36%. Patients with TNM stage >2 had a 10% 5-year survival rate; the difference was significant at p < 0.01. Patients transplanted after 1995 had a significantly better 5-year survival rate than pre-1995 patients (38% vs. 0%, p < 0.01). Patients transplanted after 1995 with TNM ≤2 and CA 19-9 ≤100 had the 5-year survival of 58%. Conclusion. By selecting CCA patients with TNM stage ≤2 and a CA 19-9 ≤100 a reasonable 5-year survival rate is possible. We think that CCA in selected cases can be an acceptable indication for liver transplantation.

  • 2. Iwata, Takashi
    et al.
    Gilispie, A
    Jorns, Carl
    Yamamoto, Shinji
    Nowak, Greg
    Ericzon, Bo-Göran
    Microdialysis monitoring for evaluation of the influence exertedby pneumoperitoneum on the kidney: an experimental study2008Ingår i: Surgical Endoscopy, ISSN 0930-2794, Vol. 22, s. 938-942Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Laparoscopic donor nephrectomy has

    become the first choice for living donor kidney transplantation,

    offering advantages over open donor nephrectomy.

    This study aimed to evaluate kidney tissue metabolism

    during and after pneumoperitoneum using a microdialysis

    technique.

    Methods

    Eight pigs underwent laparotomy and implantation

    of two microdialysis catheters: one in the cortex and

    one in the medulla of the left kidney. After laparotomy, the

    abdominal wall was closed, and pneumoperitoneum was

    induced with a constant standard pressure of 16 to 18

    mmHg for 4 h, followed by rapid desufflation. In microdialysis

    samples collected from intrarenal catheters,

    markers of ischemia (glucose, lactate, pyruvate, and lactate–

    pyruvate ratio) and the marker of cell membrane

    injury (glycerol) were monitored.

    Results

    There were no changes in glucose, lactate, or

    pyruvate level before, during, or after pneumoperitoneum,

    either in the cortex or in the medulla. Additionally, the

    calculated lactate–pyruvate ratio did not show signs of

    ischemia during or after pneumoperitoneum. However,

    with regard to the marker of cell injury, glycerol increased

    in the medulla after decompression from 22.57 ± 3.76 to

    35.67 ± 5.43 mmol/l (

    p < 0.01). This release of glycerol in

    the medulla was significantly higher than in the cortex

    (area under the curve [AUC], 22.18 ± 4.87 vs

    34.79 ± 7.88 mmol/l;

    p < 0.01).

    Conclusions

    The pattern of metabolic changes monitored

    in the kidney during and after pneumoperitoneum indicates

    some kind of cell injury predominant in the medulla without

    any signs of kidney ischemia. This nonischemic injury could

    be related to hyperperfusion of the kidney after decompression

    or injury to cells attributable to mechanical cell

    expansion at the point of rapid decompression.

  • 3. Jia, Xiaohui
    et al.
    Sharma, Amit
    Kumagai-Braesch, Makiko
    Wernerson, Annika
    Sörenby, Anne
    Yamamoto, Shinji
    Wang, Feng
    Tibell, Annika
    Exendin-4 Increases the Expression of Hypoxia-InducibleFactor-1 in Rat Islets and Preserves the Endocrine CellVolume of Both Free and Macroencapsulated Islet Grafts2012Ingår i: Cell Transplantation, ISSN 0963-6897, Vol. 21, s. 1269-1283Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this study, we evaluated the effects of exendin-4 on free and encapsulated islet grafts in a rodent model.

    We also investigated the role of a transcription factor, hypoxia-inducible factor-1 (HIF-1), in mediating the

    beneficial effects of exendin-4. Diabetic athymic mice were transplanted with free rat islets under the kidney

    capsule or with macroencapsulated rat islets SC with or without exendin-4, islet preculture (exendin-4 0.1

    nM for 20 h), and/or recipient treatment (IP 100 ng/day, day 0–7). The mice were followed for 4 weeks and

    the graft function and

    β-cell volume were evaluated. The effects of exendin-4 on islet HIF-1α mRNA

    and protein expression and on ATP content in a rat insulinoma cell line (INS-1E) were also examined.

    Preculture with exendin-4 followed by recipient treatment improved the outcome of both free (73% graft

    function vs. 26% in controls,

    p = 0.03) and macroencapsulated islet grafts (100% vs. 25% in controls, p =

    0.02). In macroencapsulated grafts, the exendin-4-treated group had significantly larger endocrine volume,

    less graft necrosis, and more blood vessels around the capsule. In rat islets cultured with exendin-4, HIF-1

    α

    mRNA and protein expression were significantly enhanced. ATP content was increased in exendin-4-treated

    INS-1E cells under hypoxic conditions. The improved functional outcome after transplantation of a marginal

    islet mass with a brief initial treatment with exendin-4 is related to a larger surviving endocrine cell volume.

