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We report on the single-shot readout of three two-electron spin states-a singlet and two triplet substates-whose z components of spin angular momentum are 0 and +1, in a gate-defined GaAs single quantum dot. The three spin states are distinguished by detecting spin-dependent tunnel rates that arise from two mechanisms: spin filtering by spin-resolved edge states and spin-orbital correlation with orbital-dependent tunneling. The three states form one ground state and two excited states, and we observe the spin relaxation dynamics among the three spin states.

We report selective injection of both spin-up and spin-down single electrons into a quantum dot (QD) from spin-polarized non-equilibrium quantum Hall edge channels (ECs) generated by selective transmission of spin-resolved ECs using a surface gate placed at a distance from the QD. We change the spin polarization of non-equilibrium ECs by changing the bias voltages applied to different source Ohmic contacts. The efficiency of spin-up electron injection reaches 0.5, which is approximately 0.2 higher than that induced by spin-dependent tunnel coupling between QD and ECs. On the other hand, the efficiency of spin-down electron injection reaches 0.4. In addition, we rectify the underestimation of the efficiency of spin filtering for equilibrium ECs by numerically subtracting the contribution of the excited states in the QD. The obtained spin-filtering efficiency is higher than that evaluated from the raw experimental data and increases with magnetic field as expected with the increase in the spatial separation between ECs., Comment: 8 pages, 7 figures

The ATM gene variants segregating in ataxia-telangiectasia families are associated with increased breast cancer risk, but the contribution of specific variants has been difficult to estimate. Previous small studies suggested two functional variants, c.7271TG and c.1066-6TG (IVS10-6TG), are associated with increased risk. Using population-based blood samples we found that 7 out of 3,743 breast cancer cases (0.2%) and 0 out of 1,268 controls were heterozygous for the c.7271TG allele (P=0.1). In cases, this allele was more prevalent in women with an affected mother (odds ratio [OR]=5.5, 95% confidence interval [CI]=1.2-25.5; P=0.04) and delayed child-bearing (OR=5.1; 95% CI=1.0-25.6; P=0.05). The estimated cumulative breast cancer risk to age 70 years (penetrance) was 52% (95% CI=28-80%; hazard ratio [HR]=8.6; 95% CI=3.9-18.9; P0.0001). In contrast, 13 of 3,757 breast cancer cases (0.3%) and 10 of 1,268 controls (0.8%) were heterozygous for the c.1066-6TG allele (OR=0.4; 95% CI=0.2-1.0; P=0.05), and the penetrance was not increased (P=0.5). These findings suggest that although the more common c.1066-6TG variant is not associated with breast cancer, the rare ATM c.7271TG variant is associated with a substantially elevated risk. Since c.7271TG is only one of many rare ATM variants predicted to have deleterious consequences on protein function, an effective means of identifying and grouping these variants is essential to assess the contribution of ATM variants to individual risk and to the incidence of breast cancer in the population.

We evaluate the Land\'e $g$ factor of electrons in quantum dots (QDs) fabricated from GaAs quantum well (QW) structures of different well width. We first determine the Land\'e electron $g$ factor of the QWs through resistive detection of electron spin resonance and compare it to the enhanced electron $g$ factor determined from analysis of the magnetotransport. Next, we form laterally defined quantum dots using these quantum wells and extract the electron $g$ factor from analysis of the cotunneling and Kondo effect within the quantum dots. We conclude that the Land\'e electron $g$ factor of the quantum dot is primarily governed by the electron $g$ factor of the quantum well suggesting that well width is an ideal design parameter for $g$-factor engineering QDs.

Magnetic properties of Pm ions in NdNiAl4 were investigated by low-temperature nuclear orientation of 144Pm. The observed γ-ray anisotropy as a function of external fields revealed a change in the magnetic structure of Pm ions at the metamagnetic phase transition of NdNiAl4. The extracted hyperfine field was 50(5) T which is substantially smaller than those previously reported.

