Development of ventricular assist device and heart transplantation in Japan: How people worked
Notice bibliographique
Résumé
The first heart transplantation (HTx) in Japan was carried out in Sapporo by Dr. J. Wada 8 months after Dr. C. Barnard performed the world's first case in Cape Town, South Africa in 1967. 1 After the recipient's death, doubts spread through mass media about the brain death and indication to that patient with valvular disease, which led to demand that the surgeon be tried for murder. 2 After this problematic case, organ transplantation from brain-dead donors was not carried out for the next three decades.After long arguments about organ transplantation from brain-dead donors, and after suffering from another antitransplant action, 3 the law allowing donation of the organs under brain death passed the Diet in 1997.HTx under legislation was started smoothly in 1999.However, over the next 10 years, organ donation was very limited because of the stringent law as donations were only possible under the presence of written will of the donor and acceptance from the family.In 2010, the law was revised as accepting the donation without donor's written will and the number of HTx has increased significantly.The cumulative number of HTx has reached over 500 in 2019.However, HTx itself has been still limited not exceeding over 100 cases per year.The development of devices for mechanical circulatory support (MCS) started very early in Japan, and two groups, one at the University of Tokyo (UT) and one at the National Cardiovascular Center (NCVC), began to develop extracorporeal ventricular assist devices (VADs) in the 1970s.The UT released the Zeon pump and the NCVC released the Toyobo pump in the 1980s.Considering the long waiting period for the coming HTx era, efforts to introduce implantable VADs (left ventricular assist devices, LVADs) were conducted starting with pulsatile devices, HeartMate (HM), and Novacor, and then, moved toward the continuous flow LVADs.During the above period, Japanese original LVADs, the EVAHEART and the DuraHeart were developed.Currently, the national supportive scheme for introducing durable LVADs has progressed under the academic autonomy system, and a significant increase of the newly implanted durable VADs has been over 100 in recent years.However, the indication of such VADs has been limited to bridge use for HTx and destination therapy (DT) has not been started.In this article, the historical steps of clinical application of advanced therapeutic modalities such as VAD and HTx are reviewed to show how the people involved struggled and worked together.This review has intended to cover the period from 1980s to mid-2010s when I worked mainly at Osaka University (Professorship was from 1991 to 2005).
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,006 | 0,006 |
| Communication savante | 0,006 | 0,007 |
| Science ouverte | 0,001 | 0,005 |
| Intégrité de la recherche | 0,004 | 0,005 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».