• 임상간호연구
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• 제19권3호
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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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권2호
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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.

• Molecules and Cells
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• 제42권9호
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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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제6권2호
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• pp.161-166
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• 2003

목 적: 상염색체 열성 유전 질환인 윌슨병에서 이형 접합 보인자인 부모를 공여자로 생체 부분 간이식을 시행 받은 윌슨병 환아의 치료 경험을 통해 이의 치료 효과를 알아보고자 본 연구를 실시하였다. 방 법: 1994년 12월부터 2002년 3월까지 서울아산병원에서 간이식을 시행받은 75명의 소아 중 윌슨병으로 간이식을 시행 받은 7명을 대상으로 수술 전후의 간 기능과 Kayser-Fleischer ring 소실 여부 및 구리 대사에 관련된 검사 소견 등을 중점으로 의무 기록을 통해 후향적으로 분석하였다. 결 과: 전체 7명의 환자 가운데 5명은 전격성 간염, 2명은 치료에 반응하지 않는 간경변으로 간이식을 받았으며, 공여자는 모두 혈연간 즉 이형 접합 보인자인 부모들이었다. 이식 후 추적 관찰 동안 환자의 생존율은 100%이었으며, 이는 같은 기간 동안 소아 간이식 전체 환자와 대사성 간 질환으로 간이식을 받은 환아의 각각의 5년 생존율 87%, 84%보다 유의하게 높았다(p<0.05). 간이식을 받은 모든 환자는 penicillamine과 구리 제한 식이를 시행하지 않고 이들의 AST치, 총 빌리루빈치 및 프로트롬빈 시간이 정상으로 회복되었고, 추적 관찰 기간 동안 윌슨병 재발의 소견은 없었다. 그리고 혈중 ceruloplasmin치와 혈중 구리 농도는 정상으로 회복되었으며, 24시간 소변 구리 배설양도수술 후 모든 환아에서 현저한 감소를 보였다. Kayser-Fleischer ring은 추적 관찰된 5명 중 4명에서 사라졌고, 추적 관찰이 3개월로 짧았던 한 명에서는 감소되었으나 남아 있었다. 결 론: 윌슨병이 내과적인 약물 치료에 반응하지 않는 간경변으로 진행하거나 전격성 간염으로 발현하여 간이식이 필요한 경우 윌슨병의 이형 접합 보인자인 부모를 이용한 혈연간 생체 부분 간이식은 효과적인 치료법임을 확인할 수 있었다.

• 동서간호학연구지
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• 제15권2호
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• pp.82-90
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• 2009

Purpose: The purpose of this study was to compare the degree of preoperative anxiety and postoperative pain among volunteer and non-volunteer donors in living liver transplantation. Methods: The 32 volunteer and 32 non-volunteer donors were recruited from a university hospital after obtaining research approval. The data were analyzed by $x^2$, t, ANOVA tests and Pearson's correlation coefficients using SPSS 12.0 program. Results: There were no significant differences in pre-operative anxiety between the two groups. However, the non-volunteer donors had significantly more severe pain for 3 post-operative days, measured by visual analogue scale (VAS) and non-verbal pain behavior scale (non-VPBS), compared to that of the volunteer donors. There was a significant correlation between preoperative state anxiety and postoperative non-VPBS score. Conclusions: These results showed that liver donors who belonged to the non-volunteer group needed much more active postoperative pain management and psychological support than the volunteer group.

• 한국보건간호학회지
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• 제19권1호
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• pp.129-138
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• 2005

As the patients who need to undergo liver transplant operation continues to grow. the number of livers that are donated can not keep pace with the demand. With the development of surgery skills, the necessity for operations from living donors is increasing. Nevertheless, satisfactory research has been conducted on the factors which generally affect the living donors. In this article. therefore. researchers focused on the factors which generally affect the donating liver donor in order to design a plan for recommending liver donation from living donors. The subjects were 91 living liver donors in C university hospital from October 1. 2000 to December 31. 2003. The results on the uncertainty of living donor, by test sheet. were analyzed with SAS program. The final results were as follows: 1. The uncertainty of the living donors was 51.54 marks per full credit 100. 2. The factor with the greatest effect on donation was the possibility of survival of the donor, followed by the admission period. marriage status and age. In recommending the living donation, the rate of donor survival after the operation was 5.2 times higher than death, 5.2 times higher when the admission period was under 20 days. 5.0 times higher when married. and 27.3 times higher when the family-related donation was very active at the age of 20s than in the 50s. These results suggest that all medical staffs should care for living donors with more interest and activity to give them the least complaints in admission and the lowest possibilities for complication. To enhance the survival rate and improve the surgical success rate. on-going monitoring should include regular health-checks. and continual efforts and education should be made to care for the health condition of the living donors after donation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권6호
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• pp.528-534
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• 2021

