{"created":"2023-05-15T09:06:06.990619+00:00","id":12153,"links":{},"metadata":{"_buckets":{"deposit":"5a936843-3f69-4235-918b-c41334632289"},"_deposit":{"created_by":14,"id":"12153","owners":[14],"pid":{"revision_id":0,"type":"depid","value":"12153"},"status":"published"},"_oai":{"id":"oai:sapmed.repo.nii.ac.jp:00012153","sets":["1875:1978:1980"]},"author_link":["17301","17302","17303","17304","17305","17306","17307","17308","17309","17310","17311","17312"],"item_2_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2011-03-31","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"92","bibliographicPageStart":"89","bibliographicVolumeNumber":"70","bibliographic_titles":[{"bibliographic_title":"市立札幌病院医誌 = Acta medica nosocomi Sapporo = The Journal of Sapporo City General Hospital"}]}]},"item_2_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は66歳、男性。ADPKDによる末期腎不全のため、1999年に血液透析導入となった。2009年、妻からのABC不適合生体青移植を希望され当科を受診した。移植前検査で血小板6.8万/mm 3と低値であったため血液内科にて、特発性血小板減少性紫斑病(ITP)と診断された。ヘリコバクターピロリ除菌療法を施行したが血小板数の上昇は見られなかった。また、術直前にガンマグロブリン大量投与療法を試みたが血小板は上昇せず5万/mm 3であった。そこで、術当日血小板を20単位輸血し、血液型不適合腎移植の脱感作プロトコールに従い生体腎移植を行うこととした( リッキシマブ、3回の血漿交換、バシリキシマブ、タクロリムス、ミコフェノール酸モフェチル、メチルプレドニゾロン)。移植後は即座に利尿が得られ、移植後4 日目には血清クレアチニン(Cre)1.59m g/diまで低下した。血小板は術直後7.5万/m m 3 、術後4日目には5.4万/mm 3 まで低下したが、術後6日目には11.3万/mm 3まで上昇した。その後、血小板は10万/mm 3以上を維持し退院。現在術後4ケ月経過しているが血小板11万/mm 3 と維持している。今回、治療抵抗性のITPを合併する腎不全患者に対して血液型不適合腎移植を行った。治療抵抗性のITPであったがリッキシマブを使用した免疫抑制により術後良好な腎機能とITPの改善を認め、 本症例はITP患者の腎移植に対しリツキシマブを使用した初めての報告である。","subitem_description_type":"Abstract"}]},"item_2_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"市立札幌病院"}]},"item_2_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0288-6073","subitem_source_identifier_type":"ISSN"}]},"item_2_version_type_15":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"内山, 結理"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"堀田, 記世彦"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"吉田, 美穂"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"高田, 徳容"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"佐藤, 択矢"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"望月, 端吾"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"村橋, 範浩"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山本, 聡"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"関, 利盛"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"富樫, 正樹"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"平野, 哲夫"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"原田, 浩"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-07-21"}],"displaytype":"detail","filename":"l425670289.pdf","filesize":[{"value":"8.1 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"l425670289.pdf","url":"https://sapmed.repo.nii.ac.jp/record/12153/files/l425670289.pdf"},"version_id":"2046ea94-97eb-415a-96d4-db5f71d6568c"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"特発性血小板減少性紫斑病を有した腎不全患者に行った血液型不適合生体腎移植の1例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"特発性血小板減少性紫斑病を有した腎不全患者に行った血液型不適合生体腎移植の1例","subitem_title_language":"ja"}]},"item_type_id":"2","owner":"14","path":["1980"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2011-06-21"},"publish_date":"2011-06-21","publish_status":"0","recid":"12153","relation_version_is_last":true,"title":["特発性血小板減少性紫斑病を有した腎不全患者に行った血液型不適合生体腎移植の1例"],"weko_creator_id":"14","weko_shared_id":-1},"updated":"2023-12-13T04:31:13.374884+00:00"}