• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.43-49
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• 2023

In Korea, the dependence on living donations is high due to the shortage of organs available for donation compared to the number of people waiting for transplants and the number of living organ donations continues to increase. In particular, the number of living-donor transplantations is high worldwide, highlighting the importance of pre-transplant psychosocial evaluation of living kidney donors. According to previous studies, when evaluating living organ donors before transplantation, it is crucial to determine whether the donor can give informed consent and be aware of the risks after surgery. Pre-transplant evaluation tests such as ELPAT living organ donor Psychological Assessment Tool (EPAT), Live Donor Assessment Tool (LDAT), Living Donation Expectancies Questionnaire (LDEQ), Minnesota Multiphasic Personality Inventory-2 questionnaire (MMPI-2) and Temperament and Character Inventory (TCI) are conducted for donors. After reviewing the literature on these pre-transplant psychosocial assessment tools, we will also look at legal considerations for living kidney donors in Korea and suggest an effective and essential pre-transplant screening evaluation method for living kidney transplant donors.

• Journal of Korean Academy of Nursing
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• v.51 no.1
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• pp.105-118
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• 2021

Purpose: This study aimed to explore young adult donors' experiences of living donor liver transplantation. Methods: A phenomenological research method was used. The participants were two women and six men. Data were collected through individual in-depth interviews from November 25th, 2019 to June 10th, 2020 and analyzed using Colaizzi's phenomenological method. Results: Five theme clusters extracted from the young adult donors' experiences were painful decision of a liver donation, the agony of both mind and body that overpowers youth, the bitter and bare face of reality that a young donor encounters, feeling the power of love that fills up the space of the organ removed, and liver donation becoming priming water for maturity. Conclusion: The results of this study provide a deeper understanding of the lives of young adult donors who have experienced unexpected difficulties as well as self growth from the donation. It is expected that the results can be of use for developing and applying customized nursing interventions for management before and after liver donation among young adult donors.

• Proceedings of the Korea Information Processing Society Conference
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• 2005.05a
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• pp.819-822
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• 2005

본 연구는 MDCT 영상을 이용하여 인체의 장기인 간을 추출하고 그 간 내부의 혈관을 추출하는 알고리즘을 제안하였다. 간에는 2개의 주요혈관이 있는데 생체 간 이식 수술시 필수적인 간의 절개 비율 및 간 내의 혈관 모습들을 제공하여 의료진에게 수술 전 혈관 형태에 대한 정확히 정보를 파악하도록 함으로써 혈관의 손상을 최대한으로 줄일 수 있도록 하여 수술 성공률을 높이는데 중요한 역할을 할 수 있다. 간을 이식 할 때 기증자와 수혜자가 동시에 생존하기 위해서는 기증자의 간으 크기가 중요하며 둘다 생존하기 위해서는 기증자는 자신의 간의 35% 이상을 남겨야 하며 수혜자 또한 생존을 위해 자신의 간의 40% 이상에 해당하는 간을 이식 받아야 하는데 간 이식에 있어서 절단 부분을 결정하는데 중요한 중간 정맥을 찾아내어 보여 줌으로써 중간 정맥을 중심으로 3가닥의 굵은 혈관과 주변혈관의 손상을 최소화하고 비율을 잘 맞추어 절단 할 수 있도록 수술하는데 도움을 줄 수 있다. 각 혈관은 원형성과 다양한 각도를 갖는 막대형의 형태를 가지고 있다는 특징을 이용해 morphological filtering을 통해 추출한 후 조합하여 재구성을 하여 혈관의 모습으로 생성해 낼 수 있었다.

• 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.

• Journal of Korean Academy of Nursing
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• v.52 no.4
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• pp.435-450
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• 2022

Purpose: The purpose of the study was to understand the care experiences of the family of living donor liver transplantation (LDLT) patients where the donation had occurred within the family. Methods: Participants were eight family caregivers who cared for recipients and donors of LDLT. Data were collected through individual in-depth interviews from November, 2020 to April, 2021. Data analysis was performed through a cyclical process of data collection and analysis by applying Giorgi's phenomenological research method. Results: The five main components extracted from the experiences of the family caregivers were: "A double-edged choice to save the family", "The harsh daily life of liver transplantation care", "The yoke of double care on both shoulders", "The power to withstand the adversity of caring", and "The recovery and growth of life pursued by trusting each other". Conclusion: The participants tried to do their best in their daily lives, while providing reassurance and care to the LDLT patients in the family; however, they expressed some worry and hardship while doing so. The results of this study provide a deeper understanding of the caring experience of the family caregivers, which may contribute to the development of nursing interventions that will aid these caregivers in providing care to their LDLT family members. Furthermore, the development and application of an integrated management program for LDLT patients in the family is required.

