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대한이식학회> 대한이식학회지> 「장기등 이식에 관한 법률」 개정을 위한 입법적 쟁점

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「장기등 이식에 관한 법률」 개정을 위한 입법적 쟁점

Legislative Issues Regarding Transplant Act

김휘원 ( Hwi Won Kim ) , 김현철 ( Hyeon Cheol Kim )
  • : 대한이식학회
  • : 대한이식학회지 31권2호
  • : 연속간행물
  • : 2017년 06월
  • : 68-74(7pages)

DOI


목차

장기이식법에 의한 이식 체계의 확립과 그 공과
개정의 필요성
개정의 방향
개정될 주요 쟁점
결 론
REFERENCES

키워드 보기


초록 보기


						
The Korean Transplant Act has been revised five times since 1999, and each revision has resulted in a slight donation rate increased; however, the organ shortage had not been solved. As a result, further revision of the Transplant Act is needed. The current focuses solely on efficiency for transplantation. Therefore, this study suggests a paradigm shift in the revision of the act through the virtuous cycle for activating donation; namely, from an efficiency-based transplant system to a donor-centered transplant system.

ECN

I410-ECN-0102-2018-500-000574114


UCI

I410-ECN-0102-2018-500-000574114

간행물정보

  • : 의약학분야  > 병리학
  • : KCI 등재
  • : -
  • : 계간
  • : 1598-1711
  • :
  • : 학술지
  • : 연속간행물
  • : 1987-2018
  • : 949


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발행기관 최신논문
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1뇌사자신장이식에서 KONOS의 경계공여자 기준의 개선을 위한 다기관 연구 수행의 타당성을 평가하기 위한 예비연구

저자 : 허우성 ( Wooseong Huh )

발행기관 : 대한이식학회 간행물 : 대한이식학회지 31권 2호 발행 연도 : 2017 페이지 : pp. 59-67 (9 pages)

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Background: The Korean Network for Organ Sharing (KONOS), which was established in December 31st, 1999, is a nationwide system of deceased donor detection and distribution. From its inception, KONOS has defined marginal donors and used this definition for over 15 years. However, this definition should be reevaluated to determine if it requires revision. This study was conducted to confirm the feasibility of the main study for revision of the marginal donor definition in deceased donor kidney transplantation.
Methods: This study is a retrospective meta-analysis of 786 patients who had deceased donor kidney transplant from six centers. After the data validation process, multivariable analysis was conducted to evaluate whether the marginal donor criteria of KONOS or UNOS expected adequately in terms of graft survival and delayed graft function (DGF).
Results: Neither the KONOS or UNOS criteria affected graft survival. Expanded criteria for donors of UNOS was a risk factor for DGF. However, KONOS criteria did not affect DGF.
Conclusions: Based on this preliminary study, there is a need to conduct a study to revise the marginal donor criteria of KONOS in deceased donor kidney transplantation. Such a study should have large scale and long-term follow-up data.

2「장기등 이식에 관한 법률」 개정을 위한 입법적 쟁점

저자 : 김휘원 ( Hwi Won Kim ) , 김현철 ( Hyeon Cheol Kim )

발행기관 : 대한이식학회 간행물 : 대한이식학회지 31권 2호 발행 연도 : 2017 페이지 : pp. 68-74 (7 pages)

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(기관인증 필요)

초록보기

The Korean Transplant Act has been revised five times since 1999, and each revision has resulted in a slight donation rate increased; however, the organ shortage had not been solved. As a result, further revision of the Transplant Act is needed. The current focuses solely on efficiency for transplantation. Therefore, this study suggests a paradigm shift in the revision of the act through the virtuous cycle for activating donation; namely, from an efficiency-based transplant system to a donor-centered transplant system.

