2016 fact book 2016 of organ transplantation in japan はじ ?· ファクトブック2016 fact...

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  • 2016

    Fact book 2016 of Organ Transplantation in Japan

    2012

    2016

    2015

    2016

  • 1997 10

    2009 72010 1

    2010 7

    2011

    2015 1

    104 63 1,494 1,661

    2014 1,572 89 57

    391 4482014 464 16

    442014 37

    7 45 16 61

    2014 61 35

    1 362014 29 7

    2015

  • 1

    1997

    2010

    2015 58

    2010

    2014 272015

    33 98 1/3

  • 2

    3 2010

    1132011 112 2014

    772015 91

  • 4 15

    2011 4 15

    2012 662015

    1524

  • 1.

    QOL

    11

    92016831

    1010

    10

    42016831

    201544(1)

    1.

  • 19971019992281

    15201512266

    7572661913

    51213

    (2)

    2.

    101561984201312

    2013

    2014

    2014520158

    EXCOR

    (3)

  • 3.

    20131218

    13082927

    144

    4. 18

  • 14592014

    12311113

    5

    5. 18

    1410VAD

    21201412316

  • 6.

    2.

    1

    23

    ACENYHA IIIIV

    60

    peak VO214.0 L/min/kg

  • 615mmHg

    2013216065

    60

    60

    60

    601239

    3.

    198220136113,395

    4,000

    20141,29720041,016

    2000

    20052011KODA

    201444622350

    )201411880

    2009100

    5-60.050.31

    3.82.32014

    10

    20085

    2009(3)2014

    61

    status 1265246

    92.8%VAD

    2,200status 162%VAD

    45%

  • 977293,838status 1

    779291,362

    9581651,703VAD

    940211,738201544

    32250%status 156

    50

    VADVAD

    188VAD

    1022010128

    EVAHEARTDuraHeart2011

    4120125

    HeartMate II20141

    Jarvik 2000VADVAD

    (7, 8)

    7.

  • 8.

    200811

    200312004

    1,000

    (9)

    20161,000

    VAD5

  • 9. status 1

    4.

    228670

    UNOS1999

    3,245

    1,600

    602013

    260

    50

    5

    2500-1,300

    2010

    1

    20112013260

    10

  • 10

    5.

    ACE

    150%1

    228670

    201691,204293

    60400

    30-60

    150%

    35-4530-405

    350

    6

    20151226616

    206

    201512593.3%1091.6%1583.2%(11)

  • 11. 2015.12.31

    201491608

    4313

    492014924

    35194.6%394.6%586.5%1067.6%15

    67.6%2067.6%109194.5%392.4%589.7%10

    87.2%

    2003201065

    14,021389.2%184.4%378.1%572.5%

    ISHLT 2011.6

    201463312452

    74.0%

    1UNOS20138,267

    2,58231.2%3

    7%

    7.

    200641

    20124

  • 1,929,200627,200200,000

    1

    10

    3

    5000

    (1 )

    250-300 (1 )

    0-650

    10

    600-800 (1 )

    20-30 (1 )

    1

    1818

    100800

    3

    16

    http://sankei.jp/pdf/20120717_akemi.pdf

  • 8,0002

    8.

    20085WHO

    200910

    5%

    10-15%

    (12)

  • 12.

    30060-100

    (13)

    13.

  • 1

    20168364

    24

    1989

    2

    1

    1

    Budd-Chiari

    5cm 13cm 3

    70

  • 65

    3

    20158,387321

    31838,0668,117

    25614255588

    7,862198612015

    1989

    2006 2009

    213201040

    201557

    2005566

    400

    1

    Organ Procurement and Transplantation Network (OPTN)

    20157,127

    6,768359

    60007,000

    2001524250

    359

    2

    0

    10

    20

    30

    40

    50

    60

    0

    100

    200

    300

    400

    500

    600

    899091929394959697989900010203040506070809101112131415

    (n=8066)

    (n=321)

  • 2 2015

    4.

    50

    1050

    974

    73640

    95%

    44%24%18%10%

    5.

    36%

    25%

    52

    117 1

    2 dual graft2

    262

    (n=448)

    (n=7127)

    95% (n=6768) 5% (n=359)

    13% (n=57)

    87% (n=391)

  • 171030

    monosegment2

    6.

    2016831362

    201110:10:

    8

    2014736

    20174Child C 10

    MELD (Model for End-stage Liver disease)

    Child B

    2011102014531

    106377

    1033.38468.961536.82014

    201620

    1

    140 100

    500 25

    1000 100

    20,000 1,000

  • 20,000 1,000

    2,200

    7

    1

    2,000

    2,464

    2016811,01834

    425

    340(13.8%)4012

    3

    3

    8

    2015318187

    15%

    14%

    17%

    1%

    41%

    12%

  • 3835811076%15761

    8438057810731568

    20164

    4 vs.

    189

    388587,1084%182376

    573,1066%20155

  • 5 (18) vs. (18)

    20

    2006

    2016

    9

    200641

    200411

    5cm13cm3

  • 1

    31

    5cm13cm3

    10

    2003

    2009

    2005221

    2008

    222

  • .