The Pancreas Transplantation (tx) Program under the Japanese Organ Transplant Act was started in 2000. PTx is indicated for type 1 diabetic patients on hemodialysis therapy. As of April 2003 93 patients are listed as candidates. Ten cases of PTx with enteric or bladder-drained technique were performed during the last 3 years as well as nine SPK and one PAK. Of 10 cases, nine recipients are insulin-free with HbA1c values ranging from 4.4% to 5.7%, although exogenous insulin was required in six cases temporarily, namely for a median 63 days (12 to 225 days). One case was lost due to pancreatic graft thrombosis. All 10 kidney grafts are functioning. Based on the experiences with 14 cases of pancreas tx using non-heart-beating (NHB) donors, we defined the criteria of NHB donor as: age younger than 40 years and cessation of respiratory support. One case of SPK with graft of NHB donor was done, and the recipient is off insulin. Pancreas and kidney are allocated for SPK if the recipient shares at least one HLA-DR antigen. Marginal donors were defined as higher mean donor age, median 37 (range 18 to 58 years); mean 38 +/- 12 years), and no death cause of by trauma. The revascularization of gastroduodenal artery to the pancreatic graft was performed in eight cases to minimize the risk of ischemic injury to the pancreatic graft and technical failure in cases of marginal donor.

We prepare a microwave electron spin resource (ESR) cavity for detecting a response from a 2DEG in an n-AlGaAs/GaAs. The response is obtained as a change in the longitudinal resistance (Δρ x x ) in v = 3 quantum Hall region, particularly as a peak in Δρ x x for resonance. We use the data of ESR to evaluate the g-factor and the lower bound for dephasing time. The resonance magnetic field suffers from nuclear spin effects via the hyperfine coupling, resulting in the ESR peak shift. We find the ESR peak shift or Overhauser shift decays with two time constants, suggesting the existence of two different origins for the relaxation.

We give an overview of our studies on the electron spin resonance (ESR) in the hexagonal triangular antiferromagnets of ABX 3 type using millimeter and submillimeter waves and static and pulsed high magnetic fields. Novel ESR modes, which cannot be understood by the conventional theory of the antiferromagnetic resonance, were observed. Examples of this include that there exists the gapless excitation even for the easy-axis anisotropy. The ESR modes can be classified by the signs of the exchange interaction J 0 along the c-axis and the anisotropy. The ESR modes were calculated within the framework of the mean-field approximation using three-sublattice and six-sublattice models for the ferromagnetic and antiferromagnetic J 0 interaction, respectively. The experimental results were well described by the present calculations.

We demonstrate the real-time detection of single photogenerated electrons in two different lateral double quantum dots made in AlGaAs/GaAs/AlGaAs quantum wells having a thin or a thick AlGaAs barrier layer. The observed incident laser power and photon energy dependences of the photoelectron detection efficiency both indicate that the trapped photoelectrons are, for the thin barrier sample, predominantly photogenerated in the buffer layer followed by tunneling into one of the two dots, whereas for the thick barrier sample they are directly photogenerated in the well. For the latter, single photoelectron detection after selective excitation of the heavy and light hole state in the dot is well resolved. This ensures the applicability of our quantum well-based quantum dot systems for the coherent transfer from single photon polarization to single electron spin states., 5 pages, 5 figures

Three laterally coupled vertical single quantum dots (tQDs) in a collinear arrangement, with common source and drain electrodes, are investigated. The tQDs are formed inside three connected pillars (mesa1, mesa2, mesa3) with four side gate electrodes (G1, G2 (G2'), G3). Three families of Coulomb oscillation lines corresponding to charges in the numbers of electrons in the three dots are observed, and the few-electron charge configurations can be assigned. We also discuss the separation of adjacent Coulomb peak lines in the stability diagram, indicating that the inter-dot Coulomb energy between adjacent dots (mesa1–mesa2 and mesa2–mesa3) is significantly larger than that between the two non-adjacent dots (mesa1–mesa3).

