Medical consultant system for improving lung transplantation opportunities and outcomes in Japan

Yasushi Hoshikawa, Y. Okada, J. Ashikari, Y. Matsuda, H. Niikawa, M. Noda, T. Sado, T. Watanabe, H. Notsuda, F. Chen, M. Inoue, K. Miyoshi, T. Shiraishi, T. Miyazaki, M. Chida, N. Fukushima, T. Kondo

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Because the shortage of donor organs is especially serious in Japan, since 2002 a unique partnership between transplant consultant physicians and local physicians has been developed to maximize the organ utilization rate. Since 2011, more than 25 lung consultant physicians have been registered to specifically assess donor lungs and provide advice on intensive respiratory care to donors. In this study, we retrospectively reviewed the efficacy of this system for lung transplantation opportunities and outcomes. One hundred eighty-seven brain-dead lung donor candidates were chronologically divided into 3 phases: I (May 1998-November 2006) and II (December 2006-January 2011), before and after medical consultants requested that local physicians administer aggressive bronchial suctioning using bronchoscopy, respectively; and phase III (February 2011-January 2013), after the emergence of lung consultants. The lung utilization rate, Pao2/Fio2 ratio at the first and second brain death examinations and at the tertiary assessment before recovery, and graft survival were analyzed. The lung utilization rate was significantly higher in phases II and III than in phase I. In phases I and II, the Pao2/Fio2 ratio at the tertiary assessment was significantly lower than that at the first or the second brain death examination, whereas it did not worsen with time in phase III. Graft survival was significantly better in phases II and III than in phase I. Graft death due to primary graft dysfunction was significantly more frequent in phase I than in phases II and III. In conclusion, this system is effective in improving lung transplantation opportunities and outcomes.

Original languageEnglish
Pages (from-to)746-750
Number of pages5
JournalTransplantation Proceedings
Volume47
Issue number3
DOIs
Publication statusPublished - 01-04-2015

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Lung Transplantation
Consultants
Japan
Lung
Brain Death
Tissue Donors
Physicians
Graft Survival
Primary Graft Dysfunction
Transplants
Bronchoscopy
Critical Care

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

Hoshikawa, Yasushi ; Okada, Y. ; Ashikari, J. ; Matsuda, Y. ; Niikawa, H. ; Noda, M. ; Sado, T. ; Watanabe, T. ; Notsuda, H. ; Chen, F. ; Inoue, M. ; Miyoshi, K. ; Shiraishi, T. ; Miyazaki, T. ; Chida, M. ; Fukushima, N. ; Kondo, T. / Medical consultant system for improving lung transplantation opportunities and outcomes in Japan. In: Transplantation Proceedings. 2015 ; Vol. 47, No. 3. pp. 746-750.
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abstract = "Because the shortage of donor organs is especially serious in Japan, since 2002 a unique partnership between transplant consultant physicians and local physicians has been developed to maximize the organ utilization rate. Since 2011, more than 25 lung consultant physicians have been registered to specifically assess donor lungs and provide advice on intensive respiratory care to donors. In this study, we retrospectively reviewed the efficacy of this system for lung transplantation opportunities and outcomes. One hundred eighty-seven brain-dead lung donor candidates were chronologically divided into 3 phases: I (May 1998-November 2006) and II (December 2006-January 2011), before and after medical consultants requested that local physicians administer aggressive bronchial suctioning using bronchoscopy, respectively; and phase III (February 2011-January 2013), after the emergence of lung consultants. The lung utilization rate, Pao2/Fio2 ratio at the first and second brain death examinations and at the tertiary assessment before recovery, and graft survival were analyzed. The lung utilization rate was significantly higher in phases II and III than in phase I. In phases I and II, the Pao2/Fio2 ratio at the tertiary assessment was significantly lower than that at the first or the second brain death examination, whereas it did not worsen with time in phase III. Graft survival was significantly better in phases II and III than in phase I. Graft death due to primary graft dysfunction was significantly more frequent in phase I than in phases II and III. In conclusion, this system is effective in improving lung transplantation opportunities and outcomes.",
author = "Yasushi Hoshikawa and Y. Okada and J. Ashikari and Y. Matsuda and H. Niikawa and M. Noda and T. Sado and T. Watanabe and H. Notsuda and F. Chen and M. Inoue and K. Miyoshi and T. Shiraishi and T. Miyazaki and M. Chida and N. Fukushima and T. Kondo",
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Hoshikawa, Y, Okada, Y, Ashikari, J, Matsuda, Y, Niikawa, H, Noda, M, Sado, T, Watanabe, T, Notsuda, H, Chen, F, Inoue, M, Miyoshi, K, Shiraishi, T, Miyazaki, T, Chida, M, Fukushima, N & Kondo, T 2015, 'Medical consultant system for improving lung transplantation opportunities and outcomes in Japan', Transplantation Proceedings, vol. 47, no. 3, pp. 746-750. https://doi.org/10.1016/j.transproceed.2014.12.041

Medical consultant system for improving lung transplantation opportunities and outcomes in Japan. / Hoshikawa, Yasushi; Okada, Y.; Ashikari, J.; Matsuda, Y.; Niikawa, H.; Noda, M.; Sado, T.; Watanabe, T.; Notsuda, H.; Chen, F.; Inoue, M.; Miyoshi, K.; Shiraishi, T.; Miyazaki, T.; Chida, M.; Fukushima, N.; Kondo, T.

In: Transplantation Proceedings, Vol. 47, No. 3, 01.04.2015, p. 746-750.

Research output: Contribution to journalArticle

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AU - Hoshikawa, Yasushi

AU - Okada, Y.

AU - Ashikari, J.

AU - Matsuda, Y.

AU - Niikawa, H.

AU - Noda, M.

AU - Sado, T.

AU - Watanabe, T.

AU - Notsuda, H.

AU - Chen, F.

AU - Inoue, M.

AU - Miyoshi, K.

AU - Shiraishi, T.

AU - Miyazaki, T.

AU - Chida, M.

AU - Fukushima, N.

AU - Kondo, T.

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Y1 - 2015/4/1

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