• Title/Summary/Keyword: 간 공여자

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Psychological Characteristics of Living Liver Transplantation Donors using MMPI-2 Profiles (MMPI-2를 이용한 생체 간 공여자들의 심리적 특성에 대한 연구)

  • Lee, Jin Hyeok;Choi, Tae Young;Yoon, Seoyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.42-49
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    • 2019
  • Objectives : Living donor liver transplantation (LDLT) is a life-saving therapy for patients with terminal liver disease. Many studies have focused on recipients rather than donors. The aim of this study was to assess the emotional status and personality characteristics of LDLT donors. Methods : We evaluated 218 subjects (126 male, 92 female) who visited Daegu Catholic University Medical Center from August 2012 to July 2018. A retrospective review of their preoperative psychological evaluation was done. We investigated epidemiological data and the Minnesota Multiphasic Personality Inventory-2 questionnaire. Subanalysis was done depending on whether subjects actually underwent surgery, relationship with the recipient, and their gender. Results : Mean age of subjects was $32.19{\pm}10.91years$. 187 subjects received LDLT surgery (actual donors) while 31 subjects didn't (potential donors). Donor-recipient relationship included husband-wife, parent-children, brother-sister etc. Subjects had statistical significance on validity scale L, F, K and all clinical scales compared to the control group. Potential donors had significant difference in F(b), F(p), K, S, Pa, AGGR, PSYC, DISC and NEGE scales compared to actual donors. F, D and NEGE scales were found to be predictive for actual donation. Subanalysis on donor-recipient relationship and gender also showed significant difference in certain scales. Conclusions : Under-reporting of psychological problems should be considered when evaluating living-liver donors. Information about the donor's overall psychosocial background, mental status and donation process should also be acquired.

Usefulness of Parallel Imaging Technique in MRCP for Liver Donor (간 공여자의 자기공명췌담관조영술에서 병렬 영상 기법의 유용성)

  • Lim, woo-taek;Jung, hong-ryang
    • Proceedings of the Korea Contents Association Conference
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    • 2015.05a
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    • pp.149-150
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    • 2015
  • 병렬영상기법(parallel imaging technique)은 하나의 수신 코일을 사용하는 기존의 방식과 달리 다수의 수신코일을 이용하여 데이터를 획득하는 기법으로서 검사시간 및 공간해상도를 향상시키기 위해 사용된다. 본 논문은 간 공여자의 자기공명영상 췌담관 조영술에서 간담도 영상의 선예도 향상을 위한 병렬영상기법의 유용성을 연구하고자 하였다.

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Detection of Hepatitis B Virus DNA in Liver Grafts Obtained from HBsAb and HBcAb Positive Organ Donors (HBsAb와 HBcAb가 양성인 장기 공여자의 간조직에서 Hepatitis B Virus DNA의 발현)

  • Jung, Chang-Woo;Jang, Joo-Young;Kim, Kyung-Mo;Lee, Sung-Gyu
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.166-172
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    • 2007
  • Purpose: It has recently been reported that de novo HBV infection following liver transplantation is caused by grafts from HBcAb positive donors, and this phenomenon has been observed in one third of the liver transplant patients in our center. Therefore, we investigated the presence of HBV virus DNA in liver tissues obtained from HBcAb positive donors to determine the mechanism by which de novo HBV infection occurs. Methods: This study was conducted on 6 patients that were HBsAg negative, HBsAb positive, and HBcAb positive who were donors for liver transplantation between November 1997 and November 1998 at Asan Medical Center. We isolated DNA from a portion of liver biopsy tissues that were obtained during the operation, and then identified the surface and core region of HBV DNA using nested PCR. In addition, four children who received liver grafts from these donors were monitored to determine if they became afflicted with non-HBV related diseases while receiving prophylaxis consisting of short-term HBIG treatment and long-term treatment with an antiviral agent. Results: The surface antigen region was identified in all 6 donors and the core antigen region was observed in 4 of the 6 donors. However, no episodes of de novo HBV infection with prophylaxis were observed. Conclusion: The results of this study support the results of previous studies, which indicated that HBV infection may be the main cause of de novo HBV infection in patients that receive HBsAb positive and HBcAb positive donor grafts.

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Donor Complication in Living Donor Liver Transplantation (생체간이식에 관한 공여자 합병증)

  • Yang, Jae Do;Yu, Hee Chul
    • Korean Journal of Transplantation
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    • v.31 no.4
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    • pp.177-181
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    • 2017
  • Living donor liver transplantation (LDLT) has become an inevitable procedure due a shortage of deceased donors under the influence of religious and native cultures. The most important concern in LDLT is donor safety. This study reviewed the safety of LDLT donors from reported studies of morbidity and mortality. Many studies have reported mortality and morbidity rates ranging from 0% to 33% for healthy liver donors. Use of laparoscopic surgery on LDLT donors has advantages of reduced blood loss, lower postoperative morbidity and shorter hospital stay relative to conventional open surgery. There is a consensus that remnant liver volume (RLV), degree of steatosis, and donor age are the most important factors influencing donor safety. In LDLT, donor hepatectomy can be performed successfully with minimal and easily controlled complications. However, a large-scale prospective cohort study is needed to better understand the risk factors and accurately determine the complication rates for LDLT.