HLA sensitization associated with previous kidney transplantation is a major drawback to retransplantation. Recently we successfully performed a third graft using intensive immunosuppression for a highly sensitized recipient. The patient was a 31-year-old man who had previously undergone a living donor graft from his father at our institute in 1999. His kidney graft function had deteriorated due to chronic allograft nephropathy, returning to hemodialysis therapy in 2005. He received a second graft from a deceased donor in another country on August 14, 2006. It rejected on postoperative day 3 possibly due to acute accelerated rejection. He was offered a third kidney from his brother. Panel-reactive antibody (PRA) tested before the third procedure revealed positive class I (88%) and class II (96%) PRAs. Mycophenolate mofetil (MMF) was started 3 weeks before the third transplantation, and preoperative plasmapheresis performed thrice. He underwent the living donor graft on March 9, 2007. Immunosuppression consisted of tacrolimus, MMF, methylprednisolone, and basiliximab. Immediately afterward there was a sudden decrease in allograft blood flow and urine output, implying hyperacute rejection. Following treatment with plasmapheresis and a single dose of rituximab (200 mg), the kidney allograft function recovered, although the PRA at 3 weeks was still positive. Six months posttransplantation, he is well with a creatinine of 0.9 mg/dL. Our protocol may reduce the risk for graft loss in a highly sensitized transplant recipient.

Background Chronic allograft nephropathy (CAN) remains the most important cause of late renal graft loss. In this study, we examined the role of peritubular capillary (PTC) injury in the development of CAN. Methods We studied renal biopsies (n = 79) obtained from grafts with CAN. PTC injury was examined morphologically by immunohistochemistry for CD34. These findings were correlated with interstitial fibrosis and graft dysfunction. Humoral immunity involved in CAN was studied by C4d staining. Results The CAN cases in the present study included chronic rejection (CR) (n = 14, 17.8%) and C4d-positive chronic humoral rejection (CHR; n = 6, 42.9% in CR cases). Irrespective of CR, CHR, or other CAN, the development of CAN was characterized by injury to and loss of identifiable PTCs, accompanied with the development of interstitial fibrosis. In CR and CHR cases, the loss of PTCs was prominent and seemed to progress within a relatively short period after transplantation. A decrease in the number of PTCs significantly correlated with the development of interstitial fibrosis (r = −0.75, P Conclusions Irrespective of whether CR, CHR, or other factors contribute to CAN, the processes involved in its development appear similar and are characterized by progressive injury and loss of PTCs, with the development of renal scarring. Immunohistochemistry for CD34 in human renal biopsies is a useful method for the detection of microvascular injury.

We report the experimental determination of Rashba spin-orbit interaction (SOI) strength in two-dimensional electrons in a MgZnO/ZnO heterostructure using electrically detected electron spin resonance. The Rashba parameter is determined to be $7.0\ifmmode\times\else\texttimes\fi{}{10}^{\ensuremath{-}14}$ eV m, which is the second smallest value among prevalent semiconductor heterostructures, following Si/SiGe. A long transverse spin relaxation time was derived to show a maximum value of 27 ns, owing to weak SOI. Our study demonstrates that the ZnO heterostructure is a promising candidate for spintronic devices utilizing long spin coherence.

Delocalization by resonance between contributing structures explains the enhanced stability of resonancehybrid molecules. Here we report the realization of resonance-hybrid states in a few-electron triple quantum dot (TQD) obseved by excitation spectroscopy. The stabilization of the resonance-hybrid state and the bond between contributing states are achieved through access to the intermediate states with double occupancy of the dots. This explains why the energy of the hybridized singlet state is significantly lower than that of the triplet state. The properties of the three-electron doublet states can also be understood with the resonance-hybrid picture and geometrical phase. As well as for fundamental TQD physics, our results are useful for the investigation of materials such as quantum dot arrays, quantum information processors, and chemical reaction and quantum simulators.

