• Title/Summary/Keyword: Living Donor

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Hepatic artery anastomosis in liver transplantation (간이식에서 간동맥 문합술)

  • Park, Myong Chul;Kim, Chee Sun;Park, Dong Ha;Pae, Nam Suk;Wang, Hee Jung;Kim, Bong Wan
    • Archives of Plastic Surgery
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    • v.36 no.1
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    • pp.33-37
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    • 2009
  • Purpose: Liver transplantation is considered as the treatment of choice in many acute and chronic liver diseases, and it is becoming more common. Since successful microscopic anastomosis of hepatic artery is a crucial requirement of successful liver transplantation, we studied and analyzed the result of hepatic artery anastomosis of liver transplantation in our liver transplantation center. Methods: 145 liver transplantations were performed between February 2005 and May 2008. Male to female ratio of the liver transplantation recipients was 3.4 : 1. Anastomosis of portal vein, hepatic vein and biliary tract was performed by the general surgeon, and anastomosis of hepatic artery was performed by the plastic surgeon under the loupe or microscopic vision. After the hepatic artery was reconstructed, anastomosed site status and flow were checked with Doppler ultrasonography intraoperatively and with contrast enhanced CT or angiography postoperatively if necessary. Results: Out of 145 liver transplantations, cadaveric liver donor was used 37 cases and living donor liver transplantation was performed 108 cases including the 2 dual donor liver transplantations. As for the baseline diseases that resulted in the liver transplantation, there were 57 cases of liver cirrhosis and hepatocellular carcinoma due to hepatitis B, taking up the greatest proportion. Single donor hepatic artery was used in 114 cases, and mean artery diameter was 2.92 mm and mean artery length was 24.25 mm. Hepatic artery was used as the recipient artery in every case except the 8 cases in which gastroepiploic artery was used as alternative. Out of 145 cases of hepatic artery anastomosis, 3 cases resulted in the thrombosis of the hepatic artery, requiring thrombectomy and re - anastomosis. In all 3 cases, thrombosis was found in left hepatic artery and there was no past history of hepatic artery chemoembolization. Conclusion: Incidence of hepatic artery thrombosis after the anastomosis of hepatic artery during liver transplantation was 2.1%, which is considered sufficiently low.

Living Related Liver Transplantation in an Infant with Neonatal Hemochromatosis

  • Choi, Shin Jie;Choi, Jong Sub;Chun, Peter;Yoo, Jung Kyung;Moon, Jin Soo;Ko, Jae Sung;Kim, Woo Sun;Kang, Gyeong Hoon;Yi, Nam-Joon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.2
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    • pp.147-151
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    • 2016
  • Neonatal hemochromatosis (NH) is a severe neonatal liver injury that is confirmed by extra-hepatic iron accumulation. Although a recent study described treating NH with exchange transfusions and intravenous immunoglobulin, liver transplantation should be considered for patients with severe liver failure that does not respond to other medical treatment. Herein, we report the case of a two-month-old female infant who presented with persistent ascites and hyperbilirubinemia. Her laboratory findings demonstrated severe coagulopathy, high indirect and direct bilirubin levels, and high ferritin levels. Abdominal magnetic resonance imaging presented low signal intensity in the liver on T2-weighted images, suggesting iron deposition. The infant was diagnosed with NH as a result of the clinical findings and after congenital infection and metabolic diseases were excluded. The infant was successfully treated with a living-donor liver transplantation. Living related liver transplantation should be considered as a treatment option for NH in infants.

Evaluation of S-Adenosyl-L-Methionine Production by Bifidobacterium bifidum BGN4

  • Kim, Ji-Youn;Suh, Joo-Won;Ji, Geun-Eog
    • Food Science and Biotechnology
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    • v.17 no.1
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    • pp.184-187
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    • 2008
  • S-Adenosyl-L-methionine (SAM) is an important metabolic intermediate in living organisms and participates in many reactions as a methyl group donor. SAM has been used as a dietary supplement and is proposed to have beneficial effects on the liver and brain. The aim of this study was to find lactic acid bacteria with high SAM-producing ability to be used as SAM enhancing probiotics. We used high performance liquid chromatography (HPLC) to quantify the amount of SAM produced, and found that Bifidobacterium bifidum BGN4 produced a significantly higher amount of SAM than other Bifidobacterium or Lactobacillus strains. The effect of various carbon and nitrogen sources on SAM production was examined. This study confirmed that Bifidobacterium may be utilized as a source of SAM in the functional food industry.

