By the time Ray Fearing was first informed of his rare ^*1kidney disease back in 2000, the damage that had already been done was such that a transplant would eventually be his only option. “By then, they (the doctors) had noticed there was a lot of protein” leaking (    14    ) his kidneys, said Fearing, 27 at the time. ”I think I was at about 20 percent kidney function when they examined tissue, and (15)it worsened to 13 percent within a year or two.” Fearing was diagnosed with focal segmental glomerulosclerosis, (16)or FSGS, a disease that causes ^*2scars on the kidney and ((17)to/it/filter/waste/properly/unable/makes) in the blood. The illness is mostly found in young adults, and about 5,400 people are diagnosed with it each year.

After years of drug therapy to delay the symptoms of his disease, Fearing finally underwent a transplant last June with a kidney that was donated by his sister Cera, 21. Unfortunately for Fearing, the operation did not (    18    ) as planned. A few days after the transplant, “I started to experience internal bleeding. And they were going to have to take it out,” he said. [A]

When rejection occurs, the donated kidney is usually discarded, which (    19    ) about 9 percent of kidney transplants. But thanks to an experimental procedure, Fearing was given the option to donate the organ to another candidate. He took that option immediately.

The reuse of Fearing's kidney is regarded by medical experts (    20    ) the first successful removal and implantation of a kidney into a second recipient after it had failed in the first, which appears to disprove previous notions that an organ could only be transplanted once, experts say. The medical findings in Fearing's case were published in the April 26 issue of The New England Journal of Medicine. Fearing donated the organ to a (    21    ) surgeon and father of five. “When they said there was a chance that I would be able to donate it to somebody else, really the other option didn't seem to be acceptable,” he said.

Dr. Lorenzo Gallon, the medical director of the kidney transplant program, said it wasn't easy to decide to reuse the kidney. One major concern was exactly how the kidney would react in a new host after sustaining damage during the time it was implanted in Fearing. “I was not comfortable when I made that decision. I was actually very nervous,” Gallon said. “If the kidney in the second recipient did not (    22    ), the patient might not be able to accept another kidney transplant in the future.” Gallon said once the kidney was implanted in the second recipient, it began to repair itself, becoming fully functional within a few weeks.

One of the major challenges of retransplantation involved coming up with a “(32)plan of attack” to address the limited length of the organ's ^*3blood vessels eaas a result of the kidney being removed twice, the transplant surgeon Dr. Joseph Leven thal said. “We knew that we were going to have to reconstruct the blood vessels,” said Leventhal, who took part in the procedure. “We took advantage of the fact that from deceased donor organs, we obtain on a regular basis blood-type ^*4compatible blood vessels that we can use for reconstruction, and we were able to use these blood vessels to reconstruct ones that had been removed (    23    ) Mr. Fearing.”

Dr. Niraj Desai, the director of the kidney transplant program, said the retransplantation of Fearing's kidney not only helped save a life but could mark a significant step toward better understanding the nature of FSGS. “Showing that this disease process can be reversed if the environment is correct is important,” Desai said. “Not only were they able to help another patient by giving them a kidney that would have otherwise been discarded, but, also, it could be argued that if treatments are adequately done for patients who have FSGS, and you can make (33)the correct environment in that patient, the damage that occurs is reversible.” [C]

Gallon said he hopes that with the success of the procedure, kidneys that would have otherwise been thought to be no longer any good to transplant might become available for the more than 90,000 Americans awaiting a new kidney. “In this day and age, we cannot make a kidney. We cannot make a heart or a liver. We have to rely on a donor to save somebody else's life,” Gallon said. “If it doesn't make a difference on a large scale, that's OK, but I think it's quite important to do this sort of approach so that we don't waste even one organ.”

Though he was forced to go back on ^*5dialysis because his body rejected the kidney, Fearing hopes another chance for a new kidney will come in time. For now, he said, he's content (    24    ) the idea that his trial might one day lead to advancements in the treatment of his disease. “The one thing that makes me happy is that this is considered a breakthrough that they learned about my disease and kidneys in general from this experience,” Fearing said. Being a part of that lessens the difficulties that I went through because I now know that what I went through will mean something to so many other people.” [D]

• *1kidney 腎臓
• *2 scar 疵痕きずあと
• *3 blood vessel 血管
• *4 compatible 適合性のある
• *5 dialysis 透析