    1

    2

    *

    2

    2

    48

    6 3

    2

  • C C

    3

    20151201511,494

    89.9 167 10.1 1,661

    633.8 1046.32014

    1,477 127 1,604

    17 40 57

    19 21

    . 2015

    ,89.9%)

    ( 3.8%)

    ( 6.3%)

    ,

    4 1,2

    932 (63.7%) 530 (36.3%)

    84 (53.8%) 72 (46.2%)

    47.0 48.0

    40 23.710

    28 4 32

    2.0

  • 2015

    . 2015

    5. 3 2

    20151,6615719894-5

    20061,000

  • 2015

    167201412740

    2015324,986

    201512,825

    3.

  • 2

    6

    2015 324,986 385.7

    1

    2015 12 31 12,8252015 12 31

    2015 12,825 167

    2015

    4619 (12.7 ) 16 1,187 (3.3 )16

    4,791 (13.1 ) 2001 16

    7

    12,8252015

    12 31

    2016 8 1 3,617

    3,350

    8.

    2016 5 9

    2016 5 9

    15,738

    73 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92

    137 38 37 82 117 131 133 170 221 176 236 242 249 339 405 417 470 549 534 547 551 463 402

    37 4 4 4 8 4 22 27 36 51 49 118 154 191 159 143 174 163 198 261 220 234 207

    174 42 41 86 125 135 155 197 257 227 285 360 403 530 564 560 644 712 732 808 771 697 609

    93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

    323 399 432 453 437 510 556 603 554 637 728 731 835 941 1043 994 1122 1277 1386 1424 1438 1477 1494

    197 199 172 186 159 149 150 139 135 112 134 167 144 181 163 184 175 146 126 116 67 42 63

    8 7 16 10 4 6 16 16 24 26 14 62 86 77 88 85 104

    520 598 604 639 596 559 724 749 705 759 866 904 995 1138 1230 1204 1311 1485 1598 1617 1593 1604 1661

  • 3,132 577

    4,277 6,268

    4,5,6,7

    198320002001

    2009201020143

    200119832000

    197.0593.42010201499.197.2

    1983200092.485.62010

    201497.893.4

    19832000192.8585.6

    2010201498.794.61983200081.4

    64.42010201496.487.5

    1980

  • 4

    5

  • 6

    7

  • 3

    19832000200120092010

    2014 3

    2000

    2001

    3

    4

    3

    19832000 62.0%20012009

    23.4%20102014 7.7%

  • 4

    9. 5,6

    2009

    2009 2014 8,124

    31 2345 web

    3

    11 52 23 34,54

    1 361

    (7.6%)

    3 39

    (0.7%)1 38 0.8% 5

  • 5

    20092014 8,124

    6

    20092014 8,124

    10

    1

    600

    18 18

  • 2008 5

    11.

    2002 1

    HLA

    16

    2009 72010 1

    12.

    200613

    1989

    20085

    13.

  • (IC)

    5

  • .

    1

    1

    QOL

    80

    SPK

    QOL

    PAK

    1PTA

    1999

    10

    20168

    17

    2000111

    20168203

    573251

    320107

    30

    51

    63

    2004

    20151227SPK;21PTA;5PAK1

  • 2

    12

    60

    (1)

    PAK

    SPK

    (2) 1

    PTA

    3

    2016812031

    7512840107

    50553033SPK151

    PAK40PTA12

  • 4

    20168151

    63

    5

    19971020004251SPK

    201512243196SPK36

    PAK11PTA3SPK1

    2720107

    6

    11313360195060

    406860%40251 %127

    3115910

    494

  • 15690307840106

    3049567.0

    727.925

    4,9741,3261,312

    8

  • 7

    24614SPK11PAK1

    PTA263111

    11

    121

    62

    12

    3

    1

    201

    421

    3586.1%79.273.9%

    19910

    1151

    1166

    519

    13592.6%

    92.689.5%

  • 8

    2015122752

    137

    54.427721017

    35.22550SPK21

    PTA5PAK1

    3

    931

    114

    9

    200641

    10

    HLA-DR

    1221

  • .

    1.

    pH

    15

    2.

    2015

    1

    1.1

    1.2

  • 1.3

    1.4

    1.5

    1.6

    1.7 PVODPCH

    1.8

    1.9

    1.10

    2 IIPs

    2.1 IPF

    2.2 INSIP

    2.3 IPPFE

    2.4 IIPs

    3

    3.1

    3.2

    3.3

    3.4

    3.5

    4

    4.1 COPD

    4.2 1

    5

    5.1 GVHD

    5.2 GVHD

    5.3 GVHD

    6

    6.1

    6.2

  • 6.3

    7 CLAD

    7.1 BOS

    7.2 RAS

    7.3 CLAD

    8

    8.1

    8.2

    8.3

    8.4

    8.5

    8.6

    8.7

    8.8

    9

    55 60

    3.

    2015 12 283

    20102015