We investigate two- and three-electron spin blockade in three vertical quantum dots (QDs) coupled in series. Two-electron spin blockade is found in a region where sequential tunneling through all QDs is forbidden but tunneling involving virtual hopping through an empty QD is allowed. It is observed only for the hole cycle with a distinct bias threshold for access to the triplet state. Three-electron spin blockade involving the quadruplet state is observed for nonequibilium conditions where sequential tunneling is allowed and the triplet state is accessible. Our results shine light on the importance of the nonequibilium conditions to obtain sufficient population of triplet and quadruplet states necessary for spin blockade. © 2013 American Physical Society.

We study the excitation spectroscopy of few-electron, parallel coupled double quantum dots (QDs). By applying a finite source drain voltage to a double QD (DQD), the first excited states observed in nonequilibrium charging diagrams can be classified into two kinds in terms of the total effective electron number in the DQD, assuming a core filling. When there are an odd (even) number of electrons, one (two)-electron antibonding (triplet) state is observed as the first excited state. On the other hand, at a larger source drain voltage we observe higher excited states, where additional single-particle excited levels are involved. Eventually, we identify the excited states with a calculation using the Hubbard model and, in particular, we elucidate the quadruplet state, which is normally forbidden by the spin blockade caused by the selection rule., Comment: 7 pages, 5 figures

Introduction Laparoscopic live donor nephrectomy is not yet widespread in Japan. After our first hand-assisted laparoscopic live donor nephrectomy (HALapNx) in 2001, we report our 100 cases and examine the possibility of making this technique widely available in Japan. Methods HALapNx was performed in 100 cases (44 males and 56 females) from February 2001 through July 2003. The operative procedure for HALapNx was briefly described here. First, 2 12-mm ports were placed in the midaxillary line at the superior and inferior level of the umbilicus. Next, a 5-cm incision was made in the midline periumbilicus and the hand port system was fitted through the abdominal incision. After 10 mm Hg pneumoperitoneum, HALapNx begins with mobilization of the left colon. Results HALapNx was completed successfully in all cases and no patients required conversion to laparotomy. The estimated blood loss was 33.5 ± 40.3 g and no patient required blood transfusion. The mean operative time was 168.8 ± 47.6 minutes, and there was no major complication in a donor. Conclusions HALapNx is technically feasible and may offer several advantages over open donor nephrectomy in terms of less blood loss, less postoperative pain, and minimal cosmetic disfigurement. In Japan, laparoscopic donor nephrectomy is not yet widespread, possibly due to the need for surgical laparoscopic skills. We believe that the best way to make laparoscopic donor naphrectomy widely available is through hand-assisted laparoscopic surgery.

Introduction Due to the continuing shortage of cadaveric donors in Japan, ABO-incompatible living kidney transplantation is being performed. Our previous studies showed that the long-term graft survival in ABO-incompatible living kidney transplantation was comparable to that in ABO-compatible living kidney transplantation. However, the impact on HLA-identity on the results of ABO-incompatible living donor kidney transplantation had not been investigated previously. Materials and methods One hundred twenty-seven recipients underwent ABO-incompatible living kidney transplantation between January 1989 and December 2000. Five were grafted from HLA-identical sibling donors group (I). The remaining 122 recipients received grafts from an HLA-nonidentical donor (group N). Both groups were similar in terms of recipient age, donor age, warm ischemic time, and total ischemic time. Three or four sessions of plasmapheresis were performed prior to transplantation. Cyclosporine or tacrolimus, methylprednisolone, and azathioprine or mycophenolate mofetil were used for immunosuppression. Splenectomy was done at the time of kidney transplantation in all patients. Results Graft loss was seen in one of the five HLA-identical recipients due to chronic rejection. Five- and 10-year graft survival rates were 80.0% I vs 72.0% N, and 80.0% I vs 54.2% N, respectively. The incidence of acute rejection in the HLA-identical recipients was lower than that in the HLA-nonidentical recipients (20% I vs 67.2% N). In conclusion, long term graft survival among ABO-incompatible kidney transplants from HLA-identical sibling donors was much better than that from HLA-nonidentical sibling donors.

