【Objective】The results of a lymphocyte crossmatch test obtained by histocompatibility laboratories are discrepant, because the assay procedures and evaluation criteria differ. In the present study, we examined the usefulness of the newly developed immunocomplex capture fluorescence analysis (ICFA) method for a lymphocyte crossmatch．
【Methods】Serum and whole blood samples were obtained from 12 subjects. They were subjected to complement-dependent cytotoxicity crossmatch (CDC), flow cytometry crossmatch (FCXM), and ICFA methods at 3 different laboratories, and then the results were compared．
【Results】The results for 11 of the 12 subjects in regard to ICFA class Ⅰ and Ⅱ were the same among the laboratories. In contrast, the results of only 5 regarding FCXM-T and 8 for CDC-T were the same among the 3 laboratories．
【Conclusion】Of the 3 crossmatch methods investigated, ICFA had the highest rate of concordance among the 3 laboratories.

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【Objective】To determine the key factors influencing the awareness and adoption of organ transplantations in a region, we performed an opinion poll among medical examinees in a general clinic.
【Design】Cross-sectional survey.
【Methods】The subjects were 1310 examinees who underwent medical examinations at the IM clinic Anjo from April 2012 to March 2013. The subjects participated in an anonymous opinion poll concerning a primary physician's existence, terminal care, attitude toward organ donation, and other things.
【Results】Among the 1310 examinees, 1242 participated in the survey (response rate: 94.8%). Although most of the patients wished to remain at home for the last moments of their life, only 35.9% had a primary physician. And though 21.7% of all examinees expressed an interest in postmortem organ donation, only 46.5% of this group declared intentions to do so. The proportion of examinees who wished to donate organs was significantly higher among younger individuals, women, and people of foreign origin (p<0.05). Among those who declared their intentions to donate organs, 43 did so via declaration-of-intention cards; 42 via driver's licenses; 32 via insurance certificates; and 53 via notices to family members and 2 others (multiple answer was included).
【Conclusion】Because less than half declared their intentions to donate organs among those who had expressed an interest in postmortem organ donation, increasing the awareness among the public may be an effective method of increasing this interest. To raise the rates of organ donations, general clinics should undertake mass awareness programs with the cooperation of the entire community.

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Heart failure has been proposed as a possible cause of neurocognitive dysfunction. In this case report, we present a patient with end stage heart disease who underwent neurocognitive assessment before and after heart transplantation. The patient was a 40-years-old, right-handed, male restaurant worker with a senior high-school education. Before heart transplantation, he had a Nipro left ventricular assist system (LVAS) placed. On the Wechsler Adult Intelligence Scale (WAIS-III), he achieved a Full Scale IQ of 67, which is in the Intellectually Deficient range of intellectual functioning. The Wechsler Memory Scale-Revised (WMS-R) showed defects in general memory (81), and he displayed poor verbal learning and memory performances in an Auditory Verbal Learning Test (AVLT). e Cerebral blood flow measured by single-photon emission computed tomography (SPECT) was moderately reduced. After heart transplantation, although his intellectual ability measured with WAIS-III was not significantly improved (a Full Scale IQ of 70), general memory (104) assessed using WMS-R was improved to normal range. Chronic cerebral hypoperfusion caused by hypotension and low cardiac output and stress may lead to impairment in neurocognitive performance in a patient requiring long-term cardiac support with a VAS. We hypothesized that improvement in neurocognitive performance after heart transplantation would be a result of improved cerebral perfusion and a decrease in stress.

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A 17-year-old male underwent a deceased donor liver transplantation (DDLT) due to ornithine transcarbamylase deficiency. The deceased liver required the second delivery, and therefore the cold ischemia time was prolonged to approximately 14 hours. After DDLT, his liver function was improved except for an episode of biliary anastomotic stricture,which was finally revised by hepatico-jejunostomy. Acute kidney injury, which transiently required hemodialysis during the perioperative period, occurred possibly because of the prolonged cold ischemia time.
In the setting of a DDLT in Japan, it is essential to promote the maximizing of the liver organs possible to transplant, such as an effective utilization of organs from extended-criteria donors.

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We report a case of late-onset hepatic vein stenosis (HVS) occurring three years after a living donor retransplantation,which was treated successfully with balloon dilation.
【Case】An 8-year-old girl had undergone a Kasai's operation for biliary atresia and a living donor liver transplantation when she was 5 years old. Resulting from graft failure, however, a consecutive retransplantation was performed 27 days after the first. Although her post operative course had been uneventful, she was diagnosed as HVS by the scheduled Doppler ultrasound and computed tomography three years after the operation. The former showed a flat wave-form of the hepatic vein, and the latter depicted HVS itself along with the congestion of liver parenchyma. Not only the steno sis, but also a spiderweb appearance and elevated pressure gradient between the hepatic vein and the inferior vena cava were demonstrated through hepatic vein angiography. The lesion was treated successfully with balloon dilation. Namely, hepatic vein stenosis and pressure gradient were ameliorated. She now shows no signs of recurrence after a 10-month follow-up.
The possibility of late-onset HVS should be recognized especially in pediatric recipients experiencing, living donors and retransplantation settings,

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