3A Case Treated with Extracorporeal Membrane Oxygenation for Disseminated Cytomegalovirus Infection after Liver Transplantation

저자 : Jimyung Park , Yoon Hyun Lee , Young Rok Choi , Yeon Joo Lee , Dong Jung Kim , Sanghoon Jheon , Young-jae Cho

발행기관 : 대한이식학회 간행물 : 대한이식학회지 31권 2호 발행 연도 : 2017 페이지 : pp. 75-81 (7 pages)

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Cytomegalovirus (CMV) is a clinically important pathogen in immunocompromised patients, especially after organ transplantation. However, there have been several reports of severe CMV infections in immunocompetent patients. This report presents a case of an immunocompetent patient who presented with fulminant hepatitis requiring liver transplantation. Because CMV was detected upon histopathologic review of the explanted liver, it was later assumed that CMV may be the primary cause of hepatitis. However, at the time of transplantation, we did not suspect CMV hepatitis. Following transplantation and initiation of immunosuppression, the patient developed viral sepsis with a disseminated CMV infection. Respiratory failure because of CMV pneumonia worsened despite antiviral therapy, and venovenous extracorporeal membrane oxygenation (ECMO) was initiated. Although ECMO has been traditionally contraindicated in patients with sepsis, this patient recovered and was successfully weaned off ECMO. CMV should be included in the differential diagnosis of fulminant hepatitis, even in immunocompetent patients, especially when liver transplantation is considered.

4Lessons Learned from Inappropriate Ligation of the Left Renal Vein for a Large Splenorenal Shunt in Living Donor Liver Transplantation

저자 : Young Seok Han

발행기관 : 대한이식학회 간행물 : 대한이식학회지 31권 2호 발행 연도 : 2017 페이지 : pp. 82-86 (5 pages)

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During living donor liver transplantation, a large spontaneous splenorenal shunt (SRS) should be addressed to obtain adequate portal inflow. Various procedures such as direct ligation of the SRS, splenectomy, left renal vein ligation (LRVL), and renoportal anastomosis can be applied to treat a large SRS according to the hemodynamics of the portal flow and anatomic conditions. Of these surgical procedures, LRVL is a simple and effective solution for treatment of a large SRS. However, to perform a LRVL, rigorous evaluation of the recipient`s anatomic and hemodynamic variations is mandatory. In the present case, we ligated the left renal vein to treat a large SRS, which resulted in an unexpected thrombosis of the left renal vein and remaining portal vein stenosis in the SRS. Therefore, we revised our decisions regarding whether the LRVL was properly applied.

5Late Onset Renal Vein Thrombosis after Kidney Transplantation

저자 : Woo Yeong Park , Seong Sik Kang , Kyubok Jin , Sung Bae Park , Seungyeup Han

발행기관 : 대한이식학회 간행물 : 대한이식학회지 31권 2호 발행 연도 : 2017 페이지 : pp. 87-90 (4 pages)

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Renal vein thrombosis is a rare but serious cause of graft loss in kidney transplant recipients that is usually associated with early surgical complications. Here, we report a rare case of sudden development of late onset renal vein thrombosis after kidney transplantation. A 32-year-old man underwent deceased kidney transplantation 2 years prior. Oliguria and pain suddenly developed at the allograft site along with an elevated serum creatinine level. Doppler ultrasound showed absence of venous flow in the transplanted kidney. Magnetic resonance imaging showed thrombosis from the allograft vein to the anastomosis with the left common iliac vein and a swollen allograft kidney. The patient underwent anticoagulation with unfractionated heparin and warfarin. Serum creatinine normalized and renal vein thrombosis disappeared after 3 months of treatment. Late-onset renal vein thrombosis is rare; however, early detection and treatment are very important to restore renal allograft function.

6Combined Heart and Liver Transplantation: The Asan Medical Center Experience

저자 : Hyo-in Choi , Tae-jin Yun , Sung-ho Jung , Jae Won Lee , Gi-won Song , Sung-gyu Lee , Kyung Mo Kim , Jae-joong Kim

발행기관 : 대한이식학회 간행물 : 대한이식학회지 31권 2호 발행 연도 : 2017 페이지 : pp. 91-98 (8 pages)

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Combined heart-liver transplantation (CHLT) is an increasingly accepted treatment for select patients with advanced heart and liver disease. However, CHLT are infrequently performed, despite growing optimism about their effectiveness. Here, we report Asan Medical Center experience with CHLT in three patients presenting with advanced heart and liver failure. One patient died of brain swelling because of intractable hyperammonemia on postoperative day 9. The two other patients were still alive at 53 and 9 months postsurgery. None of these patients required readmission for cardiac or hepatic graft dysfunction and no rejection episodes were detected on routine cardiac biopsies. This is the first report of CHLT cases from Korea.

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