Publications by authors named "Koji Takeda"
Extracellular vesicles (EVs) are cell-secreted heterogeneous vesicles that play crucial roles in intercellular communication and disease pathogenesis. Due to their non-tumorigenicity, low immunogenicity, and therapeutic potential, EVs are increasingly used in cardiac repair as cell-free therapy. There exist multiple steps for the design of EV therapies, and each step offers many choices to tune EV properties.
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- Psychopharmacotherapy is crucial for treating mentally disordered offenders (MDOs) with schizophrenia in Japan, highlighting a lack of large-scale research in forensic settings.
- The study analyzed data from 362 MDOs across 32 forensic psychiatric wards, focusing on the use of antipsychotic medications, particularly clozapine and long-acting injections (LAIs).
- Findings showed that clozapine and LAIs were used in about 23% and 25% of cases, respectively, with clozapine linked to higher seclusion rates and longer hospital stays, indicating a need for further research on medication impacts in this population.
A low-cost and low-power-consumption optical transmitter with a narrow shoreline is crucial for short-reach optical communication. To increase the shoreline bandwidth density (Gbps/mm) at low cost, multiple optical components, including lasers, should be integrated on a single chip. In this study, we develop a sixteen-channel membrane laser array integrated with silica-based spot-size convertors on a SiO/Si substrate, with a footprint of 1.
View Article and Find Full Text PDFCardiac allograft vasculopathy (CAV) is a major cause of morbidity and mortality following heart transplantation (HT). Prior studies identified distinct CAV trajectories in the early post-HT period with unique predictors, but the evolution of CAV in later periods is not well-described. This study assessed the prevalence of late CAV progression and associated risk factors in HT recipients with ISHLT CAV 0/1 at 10 years post-HT.
View Article and Find Full Text PDFBackground: Donor-derived cell-free DNA (dd-cfDNA) has emerged as a reliable, noninvasive method for the surveillance of allograft rejection in heart transplantation (HT) patients, but its utility in multi-organ transplants (MOT) is unknown. We describe our experience using dd-cfDNA in simultaneous MOT recipients.
Methods: A single-center retrospective review of all HT recipients between 2018 and 2022 that had at least one measurement of dd-cfDNA collected.
Article Synopsis
- The study looked at how to manage blood thinners after people got a special heart device called HeartMate 3.
- It compared two methods for checking the right dose of a blood thinner called unfractionated heparin (UFH).
- There were no big differences in bleeding or clotting problems between the two methods, but more research is needed to know which one is better.
Article Synopsis
- Donation after circulatory death heart transplantation may expand donor options, particularly benefiting patients with lower urgency status who are using durable left ventricular assist devices (LVADs).
- A study analyzed data from the United Network for Organ Sharing between 2019 and 2022, comparing outcomes of heart transplant recipients with LVADs to those receiving other bridging support, focusing on one-year mortality and several medical complications.
- While the one-year mortality rates showed no significant difference, patients with LVADs experienced higher rates of acute rejection, suggesting the need for careful monitoring and management post-transplant.
Article Synopsis
- This study analyzed the outcomes of 774 adult patients who received simultaneous heart-kidney transplants (SHK) under the revised UNOS heart allocation policy, focusing on 50 patients who were supported by veno-arterial extracorporeal life support (VA-ECLS) compared to 724 without.
- Results showed that VA-ECLS patients were younger and had better kidney function before transplant but faced higher rates of temporary dialysis and lower survival rates after the procedure, with significant differences in early mortality and cardiac allograft failure.
- The findings indicate that while VA-ECLS patients have similar renal outcomes post-transplant, they experience greater risks for early mortality and complications related to heart trans
Feasibility of veno-arterial extracorporeal life support in awake patients with cardiogenic shock.
Interdiscip Cardiovasc Thorac Surg
August 2024
Objectives: This study sought to demonstrate outcomes of veno-arterial extracorporeal life support (VA-ECLS) in non-intubated ('awake') patients with cardiogenic shock, as very few studies have investigated safety and feasibility in this population.
Methods: This was a retrospective review of 394 consecutive VA-ECLS patients at our institution from 2017 to 2021. We excluded patients cannulated for indications definitively associated with intubation.
Article Synopsis
- Cardiac hybrid PET/CT is used to assess cardiac allograft vasculopathy (CAV) in heart transplant patients and visually estimated coronary artery calcium (VECAC) from CT scans can help predict cardiovascular outcomes.
- A study of 430 heart transplant patients found that higher VECAC scores (specifically 10-99 and 100+) were linked to a significantly greater risk of death or retransplantation during a median follow-up of 4.2 years.
- The findings suggest that VECAC can be a valuable independent marker for predicting adverse outcomes post-heart transplant and should be considered in patient evaluations.
Article Synopsis
- Preoperative assessment of pectoralis muscle area, which estimates sarcopenia, is linked to increased risks in LVAD patients, including higher postoperative mortality and gastrointestinal bleeding.
