Urology and Kidney Transplantation Center

What we do

Our department specializes in living donor kidney transplantation for patients with end-stage renal disease (ESRD). We provide comprehensive, compassionate care—from initial counseling and donor matching to surgery and long-term post-transplant follow-up.

New Outpatient Consultation Location:

For the convenience of our patients, we have opened a dedicated Kidney Transplant Consultation Clinic at Kameda Makuhari Clinic (Department of Nephrology).
Visit Kameda Makuhari Clinic - Transplant Consultation

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Understanding End-Stage Renal Disease (ESRD) & Replacement Therapies
The kidneys filter blood to remove waste products and excess fluid, regulate electrolyte balance (Na+, K+, acid-base balance), produce blood pressure-regulating hormones, stimulate red blood cell production, and activate Vitamin D for bone health. When kidney function drops permanently, a patient enters End-Stage Renal Disease (ESRD), leading to uremia and life-threatening complications. To survive, patients require Renal Replacement Therapy (RRT):

Dialysis (Hemodialysis / Peritoneal Dialysis): While life-saving, dialysis performs only approx 10% of normal kidney function and is a supportive treatment rather than a cure. Over time, it can lead to cardiovascular and bone complications, alongside significant lifestyle, dietary, and fluid restrictions.

Kidney Transplantation: As the only curative treatment for ESRD, successful transplantation restores kidney function, liberates patients from dialysis, and improves quality of life (QoL). It also enables normal growth in children and allows women to pursue pregnancy and childbirth. Preemptive Kidney Transplantation (transplantation prior to starting dialysis) is also actively performed to optimize long-term patient survival.

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Living Donor Kidney Transplantation Criteria
Our center performs Living Donor Kidney Transplantation. Candidates must meet the following criteria:

1. Donor Criteria

Family Relationship: Must be a legally defined relative within 6th degree of consanguinity or spouse/3rd degree of affinity (Japanese Society for Transplantation Ethical Guidelines)

Health Status: Mentally and physically healthy adult, voluntarily donating out of goodwill without coercion or commercial gain

Age Limit: Generally between 20 and 70 years old (candidates up to age 80 may be considered based on physical age).

2. Recipient Criteria

Diagnosed with ESRD (currently on dialysis or approaching the need for dialysis)

Free of active malignancies, uncontrolled infections, active GI bleeding/ulcers, or severe vascular disease

Adequate cardiopulmonary fitness to undergo general anesthesia

Able to adhere to lifelong immunosuppressive therapy

ABO-Incompatible & HLA-Sensitized Transplantation:

Blood-type mismatched (ABO-incompatible) transplants are routinely performed using specialized pre-transplant desensitization regimens

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Pre-Transplant Evaluation & Timeline

Outpatient Histocompatibility Testing: Blood tests for tissue matching (HLA / Donor-Specific Antibodies) and infectious disease screening. Pre-transplant vaccinations are administered as needed.

Inpatient Pre-Operative Assessment (~1 Week Admission): Both recipient and donor undergo comprehensive health workups (ECG, Echocardiogram, CT, Endoscopy, Pulmonary Function Tests, Blood/Urine panels, and interdisciplinary evaluations with Cardiology, GI, Psychosomatic Medicine, Ophthalmology, Dental, etc.).

Timeline: The evaluation process from histocompatibility testing to surgery typically takes approximately 3 months.

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Surgical Procedure & Hospital Stay

Pre-Surgical Preparation: Recipients are admitted 1 week prior to surgery to initiate immunosuppressive medications (and plasma exchange if ABO-incompatible or antibody-positive). Donors are admitted the day before surgery.

Surgical Technique: Donor kidney retrieval is performed via Retroperitoneoscopic Donor Nephrectomy (minimally invasive approach). The kidney is then implanted into the recipient’s iliac fossa.

Post-Operative Recovery:

Recipient: Spent 1 night in the ICU, followed by general ward recovery. Discharge occurs in 2 to 4 weeks once immunosuppressant levels stabilize.

Donor: Typically discharged within 3 days post-surgery.

(Note: Smoking cessation and weight management are mandatory prior to surgery)

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Post-Transplant Follow-Up & Long-Term Care

Recipient Care: Regular visits at the Kidney Transplant Clinic to monitor graft function, drug levels, infections, and potential side effects.

First 3 months: 1–2 visits/week
3 to 6 months: Once every 2 weeks
After 6 months: Monthly visits

Donor Care: Managed at the Nephrology & Hypertension Outpatient Clinic. Most donors return to full normal activities and exercise within 3 months with no long-term physical impairment. Annual health checkups are emphasized to prevent hypertension, diabetes, or renal strain.

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Clinical Outcomes & Graft Survival Rates
(Source: Japanese Society for Transplantation 2016 Fact Book)

In Japan, living donor kidney transplants demonstrate excellent long-term outcomes thanks to modern immunosuppressive therapies:

1-Year Graft Survival: 98.7% (Living Donor)
5-Year Graft Survival: 94.6% (Living Donor)

Conditions we handle

End-Stage Renal Disease (ESRD): Severe kidney impairment requiring current or imminent dialysis.

