現在では移植医療に欠かすことのできない重要な役割を果たしているコーディネーターに，筆者は1995年4月に日本腎臓（現在：臓器）移植ネットワークが発足した当初より，2017年3月まで約22年間携わることができた．この間にコーディネーターとして，東京都内からの情報をはじめ，近隣の県からの協力要請や，脳死下提供時の緊急車両による臓器搬送など約500例弱の対応を経験できた．活動当初は教育制度もなく，ドナー情報に対しては提供施設対応や家族対応など迷い・悩みながらの連続であった．また，直接家族対応した約400症例余りにおいては，必ずと言って良いほど大なり小なりの問題が起き，自分なりに納得出来た症例はほとんど皆無であった．対応後にはいつもその経験を次の症例対応に活かし，上手く行うことを目標とする繰り返しであった．この様な意味から，コーディネーターとしての対応を教えていただいたのは，提供施設関係者であり，また対応させていただいた家族であった．症例を重ねるうちに「コーディネーターの本質」とは，「臓器提供の本質」とはと考えながら，「法と情」のなかで「本人の意思を活かすこと」，「家族の希望に則すこと」を考えながら，自己研鑽しながらコーディネーターを務めた．

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近年，脱細胞化組織は組織再生のための移植材料として広く応用されている．脱細胞化組織は，生体組織から細胞成分を除去した三次元構造を有する細胞外マトリックスであり，種々の脱細胞化技術によって得られる．この調製法の違いが，得られる脱細胞化組織の形態や構造，力学的特性，生物活性に強く影響している．臨床でも広く試みられている脱細胞化組織の同所性移植は，細胞が浸潤してECMを再構築し，最終的に元の組織を再生させる．一方で，脱細胞化組織を異所性に移植した場合は，移植部位に適した組織が構築される場合と脱細胞化組織の由来となった組織が異所性に再構築される場合とがある．本稿では，脱細胞化生体組織の作成法，現在の状況および今後の動向について解説した．

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Uterus transplantation (UTx) has become an alternative to gestational surrogacy and adoption for women with uterine factor infertility. Brännström et al. achieved the first human delivery after UTx in 2014 and to date a total of 8 babies have been born after UTx from living donors. This outcome attracted much attention worldwide and many countries have recently prepared for UTx. However, this procedure has many medical, ethical and social issues that require discussion prior to clinical application. Moreover, UTx is still in the experimental stage overseas and the safety and efficacy remain unclear despite several clinical applications. Despite the many issues to be resolved, this new organ transplantation technology will provide new hope for women with uterine factor infertility and further development of the technology is important for future reproductive and transplant medicine.

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In accordance with the GPSP ordinance of the Ministry of Health, Labor and Welfare, a special drug use surveillance (2-year observation period) was conducted to evaluate the safety and efficacy of everolimus (Brand name: Certican) in kidney transplant patients in real-world setting. Finalized observational data from 315 patients were analyzed. The mean age was 49.0 years and the median time after the transplantation to the start of the drug treatment was 11.0 months. The incidence of adverse drug reactions (ADRs; disorders, symptoms, and abnormal laboratory findings for which a causal relationship to the drug cannot be ruled out) was 53.02% (167/315 patients). ADRs with an incidence of ≥5% were stomatitis, hyperlipidemia and proteinuria. ADRs such as stomatitis, hyperlipidemia and edema peripheral, mostly occurred within 3 months after the start of the drug treatment (28.89%, 91/315 patients). Patient- and graft-survival rates were 99.05% and 98.1%, respectively. Rejection rate was 7.94%. The safety and efficacy results of this surveillance showed no additional newly identified concern in the treatment of Japanese kidney transplant patients with everolimus in clinical practice.

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Children needs the dosage forms suitable for pediatric use. A surface body area and weight change rapidly by the age. Therefore the dosage flexibility for pediatric formulation is needed. Moreover, oral medication has to be good taste. Development of age-appropriate medicine is important, because it usually influences children’s treatment adherence. Recently, improved technology of the orally disintegrating tablet (ODT) in Japan and the active development of mini-tablets formulation in foreign countries is attracting attention. The pediatric medicine manufacturing laboratory started by our center facilitates support the promotion of development of pediatric formulation.

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Nature is a very important resource for not only new drug discovery but also application of traditional medicines. Kampo (Japanese traditional) medicines have been used as the traditional formula in which multi-active ingredients may attack multiple target sites to recover complicated symptoms caused by disturbance of the body systems such as immune, neural and endocrine systems. Therefore, their multilateral actions are suitable to treat multifactorial diseases. Kampo medicines are using for the treatment depending on the patient’s clinical situation, either separately or to complement modern western medicine in Japan. Present review describes the concept and characterization of Kampo medicines, and introduces our pharmacological studies of Kampo medicines to clarify their action mechanism and active ingredients. The results may contribute for more evidence-based clinical applications of Kampo medicines.

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