    Exendin-4 may improve islet graft resistance to hypoxia during the peritransplant period by increasing the

    expression of HIF-1

     

  • 4. Kaxiras, Anastasios
    et al.
    Yamamoto, Shinji
    Söderdahl, Gunnar
    Wernerson, Annika
    Rimma, Axelsson
    Ericzon, Bo-Göran
    Cyclosporin A, but not tacrolimus, negatively affects the hepatic extraction fraction of hepatobiliary scintigraphy in liver transplant recipients2014Ingår i: European Journal of Nuclear Medicine and Molecular Imaging Redearch, ISSN 2191-219X, Vol. 4, nr 73Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Hepatobiliary scintigraphy using 99mTc-mebrofenin has been used as an investigation to study liver function after liver transplantation (LTx). Hepatic extraction fraction (HEF) is a measurement of the hepatic extraction efficiency and hepatic extraction rate. With the purpose of evaluating a possible diverging effect of cyclosporin A (CSA) and tacrolimus (TAC) on the HEF, we compared the HEF with biochemical and histological parameters in LTx patients receiving either CSA or TAC.

    Methods

    Thirty-nine adult patients who underwent LTx due to hepatitis C virus (HCV) cirrhosis were evaluated. All patients underwent a 3-month and 1-year follow-up that included hepatobiliary scintigraphy and biochemistry tests. Liver biopsy was performed at 1 year. These clinical parameters were compared between the two groups, TAC (n = 15) and CSA (n = 24).

    Results

    The average HEF was significantly lower in the CSA group compared to the TAC group both at 3 months and 1 year after LTx. The liver biochemistry tests, average donor and recipient age, average cold ischemia time (CIT), and a clearance were comparable in the two groups. The TAC group had more inflammation than the CSA group. Moreover, three patients who converted from CSA to TAC increased their HEF values.

    Conclusions

    CSA-treated patients presented a lower HEF value on hepatobiliary scintigraphy in spite of comparable liver function by traditional measurements indicating a decrease on HEF values by CSA.

  • 5.
    Wadström, J.
    et al.
    Karolinska Univ Hosp, Dept Transplantat Surg, Huddinge, Sweden; Hamad Med Corp, Dept Surg Transplantat, Doha, Qatar.
    von Zur-Mühlen, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Transplantationskirurgi.
    Yamamoto, Shinji
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Transplantationskirurgi.
    Few Gender Differences in Attitudes and Experiences after Live Kidney Donation, with Minor Changes over Time2018Ingår i: American Journal of Transplantation, ISSN 1600-6135, E-ISSN 1600-6143, Vol. 18, nr S4: Oral Abstracts, s. 451-451Artikel i tidskrift (Övrigt vetenskapligt)
  • 6.
    Wadström, Jonas
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Transplantationskirurgi. Hamad Med Corp, Dept Surg Transplantat, Doha, Qatar.
    von Zur-Mühlen, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Transplantationskirurgi.
    Yamamoto, Shinji
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Transplantationskirurgi.
    Few Gender Differences in Attitudes and Experiences after Live Kidney Donation, with Minor Changes over Time2018Ingår i: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 102, s. S336-S336Artikel i tidskrift (Övrigt vetenskapligt)
  • 7. Yamamoto, Shinji
    et al.
    Ericzon, Bo-Göran
    Domino liver transplantation as a valuable option.2013Ingår i: Transplantation international, ISSN 0934-0874, Vol. 27, nr 4Artikel i tidskrift (Refereegranskat)
  • 8.
    Yamamoto, Shinji
    et al.
    Karolinska institutet.
    Hellmann, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Endokrinkirurgi.
    Sundin, Anders
    Karolinska institutet.
    Tumors of the Adrenal Glands2014Ingår i: Nuclear Oncology / [ed] Cumali Aktolun, Stanley Goldsmith, Philadelphia: Wolters Kluwer, 2014, , s. 14s. 251-264Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 9.
    Yamamoto, Shinji
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Transplantationskirurgi. Department of surgery, Uppsala University Hospital, Uppsala, SE-75185, Sweden..
    Nelander, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Ectopic pregnancy in simultaneous pancreas-kidney transplantation: A case report2016Ingår i: International journal of surgery case reports, ISSN 2210-2612, E-ISSN 2210-2612, Vol. 28, s. 152-154Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: We present a case report of ectopic pregnancy (EP) after simultaneous pancreas-kidney transplantation (SKPTx). PRESENTATION OF CASE: A 33-year-old female status post SKPTx suddenly got abdominal pain in the lower level. She had high human chorionic Gonadotropin test. Ultrasonography revealed that there was no fetus in the uterus but a dilated right fallopian tube, which strongly suggested ectopic pregnancy. An emergency operation was performed and a dilated right side uterine tube was found with adhesions to her transplant. Salpingectomy was performed and no visible injury to the pancreas was found by the procedure. Pathological evaluation showed ectopic pregnant fetus, and no pancreas dysfunction was observed after the operation. DISCUSSION: This is the first case and operation report of EP after SKPTx. We should consider various causes of acute abdomen as well as several pathological condition in the transplanted pancreas such as pancreatitis, abscess, and thrombosis in vessels in the organ. Moreover, transplanted pancreas in abdomen is easily misrecognized as adipose tissue and there is high risk that the organ to get injured surgically. CONCLUSION: EP should be included in the different diagnosis in SKPTx female patients who get acute abdominal pain. It is highly desirable that transplant surgeon is included in the operation team for EP of these patients. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

