간행물

대한이식학회> 대한이식학회지

대한이식학회지 update

Korean Journal of Transplantation

  • : 대한이식학회
  • : 의약학분야  >  병리학
  • : KCI등재
  • :
  • : 연속간행물
  • : 계간
  • : 2671-8790
  • : 2671-8804
  • :

수록정보
수록범위 : 1권1호(1987)~35권3호(2021) |수록논문 수 : 1,249
대한이식학회지
35권3호(2021년 09월) 수록논문
최근 권호 논문
| | | |

KCI등재

1Improving self-sufficiency in organ transplantation in Korea

저자 : Curie Ahn , Samuel Lee , Yeong Hoon Kim , Jieun Oh , Ik Jin Yun , Hyung Joon Ahn , Soo Hyun Seo , Jong Cheol Jeong , Myung Soo Kim , Jongwon Ha , Soon Il Kim , In Sung Moon , Won Hyun Cho

발행기관 : 대한이식학회 간행물 : 대한이식학회지 35권 3호 발행 연도 : 2021 페이지 : pp. 137-142 (6 pages)

다운로드

(기관인증 필요)

초록보기

After attaining a qualified medical capacity in organ transplantation, Korea has been struggling to increase the number of deceased organ transplants to reach self-sufficiency. As one of these efforts, Korea revised the organ transplantation law in 2010 by adding three articles the mandatory reporting based on the recommendation of the 3rd Global Consultation on Organ Transplantation of Madrid in 2010. Along with the new constitution, considerable efforts have been initiated to upgrade the deceased organ transplantation system while maintaining the virtues of fairness, justice, and transparency. The Korean Society of Transplantation played a critical role in revising the law as well as in establishing organizations such as the Korean Organ Donation Agency (KODA; 2009), the Vitallink (2009), and the Korean Organ Transplantation Registry (KOTRY; 2010). By the activities of these professional organizations, Korea could implement fundamental programs such as mandatory reporting and could develop various education programs for organ donation for students and the general population. As a result, the number of deceased donors increased from 1.08 p.m.p. (2000) to 9.23 p.m.p.(2020). Further efforts are needed to increase the number of organ donor cardholders and family consent rates by well-designed, target-specific education programs to overcome traditional negative cultural barriers toward organ donation. The community atmosphere of honoring and thanking donors and their families should be nurtured by national and regional activities of life-sharing weeks linked with organ donor memorial parks.

KCI등재

2Insights and pearls of healthcare systems management of COVID-19 in Asia and its relevance to Asian transplant services

저자 : Terence Kee

발행기관 : 대한이식학회 간행물 : 대한이식학회지 35권 3호 발행 연도 : 2021 페이지 : pp. 143-148 (6 pages)

다운로드

(기관인증 필요)

초록보기

Asia is now the new epicenter of the coronavirus disease 2019 (COVID-19) pandemic, yet mortality rates remain among the lowest in the world. This review paper summarizes key findings from the literature in Asia on how healthcare systems, including transplant programs, have developed innovative solutions and countermeasures to mitigate the adverse impact of the COVID-19 pandemic. A review of literature using PubMed was performed, where only publications addressing COVID-19 and healthcare systems from Asia were selected. Whenever possible, the impact of COVID-19 and the countermeasure responses from transplant healthcare systems were highlighted in these publications. Transplantation in Asia has been affected to varying degrees, although many Asian countries have continued transplantation while adopting defenses that have resulted in a low COVID-19 incidence rate among transplant recipients. These defenses include protected pathways for patients, surveillance through protocol screening for COVID-19, team and infrastructure segregation, adoption of telemedicine, and patient outreach and education. Transplant healthcare systems in Asia have been effective at varying levels of success during the COVID-19 pandemic. As the pandemic continues, transplant healthcare systems must develop operational frameworks to sustain transplant activity in the new normal.

KCI등재

3Impact of delayed graft function on clinical outcomes in highly sensitized patients after deceased-donor kidney transplantation

저자 : Seong Gyu Kim , Suyeon Hong , Hanbi Lee , Sang Hun Eum , Young Soo Kim , Kyubok Jin , Seungyeop Han , Chul Woo Yang , Woo Yeong Park , Byung Ha Chung

발행기관 : 대한이식학회 간행물 : 대한이식학회지 35권 3호 발행 연도 : 2021 페이지 : pp. 149-160 (12 pages)

다운로드

(기관인증 필요)