We demonstrate one and two photoelectron trapping and the subsequent dynamics associated with interdot transfer in double quantum dots over a time scale much shorter than the typical spin lifetime. Identification of photoelectron trapping is achieved via resonant interdot tunneling of the photoelectrons in the excited states. The interdot transfer enables detection of single photoelectrons in a nondestructive manner. When two photoelectrons are trapped at almost the same time we observed that the interdot resonant tunneling is strongly affected by the Coulomb interaction between the electrons. Finally the influence of the two-electron singlet-triplet state hybridization has been detected using the interdot tunneling of a photoelectron.

Aharonov-Bohm (AB) oscillations are studied for a parallel coupled vertical double quantum dot with a common source and drain electrode. We observe AB oscillations of current via a one-electron bonding state as the ground state and an anti-bonding state as the excited state. As the center gate voltage becomes more negative, the oscillation period is clearly halved for both the bonding and antibonding states, and the phase changes by half a period for the antibonding state. This result can be explained by a calculation that takes account of the indirect interdot coupling via the two electrodes., Comment: 5 pages main text + 6 pages supplementary material

Corticosteroids are often prescribed in the acute care management of asthma. Prednisolone can be administered intramuscularly (IM) or orally in 2 different concentrations. This study evaluated parental preference for three prednisolone preparations based on the route of administration, taste, and volume required. Accompanying adults (AAs) of pediatric patients were interviewed about their preferences based on the 3 factors. Those AAs who passed the health screen (51 of 214) were asked to taste 2 oral prednisolone preparations and reinterviewed about their corticosteroid preferences. Of the 214 AAs, 96% were parents. Of the group, 43% preferred IM corticosteroids whereas 40% preferred oral corticosteroids. Without considering taste as a factor for oral corticosteroids, 94% preferred the more concentrated syrup compared with the less concentrated one. When told that the less concentrated syrup tasted better, 58% preferred the less concentrated/better tasting syrup. After the 51 taste test subcohort subjects tasted the syrups, 96% preferred the less concentrated/ better tasting syrup over the more concentrated/poorer tasting syrup. Taste is more important than volume of administration for this particular corticosteroid comparison. Simply asking parents about their IM/oral and syrup formulation preferences may be the easiest way of optimizing their treatment plan.

We describe the electronic properties of a double dot for which the lateral coupling between the two vertical dots can be controlled in-situ with a center gate voltage (Vc) and the current flows through the two dots in series. When Vc is large and positive, the two dots merge. As Vc is made less positive, two dots are formed whose coupling is reduced. We measure charging diagrams for positive and negative source-drain voltages in the weak coupling regime and observe current rectification due to the Pauli spin blockade when the hyperfine interaction between the electrons and the nuclei is suppressed., Comment: 16 pages, 3 figures, accepted for Applied Physics Letters

We used a parallel coupled vertical double quantum dot device consisting of two laterally tunnel-coupled dots and a common source and drain electrodes to study the Aharanov-Bohm (AB) effects in the vertically flowing single electron tunneling current. In the charging diagram measured at a finite source-drain voltage a bonding state as a ground state, and an antibonding state as an excited state were distinguished for the one-electron state. We observed periodic magnetic oscillations for the current through the bonding state, due to the AB effect for the two tunnel-coupled dots.