Evaluation of Automatic Image Segmentation for 3D Volume Measurement of Liver and Spleen Based on 3D Region-growing Algorithm using Animal Phantom (간과 비장의 체적을 구하기 위한 3차원 영역 확장 기반 자동 영상 분할 알고리즘의 동물팬텀을 이용한 성능검증)

  • Kim, Jin-Sung;Cho, June-Sik;Shin, Kyung-Sook;Kim, Jin-Hwan;Jeon, Ho-Sang;Cho, Gyu-Seong
    • Progress in Medical Physics
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    • v.19 no.3
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    • pp.178-185
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    • 2008
  • Living donor liver transplantation is increasingly performed as an alternative to cadaveric transplantation. Preoperative screening of the donor candidates is very important. The quality, size, and vascular and biliary anatomy of the liver are best assessed with magnetic resonance (MR) imaging or computed tomography (CT). In particular, the volume of the potential graft must be measured to ensure sufficient liver function after surgery. Preoperative liver segmentation has proved useful for measuring the graft volume before living donor liver transplantations in previous studies. In these studies, the liver segments were manually delineated on each image section. The delineated areas were multiplied by the section thickness to obtain volumes and summed to obtain the total volume of the liver segments. This process is tedious and time consuming. To compensate for this problem, automatic segmentation techniques have been proposed with multiplanar CT images. These methods involve the use of sequences of thresholding, morphologic operations (ie, mathematic operations, such as image dilation, erosion, opening, and closing, that are based on shape), and 3D region growing methods. These techniques are complex but require a few computation times. We made a phantom for volume measurement with pig and evaluated actual volume of spleen and liver of phantom. The results represent that our semiautomatic volume measurement algorithm shows a good accuracy and repeatability with actual volume of phantom and possibility for clinical use to assist physician as a measuring tool.

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Left Ventricular Remodeling in Pediatric Orthotopic Size Mismatched Heart Transplantation (몸무게 차이가 큰 성인 공여자-소아 수용자간 심장이식에서의 좌심실 재형성)

  • Lee Seung-Cheol;Yoon Tae-Jin;Kim Young-Hwee;Park In-Sook;Kim Jong-Wook;Seo Dong-Man
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.226-229
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    • 2006
  • Recently, heart transplantation has been accepted as a standard treatment for infant and children with end-stage cardiomyopathy or complex congenital heart disease. Due to the shortage of donors, size-mismatched cardiac transplantation is common. After size-mismatched transplantation, there could be side-effects such as hypertension and hypertensive encephalopathy because of the big-heart. Donor heart is also known to do remodel as time goes by. This is a case report of a size-mismatched heart transplantation between 9-year-old boy and a 39-year-old female whose body weight is almost twice of him. In this case, classical postoperative hypertension and hypertensive encephalopathy developed but was successfully managed. The donor heart has remodeled to normal dimension during 3 years follow-up period.

Preoperative Anxiety and Postoperative Pain Related to Donation Spontaneity in Living Donors Undergoing Liver Transplantation (간 공여자의 자발성 여부에 따른 수술 전 불안과 수술 후 통증 비교 연구)

  • Bea, Seng-Sim;Lee, Hyang-Yeon;Lee, Kook-Hyun
    • Journal of East-West Nursing Research
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    • v.15 no.2
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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.

Validity of Ultrasonography in the Diagnosis of Non-alcoholic Fatty Liver Disease in Living Liver Donors (생체 간이식 공여자에서 비알코올성 지방간 질환의 진단에 있어서 초음파검사의 타당도 연구)

  • Kim, Yon-Min;Han, Dong-Kyoon
    • The Journal of the Korea Contents Association
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    • v.11 no.10
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    • pp.342-348
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    • 2011
  • The study aimed to compare the validity between the abdominal ultrasonographic(US) grading system of fatty liver and histologic grading system of fatty liver in living liver donor candidates. As the fatty liver is defined as pathologic total fat >10%, US validity was sensitivity 64.6%, specificity 68%, positive predictive value 76.8%, negative predictive value 54%. As the strict data handling on US grading normal, mild fatty liver are negative, moderate fatty liver is positive, US validity was sensitivity 26.8%, specificity 100%, positive predictive value 100%, negative predictive value 45.5%. ROC curve analysis according to different cut off value of liver-to-kidney brightness ratio was Area under ROC curve=0.859(95% CI=0.795~0.922, state variable= total fat 10%). There were statistically significant difference( p<0.001). Ultrasonography for the fatty diagnosis showed a high validity to predict the result of histology grade of fatty liver.

Uncertainty and Factors Affecting Organ Donation in Living Liver Donors (생체 간이식 공여자의 불확실성과 간 공여 영향 요인)

  • Chon Hee Ok;Park Ho Ran;Park Jin Hee
    • Journal of Korean Public Health Nursing
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    • v.19 no.1
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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.

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