초록보기

Background: We investigated whether the development of delayed graft function (DGF) in pre-sensitized patients affects the clinical outcomes after deceased-donor kidney transplantation (DDKT).
Methods: The study included 709 kidney transplant recipients (KTRs) from three transplant centers. We divided KTRs into four subgroups (highly sensitized DGF, highly sensitized non-DGF, low-sensitized DGF, and low-sensitized non-DGF) according to panel reactive antibody level of 50%, or DGF development. We compared post-transplant clinical outcomes among the four subgroups.
Results: Incidence of biopsy-proven acute rejection (BPAR) was higher in two highly sensitized subgroups than in low-sensitized subgroups. It tended to be higher in highly sensitized DGF subgroups than in the highly sensitized non-DGF subgroups. In addition, the highly sensitized DGF subgroup showed the highest risk for BPAR (hazard ratio, 3.051; P=0.005) and independently predicted BPAR. Allograft function was lower in the two DGF subgroups than in the non-DGF subgroup until one month after transplantation, but thereafter it was similar. Death-censored graft loss rates and patient mortality tended to be low when DGF developed, but it did not reach statistical significance.
Conclusions: DGF development in highly sensitized patients increases the risk for BPAR in DDKT compared with patients without DGF, suggesting the need for strict monitoring and management of such cases.

KCI등재

4Use of minor donors for living donor liver transplantation and associated ethical issues

저자 : Shin Hwang , Gi-won Song , Dong-hwan Jung , Tae-yong Ha , Gil-chun Park , Chul-soo Ahn , Deok-bog Moon , Sung-gyu Lee

발행기관 : 대한이식학회 간행물 : 대한이식학회지 35권 3호 발행 연도 : 2021 페이지 : pp. 161-167 (7 pages)

다운로드

(기관인증 필요)

초록보기

Background: Living liver donation by minors is regarded as justifiable only if minors possess the capacity to consent to donation and the procedure is in their best interests. This study analyzed the incidence of and reasons for living donor liver transplantation (LDLT) by minor donors in Korea, and discussed ethical issues regarding liver donation by minors.
Methods: The databases of the Korean Network for Organ Sharing (KONOS) and Asan Medical Center (AMC) from 2010 to 2019 were retrospectively reviewed to determine the incidence of LDLT by minor donors.
Results: From 2010 to 2019, 590 (4.1%) of 14,243 liver donors in the KONOS database and 276 (7.5%) of 3,401 liver donors in the AMC database were minors. The proportions of minor donors in the KONOS and AMC databases were highest in 2012, at 4.1% and 12.6%, respectively, and lowest in 2019, at 1.1% and 3.0%, respectively. Because most LDLT recipients had relatively low model for end-stage liver disease scores and hepatocellular carcinoma, they were unlikely candidates for deceased-donor liver transplantation and were highly likely to drop out of LDLT if they waited for 1-2 years. The donor-recipient relationship of minor donors in the AMC database was first-degree in 256 (92.8%) and second- or third-degree in 20 (7.2%).
Conclusions: Liver donation by minors is limitedly acceptable only when the minor proves informed, well-considered, and autonomous consent to the procedure and the procedure is in the minor's best interests. We suggest that minors be allowed to donate only to first-degree family members.

KCI등재

5Efficacy and safety of a switch from twicedaily tacrolimus to once-daily generic tacrolimus in stable liver transplant patients

저자 : Jong Man Kim , Pyoung-jae Park , Geun Hong , Dong Jin Joo , Kwan Woo Kim , Je Ho Ryu , Young Seok Han , Jai Young Cho , Gi-won Song , Bong-wan Kim , Dong-sik Kim , Seong Hoon Kim , Sang Tae Choi , Young

발행기관 : 대한이식학회 간행물 : 대한이식학회지 35권 3호 발행 연도 : 2021 페이지 : pp. 168-176 (9 pages)

다운로드

(기관인증 필요)

초록보기

Background: Once-daily tacrolimus reduces non-compliance relative to twice-daily tacrolimus. However, little is known about the safety and efficacy of conversion from twice-daily tacrolimus to generic once-daily tacrolimus in liver transplantation (LT). Herein, we investigated the efficacy and safety of a switch from twice-daily tacrolimus to generic once-daily tacrolimus in patients with stable liver graft function.
Methods: This prospective, multicenter, open-label, single-arm study was conducted in 17 medical centers for 1 year from July 2019 to July 2020 (NCT04069065). Primary endpoint was the incidence of biopsy-proven acute rejection (BPAR) for 24 weeks after conversion. Secondary endpoints were graft failure, patient death, and adverse events (AEs).
Results: Of 151 screened LT patients, 144 patients were enrolled. BPAR, graft failure, and patient death did not occur in this patient population. There were no statistical differences in blood tests, liver function tests, or biochemical tests between visits in any of the patients. Median tacrolimus trough level decreased abruptly from 4.7 ng/mL to 3.2 ng/mL after generic once-daily tacrolimus conversion, but median tacrolimus dose increased due to low tacrolimus trough level. Ninety-two adverse events occurred in 54 patients. Liver enzyme levels increased in seven patients (4.9%) after the switch to generic once-daily tacrolimus, but the liver function tests of these patients normalized thereafter. There were three cases of severe AEs not related to investigational drug.
Conclusions: Present study suggests that conversion from twice-daily tacrolimus to generic once-daily tacrolimus is effective and safe in stable LT patients.

