The characteristics of COVID-19 infection consist of the characteristics of both influenza caused by infection-induced cytokines and varicella caused by cell-mediated immunity to the virus. An indicator of the therapeutic efficacy of anti-herpetic drugs in herpes zoster is the cessation of new lesions rather than the improvement of inflammation. Inflammation due to cell-mediated immunity reaches its peak 3 days after antigen contact in lacquer dermatitis. Therefore, the inflammation due to cell-mediated immunity in herpes zoster worsens for 3-5 days due to the persistent presence of the virus even after the start of antiviral treatment. It is a characteristic of COVID-19 pneumonia that Avigan (favipiravir) treatment is effective but that the inflammation of COVID-19 pneumonia continues to worsen for 3-5 days even after Avigan treatment.

Avigan (favipiravir) has been developed as an anti-influenza drug and is attracting attention as an anti-COVID-19 drug, because Avigan has exhibited therapeutic efficacy against new coronavirus (COVID-19) infections. This article reviews the development of Avigan as an anti-influenza drug, its mode of action as an anti-RNA-dependent RNA polymerase drug, toxicity to embryogenesis and teratogenicity, and its activity to COVID-19. The epidemic of the new coronavirus infection began, and masks, hand washing, and self-restraint were continued to prevent it. As a result, infection control measures have had the effect of reducing the epidemics of various infectious diseases except for some. This seems to be important information for implementing transplantation medicine.

Since the COVID-19 pandemic, there have been remarkable advances in diagnosis. Initially, the indication for diagnostic tests was strictly controlled by the government. Currently, however, various tests, from point-of-care testing to rapid PCR, are available for many clinics and hospitals. At the same time, the interpretation of test results became harder due to the existence of different types of testing as well as different qualities in the same type of testing. This review aims to overview the available test types and understand the basics of these tests to interpret the test results appropriately, especially in transplant recipients.

What is demanded to an academic society in a disaster is a leadership which gives a right decision to a surgeon as a captain of his or her transplant institution by affording a right chart, a right compass, and a right weather forecast. For the purpose, we organized an ad hoc committee on Covid-19 including a public health specialist and transplant infection specialists, published 4 consecutive guidelines, questions & answers, and clinical questions, released many web seminars for physician, coordinators and patients and made a registry for transplant patients who were infected with Covid-19. All of them are released in a special page for Covid-19 linked to the home page of The Japan Society for Transplantation. Our missions are to respect the will of organ donation, to protect patients, medical professionals and their families, and to sustain regional medical systems.

The revised Labor Standards Act revised by the work style reform laws was enforced in 2019. The regulation of overtime limit of doctors will be executed additionally in 2024. Ahead of effectation, the possibility of non-overtime transplantation of kidney and pancreas was investigated. Simulation was performed under the most tolerable condition set by the law. If the maximal preservation limit of static cold storage (general consensus; up to 24hrs) is applicable in all cases, some transplantations can be finished in duty hours. If the limit extends to 30 hrs, the number of in-duty transplantation will be doubled and 3 day-preservation will enables doctors to finish almost all cases within duty hours. Thus, the prolongation of organ preservation time is a key factor not only to improve working environment of doctors but also to achieve the legal compliance.

To date, various kinds of approaches for tracheal restoration have been reported. These include use of autogenous grafts, engineered prosthetic grafts, and allografts. Although some grafts showed therapeutic potentials, no one achieved successful clinical outcome especially with pediatric patients of congenital or acquired tracheal stenosis. We review the progress of tracheal restoration and discuss future view, focusing on our recent study that we performed tracheal allotransplantations to piglets with decellularized tracheal graft patches. Decellularization is likely to suppress allogeneic rejection and to lead regeneration of recipient cartilage around them. Decellularized tracheal tissue will be a key material of the restoration.

Although revised Organ Transplantation Law has been enforced since 2010 in Japan, the number of deceased donors are still few. Aiming to cultivate the understanding of organ transplantation, we performed a special coursework to 110 high school students and 219 university students in Fukushima prefecture. From the questionnaires done as a part of the coursework, not only they learned right knowledge but also had a chance to discuss organ transplantation with their family. As a result, negative images for the organ transplantation were decreased and they were thinking more actively of declaration of intention for donation. On the other hand, there still seemed to be some hurdles to declare the intention. We hope that our present study will help to understand what young generation is thinking and to approach the increase of donation.

Islet transplantation is a minimally invasive and safety therapy for type1 diabetes mellitus patients with severe hypoglycemic unawareness. Recent clinical trials have revealed that islet transplantation is effective for restoration of hypoglycemic awareness and reduction in the glycated hemoglobin level. Based on the past achievements, islet transplantation has been covered by public medical insurance since April 2020. Further development of this treatment is expected in the future. This review summarizes the brief history of listing process and the official requisite for practice.