Objective We perform living-related ABO-incompatible kidney transplantations to alleviate the organ shortage in our country. Splenectomy has been performed routinely in these recipients, although its clinical significance remains controversial. In this study, we have reported our experience with a hand-assisted laparoscopic splenectomy (HALS) technique. Methods Between April 2000 and December 2006, 50 patients (23 males) underwent ABO-incompatible kidney transplantation with HALS. The mean age and weight of the recipients were 44 ± 13 years and 56 ± 12 kg, respectively. All patients underwent preoperative plasmapheresis to reduce isoagglutinin (A and/or B antibody). In 6/50 patients, a hand-assisted device was placed through a peritoneal window in the right lower abdominal skin incision for kidney engraftment. In the remaining 44 patients, a 6-cm upper midline or periumbilical midline incision was made for the hand-assisted device in the lateral position. Results An ABO-incompatible procedure was completed successfully in all cases. The average HALS time was 118 ± 42 minutes, with an average pneumoperitoneum time of 79 ± 40 minutes and average blood loss of 48 ± 81 g. There were two conversions to open splenectomy because of intraoperative bleeding and suspected pneumothorax. Two other cases required relaparotomy because of hematoma and perforation of the ileum. Successfully operations were achieved through the previous periumbilical incision. Conclusions Although meticulous, rigorous surgical technique is essential, HALS is safe and feasible for recipients of ABO-incompatible grafts with tissue weakness and a bleeding tendency because of renal failure and preoperative plasmapheresis.

Objective The purpose of this study was to analyze the effects of immunosuppressants on hepatitis C virus (HCV) replication to establish optimal immunosuppressive therapy in HCV-positive renal transplantation. Materials and Methods Cyclosporine (CsA), tacrolimus (Tac), mycophenolate acid (MPA), the active metabolite of mycophenolate mofetil (MMF), and methylprednisolone (MP) were administered to HCV replicon cells alone or in combination with interferon (IFN). HCV RNA was quantitatively determined. Of our 2064 recipients of renal transplantations between 1980 and 2005, 153 were HCV-positive. We analyzed changes in hepatic function and the efficacy of IFN therapy in these patients. Results Only CsA strongly inhibited the growth of HCV RNA (13.1% at 1.0 μg/mL). MPA enhanced the inhibition of the growth of HCV RNA in the presence of IFN. Tac and MP reduced, rather than enhanced, the efficacy of IFN. Progression to chronic hepatitis occurred in a significantly smaller number of patients in the CsA than the Tac group (6 vs 19; P = .04). Serum alanine aminotransferase (ALT) levels were comparable pretransplantation and posttransplantation in the CsA group (24.8 ± 20.5 vs 28.9 ± 28.3 IU/L, respectively, while a significant elevation was noted in the Tac group (22.2 ± 21.5 vs 32.6 ± 30.8 IU/L, respectively; P = .024). Two of 4 patients who underwent combination therapy with IFN and ribavirin during treatment with CsA and MMF obtained an HCV-negative status for over 24 weeks. Conclusions CsA effectively prevents the progression of chronic hepatitis in HCV-positive renal transplant patients. A greater response rate can be expected by concurrent administration of CsA and MMF under IFN therapy.

Lymphatic vessels are an essential part of the immunological response. Nevertheless, little is known about the pathology of renal transplant rejection. In part the reason may be not distinguishing peritubular capillaries from lymphatic vessels by periodic acid-Schiff (PAS) staining. This study examined the morphology of lymphatic vessels in early renal allografts using double staining with PAS and podoplanin. The 41 cases were divided into four categories: (I) acute antibody-mediated rejection, (II) acute cellular rejection, (III) peritubular capillaritis only, and (IV) controls. I through III had the evidence of peritubular capillaritis exceeding grade 1 on a biopsy obtained an average of 17.3 ± 5.5 days after kidney transplantation. In addition, each lymphatic vessel density (LVD) and nodular lesion of lymphocytes (NL) were quantified as the number of each podoplanin-positive vascular profiles and NL per unit area of cortex measured Lumina Vision (Mitani). The average of the LVD was 73.0, 35.1, 37.1, and 8.1 per 10 mm 2 for groups I to IV and the average of NL was 2.8, 5.5, 1.3, 0.9, respectively. There was a significant correlation between LVD and NL. NL showed a strong relation to the accumulation of lymphocytes in lymphatic vessels (AL); 22% of the AL scores were greater than the peritubular capillaritis grade. We found lymphatic vessels to be strongly associated with any kind of inflammatory process that occurred unexpectedly soon after kidney transplantation. In addition, to avoid misdiagnosis of peritubular capillaritis, NL in early renal allograft must especially be excluded.