KCI등재

6Indications and outcomes of liver transplantation for post-Kasai biliary atresia in young adults

저자 : Jung-man Namgoong , Shin Hwang , Chul-soo Ahn , Deok-bog Moon , Tae-yong Ha , Gi-won Song , Dong-hwan Jung , Gil-chun Park , Young-in Yoon , Kyung Mo Kim , Sung-gyu Lee

발행기관 : 대한이식학회 간행물 : 대한이식학회지 35권 3호 발행 연도 : 2021 페이지 : pp. 177-182 (6 pages)

다운로드

(기관인증 필요)

초록보기

Background: Some young adults have a long survival period with native liver after Kasai portoenterostomy (KPE) for biliary atresia (BA). However, a considerable proportion of these patients require liver transplantation (LT). This study aimed to analyze the indications and outcomes of LT in young adults after a long survival period with native liver after KPE.
Methods: We selected seven patients who were 18 years or older at the time of LT out of 116 BA patients who underwent primary LT from 2008 to 2019 at Asan Medical Center.
Results: The mean ages at KPE and LT were 2.1±0.9 months and 22.0±5.1 years, respectively. Mean serum total bilirubin level and model for end-stage liver disease score at LT were 7.91±7.22 mg/dL and 15.3±6.0, respectively. The main reasons for LT were liver cirrhosis with portal hypertension-associated complications in five patients and intractable cholangitis in two patients. There were five cases of living donor LT and two cases of deceased donor LT. All the seven patients are currently alive during the mean follow-up period of 74.7±40.9 months. One patient suffered from outflow graft vein obstruction requiring endovascular stenting. Another patient showed core antibody-positivity-induced de novo hepatitis B virus infection, which was well managed with antiviral therapy.
Conclusions: Young adult patients with BA are a unique group of patients requiring specialist care regarding transition from pediatric to adult services. The outcomes of LT in young adult BA patients were excellent. Therefore, LT should be considered in patients showing serious BA-associated complications.

KCI등재

7Hepatic artery reconstruction using interposition of autologous saphenous vein conduit for living donor liver transplantation: a case report

저자 : Deok-bog Moon , Shin Hwang , Dong-hwan Jung , Chul-soo Ahn , Gil-chun Park , Tae-yong Ha , Gi-won Song , Young-in Yoon , Sung-gyu Lee

발행기관 : 대한이식학회 간행물 : 대한이식학회지 35권 3호 발행 연도 : 2021 페이지 : pp. 183-188 (6 pages)

다운로드

(기관인증 필요)

초록보기

We have preferentially used the right gastroepiploic artery (RGEA) as an alternative for the recipient hepatic artery (HA) inflow during living donor liver transplantation (LDLT), but it was not always available. We herein present a case of adult LDLT with HA reconstruction using a greater saphenous vein (GSV) conduit because of the absence of the RGEA due to prior subtotal gastrectomy. A 55-year-old male patient diagnosed with hepatitis B virus-associated liver cirrhosis and secondary biliary cirrhosis underwent LDLT using a modified right liver graft. The upper abdominal cavity was heavily adhered due to prior abdominal surgeries, thus we had to sacrifice the common bile duct and the right HA completely. A 6-cm-long GSV segment was harvested from the left ankle and interposed between the recipient gastroduodenal artery and the graft HA. The patient recovered from LDLT and HA complications did not occur. However, 8 years after LDLT, chronic rejection occurred, thus repeated deceased donor liver transplantation was performed. This patient has been doing well for 2 years after retransplantation. In conclusion, we suggest that interposition of an autologous GSV conduit can be an alternative for establishing HA inflow in LDLT when other inflow source is not available.

