• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.395-406
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• 2013

Purpose: This study was aimed to investigate the relationship between the level of stress and the quality of life among the adult recipients of living donor liver transplantation. Methods: Participants were 213 outpatients who received living donor liver transplantation at least 3 months prior to this study. Stress was measured using a modified version of the Kidney Transplant Recipient Stressor Scale (KTRSS), and the quality of life was measured using SF-36 version 2. Results: The mean of scaled stress level and quality of life of liver transplant recipients were $2.44{\pm}0.13$, $69.28{\pm}18.25$, respectively. There was an inverse correlation between those two parameters. Therefore lower stress could improve quality of life. Conclusion: For the liver transplantation recipients, improving the quality of life is to be the ultimate goal of health-related mediation. Liver transplantation recipients would need to cultivate self-care ability to manage stress, and improving their quality of life.

• The Journal of the Korea Contents Association
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• v.5 no.5
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• pp.305-305
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• 2005

In modern society, diseases are variously found. Also, disease can be fatal once starting attack or one misses the proper medical examination time. According to the development of society, our liver settled on exhausted status which causes high disease development ratio because of excess business, smoking and drinking. Especially liver related disease cannot be recovered, therefore it depends on internal organ transplant surgery. In this paper, calculate volume from rendered liver shape using 3-dimensional image processing method and we develop an image processing method for the image acquired by MDCT, that can simulate incision line decision according to blood vessel segmentation that can be used on liver transplant operation. Simulation results which adopt automatic liver segment abstraction algorithm show that it can help surgical operation.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.462-469
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• 2019

Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was $61.0{\pm}8.3years\;old$, with a mean body mass index of $28.4{\pm}4.8kg/m^2$, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of $28.7{\pm}22.8months$. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.

• Korean Journal of Clinical Pharmacy
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• v.18 no.1
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• pp.60-67
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• 2008

This study aimed to compare a microparticle enzyme immunoassay (MEIA) with a liquid chromatography-tandem mass spectrometry (LC/MS/MS) technique for the measurement of tacrolimus concentrations in adult liver transplant recipients, to investigate how the assay choice influenced the population pharmacokinetics of tacrolimus and to identify patient characteristics that affected pharmacokinetic parameters in each assay. Tacrolimus concentrations from 29 liver (n=52 paired-samples) transplant recipients measured by both MEIA and LC/MS/MS were used to evaluate the performance of these methods in the clinical setting. Tacrolimus pharmacokinetics was studied independently using MEIA and LC/MS/MS data in 70 adult patients using a population approach performed with NONMEM. Patient characteristics which influenced pharmacokinetic parameters in each assay were compared. The relation between LC/MS/MS and MEIA measurements was best described by the regression equation MEIA=1.465*LC/MS/MS-1.336 (r=0.91). Multiple linear regression analysis showed significant inverse relationships between assay difference and hematocrit (Hct) (p<0.025) in liver graft recipients. In MEIA, the population estimate of tacrolimus CL/F and apparent volume of distribution (Vd/F) were found to be 10.1 L/h and 226 L, and in LC/MS/MS, 13 L/h and 305 L respectively. Neither patient's age, weight, gender, grafted hepatic weight, albumin concentration, nor markers of liver function influenced tacrolimus CL/F The final model of CL/F was found to be 10.1+(Hct/Hct mean)$^{12.0}$ in MEIA and 13+(1+Hct/578) in LC/MS/MS indicating that CL/F was influenced by hematocrit.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.2
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• pp.238-247
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• 2024

Backgrounds/Aims: Prolonged use of steroids after liver transplantation (LT) significantly increases the risk of diabetes or cardiovascular disease, which can adversely affect patient outcomes. Our study evaluated the effectiveness and safety of early steroid withdrawal within the first year following LT. Methods: This study was conducted as an open-label, multicenter, randomized controlled trial. Liver transplant recipients were randomly assigned to one of the following two groups: Group 1, in which steroids were withdrawn two weeks posttransplantation, and Group 2, in which steroids were withdrawn three months posttransplantation. This study included participants aged 20 to 70 years who were scheduled to undergo a single-organ liver transplant from a living or deceased donor at one of the four participating centers. Results: Between November 2012 and August 2020, 115 patients were selected and randomized into two groups, with 60 in Group 1 and 55 in Group 2. The incidence of new-onset diabetes after transplantation (NODAT) was notably higher in Group 1 (32.4%) than in Group 2 (10.0%) in the per-protocol set. Although biopsy-proven acute rejection, graft failure, and mortality did not occur, the median tacrolimus trough level/dose/weight in Group 1 exceeded that in Group 2. No significant differences in safety parameters, such as infection and recurrence of hepatocellular carcinoma, were observed between the two groups. Conclusions: The present study did not find a significant reduction in the incidence of NODAT in the early steroid withdrawal group. Our study suggests that steroid withdrawal three months posttransplantation is a standard and safe immunosuppressive strategy for LT patients.

