• Journal of Korean Critical Care Nursing
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• v.10 no.3
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• pp.19-30
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• 2017

Purpose : This study investigated factors affecting the knowledge and attitude of organ procurement from brain dead patients in nurse clinicians. Methods : A survey was conducted with 160 clinical nurses from a university hospital in Seoul. Descriptive statistics, t-tests, an ANOVA, $Scheff{\acute{e}}^{\prime}s$ test, Pearson's correlation coefficient, and a multiple regression analysis were used. Results : The mean score for knowledge of organ procurement from brain dead patients was $12.41{\pm}2.16$ (mean correct answers = 62.1). Factors influencing the knowledge of organ procurement among nurse clinicians were working department (${\beta}=.454$, p < .001), a recent family death (${\beta}=.187$, p = .014), experience recognizing potential brain dead patients (${\beta}=.182$, p = .033), and experience referring to potential brain dead patients (${\beta}=-.192$, p = .048). Conclusion : To ensure effective organ procurement from brain dead patients, it is necessary to continually educate nurse clinicians to improve their attitude and knowledge concerning organ donation.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.405-413
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• 2019

Background Face transplantation has naturally evolved from reconstructive procedures. However, few institutions perform face transplantations, because it is time-consuming and it is necessary to justify non-vital organ transplantation. We investigated the process of organ donation from brain-dead patients and the possibility of incorporating face transplantation into the donation process. Methods A retrospective review was performed of 1,074 brain-dead patients from January 2015 to December 2016 in Korea. We analyzed the time intervals from admission to brain death decisions (first, second, and final), the causes of brain death, and the state of the transplanted organs. Results The patient base (n=1,074) was composed of 747 males and 327 females. The average period between admission to the first brain death decision was 8.5 days (${\pm}15.3$). The average time intervals between the first brain death decision and medical confirmation using electroencephalography and between the first brain death decision and the final determination of brain death were 16 hours 58 minutes (${\pm}14hours$ 50 minutes) and 22 hours 57 minutes (${\pm}16hours$ 16 minutes), respectively. The most common cause of brain death was cerebral hemorrhage/stroke (42.3%), followed by hypoxia (30.1%), and head trauma (25.2%). Conclusions When face transplantation is performed, the transplantation team has 22 hours 57 minutes on average to prepare after the first brain death decision. The cause of brain death was head trauma in approximately one-fourth of cases. Although head trauma does not always imply facial trauma, surgeons should be aware that the facial tissue may be compromised in such cases.

• Journal of Chest Surgery
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• v.51 no.5
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• pp.328-332
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• 2018

Background: Extracorporeal life support (ECLS) can be applied in brain-dead donors for organ perfusion before donation, thereby expanding the donor pool. The aim of this study was to examine the benefits and early clinical outcomes of ECLS for organ preservation. Methods: Between June 2012 and April 2017, 9 patients received ECLS with therapeutic intent or for organ preservation. The following data were collected: demographics, purpose and duration of ECLS, cause of death, dose of vasoactive drugs, and need for temporary dialysis before organ retrieval. The early clinical outcomes of recipients were studied, as well as survival and graft function at 1 month. Results: ECLS was initiated for extracorporeal cardiopulmonary resuscitation in 5 patients. The other patients needed ECLS due to hemodynamic deterioration during the assessment of brain death. We successfully retrieved 18 kidneys, 7 livers, and 1 heart from 9 donors. All organs were transplanted and none were discarded. Only 1 case of delayed kidney graft function was noted, and all 26 recipients were discharged without any significant complications. Conclusion: The benefits of protecting the vital organs of donors is significant, and ECLS for organ preservation can be widely used in the transplantation field.