  • 10. Yamamoto, Shinji
    et al.
    Schwarcz, Robert
    Weiland, Ola
    Oksanen, Antti
    Wernerson, Annika
    Söderdahl, Gunnar
    Sönnerborg, Anders
    Ericzon, Bo-Göran
    Long-term outcome of liver transplantation in HIV-1 positive patients: 15 years follow-up2013Ingår i: ISRN Transplantation, ISSN 2314-4092, Vol. Article ID 480582Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Liver transplantation (LT) for patients with human immunodeficiency virus type-1 (HIV-1) infection has been associated with poor outcome. However, after the introduction of the highly active antiretroviral therapy, short-term patient survival after LT has improved significantly. We examined the long-term outcome of HIV-1-positive patients who underwent LT. Medical records were analysed in nine HIV-1-positive LT patients who underwent LT from August 1998 to May 2012. Eight were known to be HIV-1 positive at the time of listing for LT and had end-stage liver disease (ESLD) due to hepatitis C. One patient had primary biliary cirrhosis, and primary HIV-1 infection was found at the date of LT. Seven of the nine patients remain alive to date. So far, three have survived more than 12 years after LT. The overall patient survival rate for both five and 10 years is 77.8%. Four patients experienced acute rejection and six acquired biopsy-confirmed HCV recurrence. HIV-1 replication was effectively blocked during follow-up in all patients. We conclude that long-term survival of HIV-1-positive patients after LT can be achieved. Our study suggests that LT can offer an effective treatment option in selected HIV-1 infected patients with ESLD

  • 11.
    Yamamoto, Shinji
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Wassberg, Cecilia
    Hellman, Per
    Sundin, Anders
    (11)C-hydroxyephedrine positron emission tomography in the postoperative management of pheochromocytoma and paraganglioma.2014Ingår i: Neuroendocrinology, Vol. 100, nr 1, s. 60-70Artikel i tidskrift (Refereegranskat)
  • 12. Yamamoto, Shinji
    et al.
    Wilczek, Henryk
    Duraj, Frans
    Groth, Carl-Gustav
    Ericzon, Bo-Göran
    Liver Transplantation with Grafts from ControlledDonors after Cardiac Death: A 20-Year Follow-up at a Single Center2010Ingår i: American Journal of Transplantation, ISSN 1600-6135, E-ISSN 1600-6143, Vol. 10, nr 3, s. 602-611Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The first liver transplantation (LTx) in Sweden was performed in 1984, but brain death as a legal death criterion was not accepted until 1988. Between November 1984 and May 1988, we performed 40 consecutive LTxs in 32 patients. Twenty-four grafts were from donors after cardiac death (DCD) and 16 grafts from heart-beating donors (HBD). Significantly, more hepatic artery thrombosis and biliary complications occurred in the DCD group (p < 0.01 and p < 0.05, respectively). Graft and patient survival did not differ between the groups. In the total group, there was a significant difference in graft survival between first-time LTx grafts and grafts used for retransplantation. There was better graft survival in nonmalignant than malignant patients, although this did not reach statistical significance. Multivariate analysis revealed cold ischemia time and post-LTx peak ALT to be independent predictive factors for graft survival in the DCD group. In the 11 livers surviving 20 years or more, follow-up biopsies were performed 18-20 years post-LTx (n = 10) and 6 years post-LTx (n = 1). Signs of chronic rejection were seen in three cases, with no difference between DCD and HBD. Our analysis with a 20-year follow-up suggests that controlled DCD liver grafts might be a feasible option to increase the donor pool.

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