KCI등재

8Clinical sequence of an adult recipient undergone split liver transplantation using a right liver graft with erroneous deprivation of the middle hepatic vein trunk: a case report

저자 : Geunhyeok Yang , Shin Hwang , Chul-soo Ahn , Tae-yong Ha , Dong-hwan Jung

발행기관 : 대한이식학회 간행물 : 대한이식학회지 35권 3호 발행 연도 : 2021 페이지 : pp. 189-194 (6 pages)

다운로드

(기관인증 필요)

초록보기

The anatomy of middle hepatic vein (MHV) varies widely, and some individuals have aberrant MHV anatomy, thus there is risk of iatrogenic damage to graft MHV during liver splitting. We present the clinical sequences of an adult recipient who received a split right liver graft with erroneous deprivation of the MHV trunk. This is the case was a 58-year-old male patient with hepatitis B virus-associated liver cirrhosis who suffered from hepatic encephalopathy. The split right liver graft had a graft-to-recipient weight ratio of 2.1%. Soon after graft reperfusion, large-sized hepatic venous congestion (HVC) appeared at the graft liver surface, indicating lack of MHV drainage. The amount of HVC was approximately 20% of the right liver graft mass at day 1, which had gradually reduced on follow-up computed tomography (CT) scans. Although liver function recovered progressively, the patient remained bed-ridden because of pre-existing hypoxic brain damage. The patient passed away 4 years after transplantation because of pneumonia and multi-organ failure. The present case implies that there is some possibility of unrecognized damage to the graft MHV during liver splitting, suggesting the necessity of preoperative donor abdomen CT scan and preparation of intraoperative ultrasonography for easy evaluation of graft liver MHV anatomy.

KCI등재

9Selected deceased donor liver transplantation in controlled Fournier's gangrene: a case report

저자 : Byeong Gwan Noh , Nuri Lee , Byoung Chul Lee , Myunghee Yoon

발행기관 : 대한이식학회 간행물 : 대한이식학회지 35권 3호 발행 연도 : 2021 페이지 : pp. 195-199 (5 pages)

다운로드

(기관인증 필요)

초록보기

Bacterial infection represents a turning point in the natural history of cirrhosis, causing the development of acute-on-chronic liver failure. It significantly affects the outcome of patients listed for liver transplantation. We report the case of a 57-year-old man who had been regularly treated for hepatitis B virus, alcoholic liver cirrhosis, and hepatic failure. The patient was hospitalized again due to variceal bleeding and hepatic coma. He visited the emergency room with painful anal swelling, dysuria, icteric sclera, and serious abdominal distension. The painful anal swelling and necrosis progressed; thus, he was diagnosed with Fournier's gangrene. Enterococcus faecium and Candida albicans were detected in the blood. Gangrene wound debris was studied extensively. Despite appropriate antibiotic treatment, vancomycin-resistant enterococcus and C. albicans were continuously present in the blood. Wide debridement of the wound and T-colostomy were performed. After this, norepinephrine and vasopressin were used to maintain stable vital signs. It was difficult to establish a liver transplant operation. Despite repeated bleeding, bacterial infections improved with additional antibiotics. Finally, selected deceased donor liver transplantation in controlled Fournier's gangrene was successfully performed. Controlled infections may be allowed in transplantation surgery.

KCI등재

10Reusing hepatic grafts in Korea: a case report

저자 : Hye Young Kim , Byunghyun Choi , Minhwa Kim , Younjung Choi , Jeongrim Lee , Won Hyun Cho

발행기관 : 대한이식학회 간행물 : 대한이식학회지 35권 3호 발행 연도 : 2021 페이지 : pp. 200-206 (7 pages)

다운로드

(기관인증 필요)

초록보기

The shortage of donor organs has compelled transplant centers to use organs from non-standard donors. The Korean Network for Organ Sharing data showed that there were 5,804 potential recipients on the waiting list, and only 1,579 patients underwent liver transplant in 2019. Reuse of a graft that has been transplanted previously to other recipients could be an option in this situation. However, given the susceptibility of hepatic grafts to ischemic damage, their reuse must be considered extremely carefully. In this retrospective, observational study, we investigated the outcomes of six cases of hepatic graft reuse in Korea since the year 2000, from information gathered from patient medical records from ten transplant centers. Only three of the six reused hepatic grafts functioned well. Among the three successful transplants, two had minimal ischemic damage owing to a longer interval between the first and second transplants, and because they were obtained from living donors. Two of the five cadaveric transplants were successful. The outcome of reusing hepatic grafts in Korea has not been ideal. However, in patients with limited choices, it can be carefully considered, provided the graft is thoroughly checked for ischemic damage and the recipient status is ascertained.

1
권호별 보기

내가 찾은 최근 검색어

최근 열람 자료

맞춤 논문

보관함

내 보관함
공유한 보관함

1:1문의

닫기