Number of cases

Total Outpatient Visits: 487 patients
Total Inpatient Admissions: 359 patient days (or admissions)

Operation results

Living kidney transplantation
2018: 3 cases
2017: 9 cases

List of Doctors

Deputy Chief, Department of Urology; Assistant Chief, Surgical Oncology; Director in charge of surgery, Renal Transplant Center

Atsuhiko OCHI

Subspeciality
Urological / retroperitoneal tumors (renal cell carcinoma, upper tract urothelial carcinoma, bladder cancer, adrenal tumor), renal failure (renal transplantation)

Department name	Urology and Kidney Transplantation Center
Medical School	Kanazawa University
Special Qualifications	M.D., Ph.D. JUA Board Certified Urologist / Instructor Certified Urologist in the Endoscopic Surgical Skill Qualification System of the Japanese Urological Association and the Japanese Society of Endourology and Robotics Board Certified Physician in Endoscopic Surgery of the Japanese Society for Endoscopic Surgery (urologic laparoscopy) Certified Transplant Physician of the Japan Society for Transplantation Certified Specialist in Renal Transplantation of the Japanese Society for Clinical Renal Transplantation Certified Physician of the Japanese Board of Cancer Therapy Certified Specialist / Instructor of the Japanese Sarcoma Association Da Vinci console surgeon certificate Completed the clinical training instructor workshop Completed the palliative care praining program Completed the online medical care training program designated by the Ministry of Health, Labour and Welfare
Education & Career	Mar 2005: Graduated from School of Medicine, Kanazawa University Apr 2005: Junior Resident, Postgraduate Education Center, Kameda Medical Center Apr 2007: Senior Rsident, Department of Urology Apr 2011: Assistant Chief, Department of Urology Oct 2016: Assistant Chief, Department of Urology; Staff Physician, Renal Transplant Center Mar 2017: Assistant Chief, Department of Urology / Renal Transplant Center Dec 2018: Assistant Chief, Department of Urology; Director in charge of surgery, Renal Transplant Center Sep 2020: Completed the doctoral course, Graduate School of Medical and Dental Sciences (Department of Clinical Anatomy), Institute of Science Tokyo (formerly Tokyo Medical and Dental University) Sep 2021: Visiting Professor (laparoscopic urological surgery), Faculty of Medicine, Thammasat University (Thailand) Apr 2022: Assistant Chief, Department of Urology; Assistant Chief, Surgical Oncology; Director in charge of surgery, Renal Transplant Center Aug 2023: Deputy Chief, Department of Urology; Assistant Chief, Surgical Oncology; Director in charge of surgery, Renal Transplant Center

Chief of Nephrology & Hypertension

Tomo SUZUKI

Subspeciality
Kidney Diseases In General ， Nephritis ， Renal Pathology

Department name	Urology and Kidney Transplantation Center
Medical School	St. Marianna University School of Medicine
Special Qualifications	Board Certified Specialist of The Japanese Society of Internal Medicine Board Certified Specialist of Japanese Society of Nephrology Board Certified Specialist of The Japanese Society for Dialysis Therapy Board Certified Specialist of Japanese Society for Apheresis
Education & Career	2006 Mar. Graduated from St. Marianna University School of Medicine 2006 Apr. Junior Resident，The University of Tokyo Hospital 2007 Apr. Junior Resident，ASAMA General Hospital 2008 Apr. Senior Resident of Nephrology & Hypertension， Kameda Medical Center 2011 Apr. allergy，National Hospital Organization Chiba East Hospital 2012 Apr. Term Assistant Professor，St.Marianna University School of Medicine Hospital 2012 Aug. St. Marianna University School of Medicine， Yokohama City Seibu Hospital 2013 Apr. nephrology，Inagi Municipal Hospital 2014 Apr. Renal vascular pathology，University of Tsukuba Faculty of Medicine 2016 Apr. Assistant Professor，St.Marianna University School of Medicine Hospital 2018 Oct. Chief of Nephrology & Hypertension，Kameda Medical Center Nephrology & Hypertension，St.Marianna University School of Medicine Hospital (part-time)

Vice Chief of Surgical Oncology

Jun YASHIMA

Subspeciality
Abdominal cavity
Retroperitoneal sarcoma

Department name	Urology and Kidney Transplantation Center
Medical School	Yokohama City University School of Medicine
Special Qualifications	Board Certified Specialist and Advanced Certified Speialist of Japan Surgical Society Board Certified Specialist and Advanced Certified Speialist of Japan Sarcoma Association Board Certified Physician of The Japan Society for Transplantation Board Certified Physician of Japanese Society for Clinical Renal Transplantation Board Certified Specialist and Advanced Certified Speialist of The Japanese Society for Dialysis Therapy
Education & Career	1998 Mar. Graduated from Yokohama City University School of Medicine 1998 Jun. Kidney Center， Tokyo Women’s Medical University 2003 Jun. Hachinohe 99 clinic 2005 Mar. Kidney Center， Tokyo Women’s Medical University 2008 Apr. Assistant Professor，Transplant surgery， International University of Health and Welfare Atami Hospital 2010 Jul. Lecturer，Transplant surgery， International University of Health and Welfare Atami Hospital 2014 Apr. Associate Professor，Transplant surgery， International University of Health and Welfare Atami Hospital 2019 Apr. Professor，Transplant surgery， International University of Health and Welfare Atami Hospital 2020 Apr. Vice Chief of Surgical Oncology， Kameda Medical Center

Assistant Chief, Department of Urology; Renal Transplant Center (in charge of surgery)

Minoru NAKAZONO

Subspeciality
Urological malignancy

Department name	Urology and Kidney Transplantation Center
Medical School	Kobe University
Education & Career	Mar 2014: Graduated from Kobe University School of Medicine Apr 2014: Junior Resident, Tokyo Saiseikai Central Hospital Apr 2016: Department of Urology, Jikei University School of Medicine Oct 2016: Jikei University Kashiwa Hospital Oct 2017: Jikei University Hospital Apr 2018: Kosei Hospital Apr 2019: Jikei University Katsushika Medical Center Apr 2019: Jikei University Katsushika Medical Center July 2020: Kameda Medical Center July 2022: Jikei University Hospital Jan 2023: Kosei Hospital Apr 2024: Joined Kameda Medical Center as Assistant Chief, Department of Urology / Renal Transplant Center (in charge of surgery)