Purpose: Living-donor liver transplant emerged as an alternative treatment for end stage liver disease due to the lack of cadaveric organs availability that met the demand. In Portugal, pediatric living-donor liver transplant (P-LDLT) was initiated in 2001 in Portugal in order to compensate for the scarcity of cadaveric organs for such cases. The aim of this study was to retrospectively analyze the morbi-mortality of the 28 donors included in P-LDLT program performed at Coimbra's Pediatric Hospital (CHUC), a Portuguese reference center. Methods: We retrospectively collected pertinent donor data and stratified complications according to Clavien's scoring system. Results: In total, 28.6% (n=8) of the donors had surgical complications. According to Clavien-Dindo's classification, two donors had major complications (Clavien grade ≥3), four donors had grade 2 complications, and two donors had grade 1 complications. There were no P-LDLT-related mortalities in the present case series. The most common verified complications were biliary tract injuries and superficial incisional infections, which are consistent with the complications reported in worldwide series. Conclusion: These patients from CHUC shows that donor hepatectomy in P-LDLT is a safe procedure, with low morbidity and without mortality.

• 한국간호교육학회지
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• 제24권4호
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• pp.433-442
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• 2018

Purpose: This study was performed to investigate the factors affecting postoperative pain and length of hospital stay of liver transplantation donors. Methods: This is a retrospective study using the Electronic Medical Records (EMR) of 91 patients operated on at a tertiary hospital in Seoul, Korea in 2016. The collected data were analyzed using descriptive statistics, t-test, Mann-Whitney U test and Kruskal-Wallis test, Spearman's rank correlation, and multiple regression analysis. Results: The average age of the donors was $35.7{\pm}12.2$ years, and all donors were family members. PCA was applied for control pain in all patients, and 40.7% of PCA-related side effects were observed. The average length of hospital stay was $9.24{\pm}2.52$ days. The factors influencing the length of hospital stay were operative methods, pain control methods, and postoperative complications. The length of hospital stay was 1.29 days shorter if donors had no complication, 1.43 days shorter when only PCA was used, and 1.19 days shorter when laparoscopic resection was performed (Adjusted $R^2=0.17$, F=4.67, p<.05). Conclusion: The results of this study can be used as basic data for practical and effective postoperative nursing education and intervention of living liver donors.

• 대한미세수술학회:학술대회논문집
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• 대한미세수술학회 1996년도 제16차 학술대회
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• pp.158-158
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• 1996

• Advances in pediatric surgery
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• 제13권2호
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• pp.135-143
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• 2007

Biliary atresia (BA) is an uncommon neonatal surgical disease that has a fatal outcome if not properly treated. The survival rates of the patients with native liver after Kasai's operation in countries outside Japan are not so good. We reviewed the results of 22 cases of biliary atresia treated in Kosin University Hospital between October 1987 and March 2001. There were 13 males and 9 females aged from 21 to 106 days (mean 52 days). There were 3 cases of Type I (13.6%), and 3 of Type II (13.6%), and 16 Type III (72.7%). The operative methods were resection of the common bile duct remnant and cyst followed by Roux-en-Y hepaticojejunostomy in 3 cases for Type I BA; Kasai I in 15 cases, Kasai II in 1 case, and Ueda's operation in 3 cases for Types II and III BA. There was no death within the first 30 days after operation. We were able to follow 21 of the 22 patients (95.4%) for more than 5 years. The actual 5 year survival rate (YSR) was 40.9%. One Type I case received a living-related liver transplantation at 6 years of age because of the multiple intrahepatic stones and liver cirrhosis. Five YSR after biliostomy group (Kasai II and Ueda op.) was 75 % (3/4) while that of Kasai I was 20% (3/15). One case had no bile duct in the resected fibrotic plaque on microscopic review and died 8 months after Kasai I operation, would have been a strong candidate for early liver transplantation. From the above result, our conclusions are as follows; (1) early liver transplantation should be considered for cases of no bile duct after pathologic examination of the resected specimen, (2) measures to prevent postoperative cholangitis and prevention of postoperative liver cirrhosis are needed, (3) liver transplantation program should be available for failed cases.