• Journal of Korean Biological Nursing Science
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• v.15 no.4
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• pp.193-201
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• 2013

Purpose: The purpose of the study was to evaluate the effect of the immediate postoperative nutritional status and calorie adequacy on clinical outcomes in liver transplant recipients. Methods: A total number of 99 patients who received liver transplants were recruited from a tertiary university hospital. Demography, subjective global assessment, clinical outcomes and calorie adequacy were evaluated through personal interviews, electronic medical records and dietary records. Anthropometric measures, body mass index and percent of ideal body weight were also obtained. Results: At admission to the Surgical Intensive Care Unit (SICU), the triceps skinfold thickness and mid-arm muscle circumference were significantly lower in the malnourished group than in the well-nourished group (p<.05, respectively). In the clinical outcomes, transfusion of red blood cells, mechanically ventilated hours, length of stay in the Intensive Care Unit (ICU), length of stay in the hospital, and prothrombin time were significantly higher in the malnourished group than in the well-nourished group (p<.05, respectively). The mechanically ventilated hour was significantly higher in the group with less than 50% of their required energy intake (p<.05). Conclusion: Therefore, it is important to assess the nutritional status of immediate postoperative patients. Furthermore, studies on nutritional interventions are urgently needed to provide adequate nutritional care for patients in ICUs.

• Korean Journal of Adult Nursing
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• v.24 no.3
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• pp.284-293
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• 2012

Purpose: The aim of this study was to compare the levels of anxiety, depression, and quality of life (QOL) among kidney or liver transplant candidates and recipients. Methods: A cross-sectional descriptive design was utilized. The 160 subjects were recruited and assigned to three different conditions: awaiting transplant group; post-transplantation (TPL) group within less than one year of surgery; and post-TPL group with one year and no more than two years post surgery. The levels of anxiety and depression were measured by the Hospital Anxiety and Depression Scale. The level of quality of life was measured by the Medical Outcomes Study Short Form-36 version 2. Results: The anxiety score was significantly higher in the waiting group compared with the 1~2 years post TPL group. The depression score was significantly higher in the waiting group compared with the post TPL groups. The QOL was significantly lower in the waiting group compared with the post TPL groups. Conclusion: Our results show a high prevalence of anxiety and depression and a marked reduction in the QOL in transplant candidates compared to the recipients. This study indicates that the group waiting for transplants may have unmet needs during that time period. Health professionals should be encouraged to attend to the psychological distress of the transplant candidates in order to improve their quality of life.

• IMMUNE NETWORK
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• v.22 no.3
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• pp.24.1-24.12
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• 2022

Coronavirus disease 2019 (COVID-19) vaccination in immunocompromised, especially transplant recipients, may induce a weaker immune response. But there are limited data on the immune response after COVID-19 vaccination in liver transplant (LT) recipients, especially on the comparison of Ab responses after different vaccine platforms between mRNA and adenoviral vector vaccines. Thus, we conducted a prospective study on LT recipients who received two doses of the ChAdOx1 nCoV-19 (ChAdOx1), mRNA-1273, or BNT162b2 vaccines compared with healthy healthcare workers (HCWs). SARS-CoV-2 S1-specific IgG Ab titers were measured using ELISA. Overall, 89 LT recipients (ChAdOx1, n=16 [18%]) or mRNA vaccines (mRNA-1273 vaccine, n=23 [26%]; BNT162b2 vaccine, n=50 [56%]) received 3 different vaccines. Of them, 16 (18%) had a positive Ab response after one dose of COVID-19 vaccine and 62 (73%) after 2 doses. However, the median Ab titer after two doses of mRNA vaccines was significantly higher (44.6 IU/ml) than after two doses of ChAdOx1 (19.2 IU/ml, p=0.04). The longer time interval from transplantation was significantly associated with high Ab titers after two doses of vaccine (p=0.003). However, mycophenolic acid use was not associated with Ab titers (p=0.53). In conclusion, about 3-quarters of LT recipients had a positive Ab response after 2 doses of vaccine, and the mRNA vaccines induced higher Ab responses than the ChAdOx1 vaccine.

• Journal of Yeungnam Medical Science
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• v.37 no.1
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• pp.2-12
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• 2020

Drug-induced liver injury (DILI), including herbal and dietary supplement hepatotoxicity, is often passed lightly; however, it can lead to the requirement of a liver transplant or may even cause death because of liver failure. Recently, the American College of Gastroenterology, Chinese Society of Hepatology and European Association for the Study of the Liver guidelines for the diagnosis and treatment of DILI have been established, and they will be helpful for guiding clinical treatment decisions. Roussel Uclaf Causality Assessment Method scoring is the most commonly used method to diagnose DILI; however, it has some limitations, such as poor validity and reproducibility. Recently, studies on new biomarkers have been actively carried out, which will help diagnose DILI and predict the prognosis of DILI. It is expected that the development of new therapies such as autophagy inducers and various other technologies of the fourth industrial revolution will be applicable to DILI research.

• Transactions on Electrical and Electronic Materials
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• v.16 no.1
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• pp.25-28
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• 2015

In this study, a basic research on artificial liver was performed for its application to people on the waiting list of liver transplant or patients with hepatic insufficiency. Artificial livers are generally classified into mechanic type, bioartificial type, and hybrid type. An extracorporeal circulation device was examined herein, which is indispensable in the application of an artificial liver, for its effectiveness in supporting the recovery of liver functions. Extracorporeal circulation system is a treatment and life-support system which sends out the patient's blood, removes toxicity by various methods, and then sends the blood back to the interior of the body. This study used an extracorporeal circulation system which enables the Plasma Perfusion by CVVH method, and applied the program of Bioateco corp. Animals with acute hepatic insufficiency were produced to apply the extracorporeal circulation device. As a result, their ammonia, bilirubin, SGOT, SGPT, and bile acid levels rose, confirming the liver function restoration in the experimental animals.