Between April 1995-December 2003, 1,324 deceased donor kidney transplantations were performed in 139 transplant institutes in Japan. Of these, 45 transplants were from heart-beating and 1,279 transplants were from non-heart-beating deceased donors (NHBDD). Clinical outcomes for the 1,279 recipients of NHBDD kidney transplants were investigated. The overall 5-year patient and graft survival rates were 90% and 72%, respectively. A total of 112 NHBDD kidney grafts never functioned after transplantation and the recipients had to remain on dialysis. The causes of nonfunction were rejection, primary nonfunction, death, thrombosis and others in the order of the incidence. The major causes of graft loss were nonfunction, death, chronic rejection and acute rejection in that order. Major causes of recipient deaths were pneumonia, sepsis and CVA within 12 months, and heart diseases, sepsis, malignancy and pneumonia more than 12 months after transplantation. Kidneys from female donors, donors aged 15 or less or over age 60, donors with extrinsic causes of death other than head trauma, recipients over age 60 and those with diabetic nephropathy as their original disease were found to be at risk for poor graft survival. The lowest and last donor serum creatinine level did not influence the incidence of nonfunction or graft survival. However, graft survival was significantly poorer among recipients of older "expanded" donor kidneys than for recipients of younger grafts. The warm and total ischemia times should be kept shorter than 30 minutes (better 15 minutes), and 12 hours, respectively to minimize the incidence of nonfunction and early graft loss. It is especially important in cases with WIT over 30 minutes that the total ischemia should be kept within 12 hours. Cannulation before cardiac standstill was important to reduce the incidence of nonfunction and achieve high graft survival rates with NHBDD kidneys. The discontinuance of ventilator support also reduced the incidence of graft nonfunction. The combination of CsA or Tacrolimus and MMF as both the induction and maintenance regimen significantly improved graft survival. The use of either anti-T cell antibodies or basiliximab was also associated with significantly better graft survival for NHBDD kidneys. The combination of basiliximab, CsA and MMF resulted in a graft survival rate of 98% at one and 2 years.

Basiliximab added to a maintenance regimen consisting of cyclosporine microemulsion and mycophenolate mofetil was studied for its effectiveness in allowing early steroid withdrawal in renal transplantion. Furthermore, the cyclosporine-sparing effects between groups with and without basiliximab induction therapy were compared. Patients. Between September 2001 and June 2003, 90 patients underwent renal transplants with cyclosporine-based immunosuppression, namely, cyclosporine, mycophenolate mofetil, and methylprednisolone, (group 1; n = 25). During the latter half of the study basiliximab was administered during the induction phase (group 2; n = 65). In group 2, steroids were completely withdrawn on postoperative day 14 in 57 patients. Results. The incidence of acute rejection was significantly higher among group 1 patients (P = .005). The incidence of steroid-resistant rejection in group 1 patients was significantly higher (P = .025). At each time point cyclosporine levels in group 1 patients were significantly higher (P