• Journal of Korean Academy of Nursing
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• v.45 no.6
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• pp.802-811
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• 2015

Purpose: The purpose of this study was to test and validate a model to predict living and brain death organ donation intention in nursing students. The conceptual model was based on the theory planned behavior. Methods: Quota sampling methodology was used to recruit 921 nursing students from all over the country and data collection was done from October 1 to December 20, 2013. Results: The model fit indices for the hypothetical model were suitable for the recommended level. Knowledge, attitude, subjective norm and perceived behavioral control explained 40.2% and 40.1% respectively for both living and brain death organ donation intention. Subjective norm was the most direct influential factor for organ donation intention. Knowledge had significant direct effect on attitude and indirect effect on subjective norm and perceived behavioral control. These effects were higher in brain death organ donation intention than in living donation intention. Conclusion: The overall findings of this study suggest the need to develop systematic education programs to increases knowledge about brain death organ donation. The development, application, and evaluation of intervention programs are required to improve subjective norm.

• The Journal of Korean Academic Society of Nursing Education
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• v.23 no.4
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• pp.389-397
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• 2017

Purpose: This study was conducted to examine awareness of biomedical ethics, and to identify affecting factors of the awareness of biomedical ethics in nursing students. Methods: The subjects consisted of 266 nursing students their third and fourth years of study. The data were collected from October to December, 2015 by self-report using questionnaires. Data analysis was performed using SPSS/WIN 18.0, descriptive statistics, t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson correlation coefficient, and multiple regression analysis. Results: The mean score of the awareness of biomedical ethics was $2.81{\pm}0.22$, perception of death was $3.15{\pm}0.36$, and knowledge of brain death, organ donation, and organ transplant was $12.12{\pm}3.02$. The prediction factors of awareness of biomedical ethics were gender (${\beta}=.29$, p<.001), participation in religious activity (${\beta}=.23$, p=.015), and perception of death (${\beta}=.20$, p=.016). The explanation power was 17.1%. Conclusion: These results showed that education about biomedical ethics is necessary for nursing students, and the development of biomedical ethics educational programs should reflect affecting factors.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.12
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• pp.836-844
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• 2020

In modern society, there is a growing demand for human tissue donation along with organ donation. However, the awareness of tissue donation and actual donation rates remain very low in South Korea. This study was undertaken to evaluate the current status of domestic laws and systems, and to compare them with the operation systems of major foreign countries, by reviewing literature and web sites of organ donation and registration. The authors present three measures to promote human tissue donation in Korea: integration of a dual legal system in a legal aspect, vitalization of the Opt-out system in terms of system operation, and activation of public relations in terms of social and cultural aspects. The Opt-out system, in particular, is the most effective way to activate transplants in the form of presumed consent of countries without undue pressure. However, the presumed consent method requires various stages of social public debate, and the requirement is a proper domestic understanding of the registration system for rejection. In conclusion, we believe the solution towards a positive inclination for organ donation is a public policy to increase the supply for organs and human tissue transplants, and positive perception of donations, public promotion, and support for postmortem donors and their families.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.3
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• pp.388-392
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• 2024

In liver transplantation, the primary concern is to ensure an adequate future liver remnant (FLR) volume for the donor, while selecting a graft of sufficient size for the recipient. The living donor-resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (LD-RAPID) procedure offers a potential solution to expand the donor pool for living donor liver transplantation (LDLT). We report the first case involving a cirrhotic patient with autoimmune hepatitis and hepatocellular carcinoma, who underwent left lobe LDLT using the LD-RAPID procedure. The living liver donor (LLD) underwent a laparoscopic left hepatectomy, including middle hepatic vein. The resection on the recipient side was an extended left hepatectomy, including the middle hepatic vein orifice and caudate lobe. At postoperative day 7, a computed tomography scan showed hypertrophy of the left graft from 320 g to 465 mL (i.e., a 45.3% increase in graft volume body weight ratio from 0.60% to 0.77%). After a 7-day interval, the diseased right lobe was removed in the second stage surgery. The LD-RAPID procedure using left lobe graft allows for the use of a small liver graft or small FLR volume in LLD in LDLT, which expands the donor pool to minimize the risk to LLD by enabling the donation of a smaller liver portion.