Hybrid Biomaterial of PLGA Microspheres and Hyaluronic Acid as a Potential Injectable Bulking Agent for Urologic and Dermatologic Applications

  • Cho, Eui-Ri;Kang, Sun-Woong;Kim, Byung-Soo
    • 한국생물공학회:학술대회논문집
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    • 2003.10a
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    • pp.644-647
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    • 2003
  • Materials currently used as an injectable bulking agent in the dermatologic and urologic fields revealed several drawbacks such as particles migration, inflammatory reaction, allergic reaction, rapid volume shrinkage, and necessity of a donor site. In this study, we have developed injectable biomaterial comprising poly (DL- lactide-co-glycolide)(PLGA) and hyaluronic acid gel to overcome these problems. PLGA is a biocompatible synthetic material and hyaluronic acid is a common substance found in living organisms. We examined the feasibility of injection through needle and tested biocompatibility in animal model. After transplantation, injected sites and distant organs were examined histologically to verify a new tissue formation, inflammation, and particles migrations. Injected volume was maintained approximately 80 percent for 2 months. Results demonstrated that the developed material was injectable through various gauges of needles and induced a new bulking tissue formation without serious inflammatory reaction.

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Stem Cell Biotechnology for Cell Therapy

  • LEE Dong-Ree;KIM Ha Won
    • Biomolecules & Therapeutics
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    • v.13 no.4
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    • pp.199-206
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    • 2005
  • Cell therapy (CT) is a group of techniques to treat human disorders by transplantation of cells which have been processed and propagated independent of the living body. Blood transfusion and bone marrow transplant have been the primary examples of cell therapy. With introduction of stem cell (SC) technologies, however, CT is perceived as the next generation of biologies to treat human diseases such as cancer, neurological diseases, and heart disease. Despite potential of cell therapy, insufficient guidelines have been implemented concerning safety test and regulation of cell therapy. This review addresses the safety issues to be resolved for the cell therapy, especially SC therapy, to be successfully utilized for clinical practice. Adequate donor cell screening must preceed to ensure safety in cell therapy. In terms of SC culture, controlled, standardized practices and procedures should be established. Further molecular studies should be done on SC development and differentiation to enhance safety level in cell therapy. Finally, animal model must be further installed to evaluate toxicity, new concepts, and proliferative potential of SC including alternative feeder layer of animal cells.

Pediatric Liver Transplantation (소아 간이식)

  • Lee, Sanghoon;Lee, Suk-Koo
    • Advances in pediatric surgery
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    • v.19 no.1
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    • pp.14-21
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    • 2013
  • Pediatric liver transplantation has evolved into a definite and effective therapeutic modality for various liver diseases in the pediatric patient. During the last 25 years, liver transplant outcomes in Korea have reached international standards and Korea has become the leader in living-donor liver transplantation. This review will present the cumulative outcomes of pediatric liver transplantation performed in Korea and will focus on other issues of interest involving pediatric liver transplant recipients, especially in the field of immunosuppression and post-transplant lymphoproliferative disease.

Technical Aspects of Lung Transplantation: Pediatric and Lobar Transplantation

  • Choi, Sehoon
    • Journal of Chest Surgery
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    • v.55 no.4
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    • pp.313-318
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    • 2022
  • Fewer patients undergo pediatric lung transplantation (PLT) than adult lung transplantation. Size mismatch is the key factor that limits the availability of potential donors. Every candidate for PLT is in a different scenario in terms of age, height and weight, size of structures, indications for PLT, the concomitant presence of a cardiac anomaly, and other individual-specific factors; thus, a thorough understanding of pediatric patients' medical problems is essential. Living-donor lobar lung transplantation (LDLLT) has only been performed once in Korea to date. However, since each step in the LDLLT is a well-established procedure, including intrapericardial lobectomy, lung procurement, and lobar lung transplantation, qualified surgeons and lung transplantation teams are competent to perform LDLLT in clinically necessary situations.