Aims Effect of early steroid withdrawal protocol using basiliximab in kidney transplantation (KTx) on the clinical outcomes was investigated as compared with triple regimen. Methods Kidney transplant patients in group 1 (n = 62) were treated with 8 mg/kg of cyclosporine (CsA), 2000 mg of MMF, two bolus IV injections of 20 mg of basiliximab and 500 mg of methylprednisolone (MP) rapidly tapered and withdrawn at 14 postoperative days (POD). Group 2 (n = 56) was treated with same dose of CsA and MMF, and 250 mg of MP tapered and continued. Acute rejection (AR) episodes were treated with MP pulse therapy followed by muromonab CD3 (OKT3) in case of steroid-resistant rejection. Results In 46 of 62 cases (74.2%) in group 1, steroid was successfully withdrawn at 13.7 ± 1.7 POD. Graft survival at 3, 6, and 12 months in group 1 was 100%, 100%, and 98.4% (one death with functioning graft), and 100%, 98.2%, and 96.4% in group 2, respectively. The incidence of AR was 12.9% for group 1 and 42.9% for group 2, among which 21 cases in group 2 were treated with ALG or OKT3; no patient needed ALG or OKT3 in group 1. Fifteen cases in group 1 and 13 cases in group 2 developed CMV antigenemia, among which febrile episode was exhibited in 3 cases (4.8%) in group 1 and 5 cases (8.9%) in group 2. Conclusions Early steroid withdrawal protocol using basiliximab is promising for reducing the incidence of AR (especially steroid-resistant rejection), CMV diseases, and steroid-related complications.

Introduction We have performed ABO-incompatible (ABO-i) kidney transplantation (KT) to alleviate the severe organ shortage in our country. Induction therapy with basiliximab, a monoclonal anti-interleukin-2 receptor antibody, is known to be effective in reducing the incidence of acute rejection (AR) after ABO-compatible KT. However, the efficacy of basiliximab in ABO-i KT is still unknown. In this study, we evaluated the effect of basiliximab to decrease overall maintenance immunosuppression (a steroid withdrawal protocol) and to improve the outcome of ABO-i KT. Patients and methods Between April 2002 and May 2003, 14 adult patients underwent ABO-i KT from living donors with cyclosporine (CsA)-based immunosuppression. There were seven men and seven women of mean age 48 ± 10 years. Three of the 12 cases were second KT. Three sessions of plasmapheresis were performed to remove anti-AB antibodies before KT. Splenectomy was performed in all patients. Immunosuppression consisted of methylprednisolone (MP), CsA, and mycophenolate mofetil, in addition to antibody induction with basiliximab. MP was completely withdrawn on postoperative day 14. Results In 3 of 14 recipients, MP was restarted because of AR or a suspicion of AR. Both patient and graft survivals were 100%. The incidence of biopsy-proven AR was 14% (2/14). There was no adverse effect related to the antibody therapy. Conclusion The use of basiliximab induction therapy may eliminate the need for steroid maintenance therapy without increasing AR risk, even among ABO-i KT recipients. We conclude that basiliximab provides safe and effective induction immunosuppression in ABO-i KT recipients.

An intraoperative fluorescent imaging system (SPY system; NovadaqTechnologies, Inc, Concord, Ontario, Canada) that enables vascular surgeons to confirm the location and states of the reconstructed vessels during surgery, has been developed in the field of open heart surgery. In this paper, we evaluated the usefulness of the SPY system in kidney and liver transplantation. Patients and methods SPY system visualizes arteries and grafts intraoperatively, using indocyanine green (ICG) with a portable imaging device. The modality was evaluated in 15 patients undergoing kidney (n = 13) or liver (n = 2) transplantation with respect to safety, feasibility of use, and image quality. Images were generated and acquired with a portable laser diode/infrared camera device after injection of 10 mL of ICG (2.5 mg/mL) intravenously. Result There was no complication associated with ICG injection or the imaging device. The SPY system was easily used during transplant surgery and adequately demonstrated reconstructed arteries and patency in all patients. Conclusion The intraoperative imaging system enables the surgeon to view, record, and replay real-time images of the reconstructed arteries during surgery. The system may provide useful information during surgery such as solid organ transplantation that requires vascular reconstruction.