- A study involving 254 LVAD patients found that those with low pectoralis muscle area (low-PMI cohort) exhibited significantly elevated inflammation and endotoxemia markers compared to others.
- Patients with low pectoralis muscle area experienced longer hospital stays and a greater likelihood of readmissions within 90 days and one year after surgery.
Objectives: Veno-arterial extracorporeal life support (V-A ECLS) is increasingly being utilized for postcardiotomy shock (PCS), though data describing the relationship between type of indexed operation and outcomes are limited. This study compared V-A ECLS outcomes across four major cardiovascular surgical procedures.
Methods: This was a single-center retrospective study of patients who required V-A ECLS for PCS between 2015 and 2022.
Article Synopsis
- This study compares two methods of estimating kidney function (eGFRcysC and eGFRsCr) in heart transplant recipients, focusing on how body mass index (BMI), steroid use, and muscle mass affect accuracy.
- Significant differences between the two eGFRs were noted, especially early after transplantation, with eGFRcysC showing more stability over time compared to eGFRsCr.
- Using eGFRcysC can impact dosing for the medication valganciclovir, suggesting that 46% of patients would have required dosage adjustments, mostly reductions, highlighting the importance of accurate kidney function assessment.
Article Synopsis
- The HeartMate 3 survival risk score was validated to predict survival chances for patients receiving a HeartMate 3 left ventricular assist device, categorizing them into different survival probability groups.
- A study involving 181 patients revealed that those in the high survival group had a significantly higher two-year survival rate compared to average and low survival groups, with rates of 93.5%, 81.6%, and 82.0%, respectively.
- Although the score's original stratification didn't clearly show survival differences, using a binary cutoff indicated better survival for patients in the high-risk category, demonstrating its potential utility in clinical settings.
Article Synopsis
- The study focuses on the long-term survival rates of adult patients with congenital heart disease who underwent orthotopic heart transplantation, distinguishing between those with single-ventricle versus biventricular circulation.
- A total of 61 patients were analyzed, with single-ventricle patients being younger and having more complications like cirrhosis and protein-losing enteropathy compared to biventricular patients.
- Five-year survival rates were significantly lower for single-ventricle patients (66%) than for biventricular patients (91%), indicating that the type of congenital heart disease affects post-transplant outcomes.
Article Synopsis
- - The study investigated the effects of two heart preservation methods—ice-cold storage (ICS) and the Paragonix SherpaPak CTS—on ischemia reperfusion injury (IRI) following heart transplantation, as ischemic times have increased since the 2018 allocation system change.
- - Analysis of biopsies from 90 heart transplant recipients showed similar IRI rates between the two methods, but the CTS group had a significant reduction in coagulative myocyte necrosis (CMN) from weeks 1 to 4, and both methods showed reductions by week 8.
- - Despite longer ischemic times with CTS, the study found no significant differences in rejection rates or survival between the groups, suggesting that CTS is a viable option
Background: Although adverse technical events during aortic root replacement (ARR) are not uncommon and are extremely challenging, there is scant literature to help surgeons prepare for such situations. We describe our experience of outstanding technical events during ARR.
Methods: This is a retrospective study of 830 consecutive ARRs at a single center from 2012 to 2022.
The presence of adhesions and patent bypass grafts may create challenges for standard 14 mm outflow graft placement during left ventricular assist device implantation. We retrospectively describe our experience using a 10 mm Bioline Fusion graft (Getinge, Goteborg, Sweden) as the outflow graft in patients undergoing primary Heartmate 3 (Abbott, Abbott Park, IL) implantation. One hundred one patients underwent Heartmate 3 left ventricular assist device implantation, 80% via a thoracotomy approach, with the standard 14 mm outflow graft (78) or a 10 mm Bioline Fusion outflow graft (23).
View Article and Find Full Text PDFWe developed short-active-length distributed Bragg reflector (DBR) lasers to reduce the power consumption of chip-to-chip optical interconnects. These lasers have buried bulk InGaAsP waveguides to increase the coupling efficiency between the active region and DBR to 99.79% from the 98.
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- This study investigates the causes and impact of hospital readmissions in patients with HeartMate 3 (HM3) left ventricular assist devices (LVAD), revealing that readmissions are frequent and affect quality of life.
- Of 182 patients, 92% were discharged after initial hospitalization, experiencing a total of 407 unplanned readmissions, with major infections being the leading cause.
- Survival rates remained high despite readmissions, and certain factors like male gender, diabetes, and previous readmissions were linked to an increased risk of future hospitalizations.
Article Synopsis
- The study aimed to evaluate how aortic insufficiency develops in patients who had central aortic valve repair during continuous-flow left ventricular assist device placement.
- A review was conducted on 656 patients who received HeartMate II or 3 devices from 2004 to 2022, with 105 meeting the criteria for analysis, revealing that most were older men receiving the device as long-term therapy.
- Results showed high rates of freedom from moderate aortic insufficiency post-implantation (over 90% at three years) and a three-year survival rate of 63.4%, suggesting that central aortic valve repair could effectively address aortic insufficiency in these patients.