A case report of embryo transfer with air-transported fresh bovine embryo produced by multiple ovulation in Hanwoo

  • Sang-Yup Lee;Seong-Eun Heo;Won-Jae Lee
    • Journal of Animal Reproduction and Biotechnology
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    • v.38 no.2
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    • pp.84-88
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    • 2023
  • Because multiple ovulation embryo transfer (MOET) in cattle includes several benefits such as wide spreading of genetically superior offspring for long distance, this biotechnological method has been widely applied to Hanwoo. When the recipients are not stayed close after embryo recovery from donor, the embryos are moved to other farms via several vehicles (car, train, and airplane). However, air travel induces lesser oxygen level, increased vibration, lower air pressure, higher noise, and increased exposure of cosmic radiation to living things than ground level. It was still unknown that fresh embryos obtained from multiple ovulation of Hanwoo could maintain their fertility after being transported via air plane, the present case report introduced a clinical case of MOET in Hanwoo after shipping fresh embryos via air transportation. The donor was multi-ovulated via follicle-stimulating hormone series of injection, which was followed by a gonadotrophin-releasing hormone injection and artificial insemination twice. The embryos were recovered by the uterine flushing, packed in ministraws, transported to recipients for 6 h including 1 h air flight, and then transferred to the synchronized recipients. During pregnancy diagnosis of early gestation period, 5 of 7 recipients (71.4%) presented no heat signs and showed fetal sacs with fluid under transrectal ultrasonography. After normal gestation period, all recipients naturally delivered healthy calves (male n = 2 and female n = 3) without abortion, stillbirth, and premature birth. The present case report indicated that transportation of fresh embryos for MOET via domestic flight in Korea did not affect to their fertility.

Relationship between Early Postoperative Renal Scintigraphy and Long-term Transplant Survival (신 이식 직후 신장 스캔 소견과 이식신 장기 생존의 관계)

  • So, Young;Lee, Kang-Wook;Shin, Young-Tai;Ahn, Moon-Sang;Bae, Jin-Sun;Sul, Chong-Koo;Jung, In-Mok
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.4
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    • pp.251-257
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    • 2001
  • Purpose: We investigated the possibility of early postoperative Tc-99m DTPA scintigraphy in predicting long-term renal transplant survival. Materials and Methods: 64 living donor (LD) grafts were divided into two groups according to the graft function on early post-operative renal scintigraphy. Survival analysis was performed using Kaplan-Meier method and Cox proportional hazard model. Chi-square test was performed to evaluate the difference in the frequency of acute rejection. Results: Cumulative renal transplant survival was decreased in 11 patients with abnormal renal scintigraphy, but it was not statistically significant. Decreased graft function on early post-operative renal scintigraphy was not a predictor of long-term graft survival. The frequency of acute rejection was higher in abnormal scintigraphy group, and the difference was statistically significant. Conclusion: Decreased graft function on early post-operative renal scintigraphy has no direct effect on long-term renal transplant survival in LD transplantation. But it may have an indirect elect through increasing the frequency of acute rejection.

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Upregulation of Carbonyl Reductase 1 by Nrf2 as a Potential Therapeutic Intervention for Ischemia/Reperfusion Injury during Liver Transplantation

  • Kwon, Jae Hyun;Lee, Jooyoung;Kim, Jiye;Kirchner, Varvara A.;Jo, Yong Hwa;Miura, Takeshi;Kim, Nayoung;Song, Gi-Won;Hwang, Shin;Lee, Sung-Gyu;Yoon, Young-In;Tak, Eunyoung
    • Molecules and Cells
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    • v.42 no.9
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    • pp.672-685
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    • 2019
  • Currently, liver transplantation is the only available remedy for patients with end-stage liver disease. Conservation of transplanted liver graft is the most important issue as it directly related to patient survival. Carbonyl reductase 1 (CBR1) protects cells against oxidative stress and cell death by inactivating cellular membrane-derived lipid aldehydes. Ischemia-reperfusion (I/R) injury during living-donor liver transplantation is known to form reactive oxygen species. Thus, the objective of this study was to investigate whether CBR1 transcription might be increased during liver I/R injury and whether such increase might protect liver against I/R injury. Our results revealed that transcription factor Nrf2 could induce CBR1 transcription in liver of mice during I/R. Pre-treatment with sulforaphane, an activator of Nrf2, increased CBR1 expression, decreased liver enzymes such as aspartate aminotransferase and alanine transaminase, and reduced I/R-related pathological changes. Using oxygen-glucose deprivation and recovery model of human normal liver cell line, it was found that oxidative stress markers and lipid peroxidation products were significantly lowered in cells overexpressing CBR1. Conversely, CBR1 knockdown cells expressed elevated levels of oxidative stress proteins compared to the parental cell line. We also observed that Nrf2 and CBR1 were overexpressed during liver transplantation in clinical samples. These results suggest that CBR1 expression during liver I/R injury is regulated by transcription factor Nrf2. In addition, CBR1 can reduce free radicals and prevent lipid peroxidation. Taken together, CBR1 induction might be a therapeutic strategy for relieving liver I/R injury during liver transplantation.