• 問14 空所(    14    )に入れるのに最も適切な語を(a)～(d)の中から1つ選びなさい。
  • (a) on
  • (b) from
  • (c) for
  • (d)with
• 問15 下線部(15)のitが示すものを(a)～(d)の中から１つ選びなさい。
  • (a) the first biopsy of the kidney
  • (b) the action of the kidney
  • (c) protein in the kidney
  • (d) Fearing's disease of the kidney
• 問16 下線部(16)と文法的に同じ使い方のorを含む文を(a)～(d)の中から1つ選びなさい。
  • (a) His wife, or his better half, does allot the cooking.
  • (b) He is wrong or I am.
  • (c) Put your coat on, or you'll catch cold.
  • (d) Rain or shine, I'll go.
• 問17 下線部(17)の語を並べかえて意味の通る文にする場合に、4番目に来る語を(a)～(d)の中から1つ選びなさい。
  • (a) filter
  • (b) unable
  • (c) it
  • (d) to
• 問18 空所(    18    )に入れるのに最も適切なものを(a)～(d)の中から1つ選びなさい。
  • (a) back up
  • (b) act out
  • (c) turn out
  • (d) line up
• 問19 空所(    19    )に入れるのに最も適切なものを(a)～(d)の中から1つ選びなさい。
  • (a) falls back on
  • (b) puts off
  • (c) drops in on
  • (d) takes place in
• 問20 空所(    20    )に入れるのに最も適切な語を(a)～(d)の中から1つ選びなさい。
  • (a) with
  • (b) for
  • (c) as
  • (d) on
• 問21 空所(    21    )に入れるのに最も適切なものを(a)～(d)の中から1つ選びなさい。
  • (a) 67 year-old
  • (b) 67-years-old
  • (c) 67-years old
  • (d) 67-year-old
• 問22 空所(    22    )に入れるのに最も適切な語を(a)～(d)の中から1つ選びなさい。
  • (a) move
  • (b) work
  • (c) transplant
  • (d) remove
• 問23 空所(    23    )に入れるのに最も適切な語を(a)～(d)の中から1つ選びなさい。
  • (a) from
  • (b) on
  • (c) away
  • (d) with
• 問24 空所(    24    )に入れるのに最も適切な語を(a)～(d)の中から1つ選びなさい。
  • (a) at
  • (b) for
  • (c) by
  • (d) with
• 問25 本文中の[A]～[D]のいずれかに、英文He continued that he didn't want this to be wasted and it was just not an option to throw it outを入れるのに最も適切なものを(a)～(d)の中から1つ選びなさい。
  • (a) [A]
  • (b) [B]
  • (c) [C]
  • (d) [D]

問26～問35について、本文の内容に一致する最も適切なものを(a)～(d)の中から1つずつ選びなさい。

• 問26 In what condition was Fearing when he was first told of his illness ?
  • (a) He had so many choices to treat his condition.
  • (b) He had no choice except a transplant.
  • (c) He needed to begin drug therapy.
  • (d) He was put on a list for a transplant.
• 問27 Who gave Fearing a kidney?
  • (a) the staff coordinating organs
  • (b) his younger sister
  • (c) an unfamiliar person
  • (d) his elder sister
• 問28 What percentage of Fearing's kidney function was lost in one or two years?
  • (a) 27%
  • (b) 20%
  • (c) 13%
  • (d) 7%
• 問29 What did Fearing decide to do after the rejection of his transplanted organ?
  • (a) He decided to wait for his kidney's recovery.
  • (b) He decided to have a second operation to repair his kidney.
  • (c) He decided to donate his new kidney to another.
  • (d) He decided to publish his case in a medical journal.
• 問30 Who was the last recipient of Fearing's kidney?
  • (a) a young surgeon
  • (b) a man who had five children
  • (c) a medical expert who retired
  • (d) his sister
• 問31 What was the most important point of Fearing's case?
  • (a) One recipient could be alive.
  • (b) It changed the idea that a transplanted organ was not acceptable for reuse.
  • (c) It indicated that dialysis would not be an option after surgery.
  • (d) FSGS was no longer a serious disease.
• 問32 What was Dr. Gallon's “plan of attack”?
  • (a) to limit the length of the organ's blood vessels
  • (b) to reconstruct blood vessels from deceased organ donors
  • (c) to have more doctors take part in the procedure
  • (d) to remove blood vessels from Mr. Fearing
• 問33 In this article, what does “the correct environment” mean?
  • (a) retransplantation
  • (b) a clean hospital
  • (c) blood-type compatible blood vessels
  • (d) a properly functioning body
• 問34 How did Fearing feel after his experience?
  • (a) He felt disappointed to have to return to dialysis.
  • (b) He felt satisfied to be able to have contributed to medical progress.
  • (c) He felt disturbed that his disease would gradually get worse.
  • (d) He felt delighted that the organ was not immediately discarded.
• 問35 If you give a title to this article, which is the most suitable?
  • (a) The Third Chance for One Kidney
  • (b) The Difficulties of a Transplant
  • (c) A Marvelous Surgery on a Kidney
  • (d) A Miracle of the Kidney