• Korean Journal of Transplantation
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• v.28 no.3
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• pp.144-153
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• 2014

Background: Normal renal function and health have been recognized as important factors in living donors after kidney donation. The purpose of this study was to evaluate the health status and health-promoting lifestyle in living donors after kidney donation. Methods: A total of 678 living-kidney donors were counted in our center from January 1990 to December 2011. Only 84 donors agreed to participate in the survey by telephone. We received consent for participation in our survey from 48 donors (57.1%). Data were collected from May to August 2013 using donor characteristics, health status, and Health Promoting Lifestyle Profile I (HPLP-I). Results: The donors were predominantly female (62.5%) and the average age was 48.9±11.8 years, and the average period after nephrectomy was 9.7±5.7 years. The characteristics of donors included ideal body weight (37.5%), overweight (37.5%) in body mass index, and good health status (81.3%). Most donors underwent an annual medical check-up (56.2%), no health problem (81.3%), and no disease (64.6%). However, one patient was treated with dialysis for renal failure due to diabetes. The total average score for HPLP-I was 128.3±13.9. Higher than average scores (116.3±19.1) were observed for the general middle-aged woman. There were statistically significant differences in self-realization and nutrition in subsection of HPLP-I. Self-realization showed a higher score for Christian (F=2.743, P=0.041) and good health (F=3.389, P=0.017). Nutrition showed a higher score for overweight, obesity (F=6.783, P=0.000), and older than 60 (F=3.854, P=0.009). Conclusions: Most living kidney donors were healthy after their donation and had relatively high scores for health-promoting lifestyle. However, one patient had a serious health problem. In addition, younger, longer period after donation, and the rare health examination of donors showed a lower health-promoting lifestyle. Designed and continuous health-care management after transplantation is needed for kidney donors.

• Journal of the Institute of Electronics Engineers of Korea SP
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• v.47 no.1
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• pp.17-24
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• 2010

This paper proposed the method to separate a liver into left and right liver lobes for exact volumetry of the river graft at abdominal MDCT(Multi-Detector Computed Tomography) image before living donor liver transplantation. On the image of segmented liver, 4 points(the middle point of Inferior Vena Cava, a point of Middle Hepatic Vein, a point of Portal Vein, a middle point of gallbladder fossa) are selected. A liver is separated into left and right liver lobes on the basis of the 4 points. The volume and ratio of the river graft are estimated. The volume estimated using 4 points and the manual volume that radiologist processed and estimated are compared with the weight measured during surgery to support proof of the exact volumetry. After selection the 4 points, the time involved in separation a liver into left and right river lobe and volumetry of them is measured for confirmation that the algorithm can be used on real time during surgery. This study progressed to ensure donor's and recipient's safe who will undergo the liver transplantation.

• Journal of the Korea Society of Computer and Information
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• v.17 no.3
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• pp.51-57
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• 2012

Hepatic vessel tree is the key structure for hepatic disease diagnosis and liver surgery planning. Especially, it is used to evaluate the donors' and recipients' liver for the LDLT(Living Donors Liver Transplantation) and estimate the volumes of left and right hepatic lobes for securing their life in the LDLT. In this study, we propose a method to apply canny edge detection that is not affected by noise to the liver images for automatic segmentation of hepatic vessels tree in contrast abdominal MDCT image. Using histograms and average pixel values of the various liver CT images, optimized parameters of the Canny algorithm are determined. It is more time-efficient to use the common parameters than to change parameters manually according to CT images. Candidates of hepatic vessels are extracted by threshold filtering around the detected the vessel edge. Finally, using a system which detects the true-negatives and the false-positives in horizontal and vertical direction, the true-negatives are added in candidate of hepatic vessels and the false-positives are removed. As a result of the process, the various hepatic vessel trees of patients are accurately reconstructed in 3D.

• The KIPS Transactions:PartB
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• v.19B no.2
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• pp.123-126
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• 2012

This paper proposed a method to separate a liver into left and right liver lobes for simple and exact volumetry of the river graft at abdominal MDCT(Multi-Detector Computed Tomography) image before the living donor liver transplantation. A medical team can evaluate an accurate river graft with minimized interaction between the team and a system using this algorithm for ensuring donor's and recipient's safe. On the image of segmented liver, 2 points(PMHV: a point in Middle Hepatic Vein and PPV: a point at the beginning of right branch of Portal Vein) are selected to separate a liver into left and right liver lobes. Middle hepatic vein is automatically segmented using PMHV, and the cutting line is decided on the basis of segmented Middle Hepatic Vein. A liver is separated on connecting the cutting line and PPV. The volume and ratio of the river graft are estimated. The volume estimated using 2 points are compared with a manual volume that diagnostic radiologist processed and estimated and the weight measured during surgery to support proof of exact volume. The mean ${\pm}$ standard deviation of the differences between the actual weights and the estimated volumes was $162.38cm^3{\pm}124.39$ in the case of manual segmentation and $107.69cm^3{\pm}97.24$ in the case of 2 points method. The correlation coefficient between the actual weight and the manually estimated volume is 0.79, and the correlation coefficient between the actual weight and the volume estimated using 2 points is 0.87. After selection the 2 points, the time involved in separation a liver into left and right river lobe and volumetry of them is measured for confirmation that the algorithm can be used on real time during surgery. The mean ${\pm}$ standard deviation of the process time is $57.28sec{\pm}32.81$ per 1 data set ($149.17pages{\pm}55.92$).