the 52 bulletin
SCTS Ionescu Medical Student Travelling Fellowship 2017:
Osaka University Hospital
Martyn Eckersley, Academic FY2, Southend University Hospital NHS Foundation Trust drive line, the first time this has been done in Japan. This can lead to reduced infection rates and also allows the patient to swim and take a bath, an important part of Japanese life. A novel treatment that I observed at Osaka University Hospital was myocardial sheet transplantation. Skeletal myocytes are removed from a patient, stimulated to develop into cardiomyocytes and are Medical students from Osaka University Medical School, University of Malaysia Sarawak and Myself (2nd left), with finally implanted onto the Prof Yoshiki Sawa - Osaka University Medical School Dean patients epicardium. The desired effect being improved left ventricular ejection fraction, and saka University Hospital is a improved cardiac remodelling. Osaka large tertiary centre located in the University Hospital is one of the main Suita district of Osaka. It has 50 centres of research in this field, and it was inpatient beds, as well as a large ITU. It is a interesting learning about it and the exciting world leader in implantable ventricular assist applications it may have in the future. devices (VAD) and regenerative medicine. Finally, as mentioned earlier, Osaka Patients are accepted from throughout Japan University Hospital is one of the 11 in Japan from Hokkaido in the North to Okinawa in that are licensed to carry out adult heart the far South West, as well as from abroad. It transplantation. Heart transplantation only is also one of the 11 centres in Japan with a began in 2005, with numbers exceptionally license to carry out heart transplant surgery. low until a change in the law in 2014. The most prevalent cardiovascular Numbers of transplants have remained low, diseases in Japan are the same as those in the despite a population of 120 million. In Japan UK. Including Ischaemic heart disease, atrial only 51 heart transplants were carried out in fibrillation, hypertension, cerebrovascular 2016, this compares with 195 in the UK, a disease, peripheral artery disease and heart country with a population of approximately failure. Notably the incidence of aortic dissection half that and 68 per day in the United States. is higher in Asian populations, with rates being The issues with low transplant numbers 3 times greater than those seen in Europe. are common to both health systems and Whilst on my placement in Osaka I was are largely due to low number of donors. able to observe a wide range of adult Donor rates are lower in Japan than in the cardiac surgery inncluding off pump CABG, UK, perhaps for cultural reasons and also a combined AVR/MVR, and aortic arch patient`s family can block organ donation even replacement following dissection. if the patient was previously registered as an One difference between Osaka and organ donor, like in the United Kingdom. my previous placements at Barts is the Importantly my time in Japan was not provision of Ventricular Assist Devices, a all spent in the hospital. I was able to explore procedure not currently carried out at Barts the magnificent sites such as Todaiji temple Heart Centre. Whilst I was there I saw the in Nara, Himeji castle, the shrines of Kyoto, implantation of a VAD with a postauricular
O
take in a rugby game in Tokyo, as well as the humbling peace park and ground zero at Hiroshima. Whilst initimidating and a bit overwhelming at first Japan is an incredible country, with distinct differences in their culture and attitudes as well as the healthcare system. I have thoroughly enjoyed my time in Japan and cannot wait to visit again in the future and I would encourage anyone else to do the same. I would like to thank Mr and Dr Ionescu and the SCTS for their generous support, without which I would not have been able to complete this elective. n
