• Title/Summary/Keyword: Living Donors

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Insurance risk analysis of kidney donors (신장 공여자의 보험의학적 위험분석)

  • Kim, Dong-Jin
    • The Journal of the Korean life insurance medical association
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    • v.29 no.2
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    • pp.18-21
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    • 2010
  • Background: The kidney transplantation is increasing. The kidney donation of a living donor is more common in Korea than in other countries. Underwriters may encounter a case of a kidney donor. So we need to determine medical risk for a living kidney donor. Methods: Comparative mortality figures were calculated from a source article using mortality analysis methods. Results: Mortality Ratio of a living kidney donor was estimated to 106%, and Excess Death Rate was 0.89 per 1000. Discussion: A healthy kidney donor is quite within standard, even better in terms of medical risk.

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POSTOPERATIVE COMPLICATIONS IN LIVER TRANSPLANTATION DONORS AND USEFULNESS OF INTERVENTIONAL MANAGEMENT (생체 간이식 수술 후 공여자의 합병증 및 중재적 시술의 유용성)

  • Lee In Sick;Lee Hyeong Jin;Ryoo Myung Sun;Ko Gi Young
    • Journal of The Korean Radiological Technologist Association
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    • v.28 no.1
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    • pp.83-89
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    • 2002
  • To evaluate the incidence of postoperative complication,』 following living liver donation and the effectiveness of interventional management for treating postoperative complications. Between January 1997 and December 2001, 386 consecutive healthy honors f

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Enzymatic Synthesis of Sorbitan Methacrylate: Effect of Acyl donor and Molar ratio

  • Lee, Hye-Jin;Jeong, Gwi-Taek;Lee, Kyoung-Min;Ryu, Hwa-Won;Kim, Do-Man;Park, Don-Hee;Kim, Hae-Sung
    • 한국생물공학회:학술대회논문집
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    • 2005.04a
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    • pp.296-299
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    • 2005
  • Sugar polymers have been considered as biomaterial. Biomaterials are widely utilized for a medical applications in direct contact with living tissue Clearly, biomaterials must be carefully and microscopically fabricated for optimal acceptance within the living organism in both functional and structural senses. In this study, the enzymatic synthesis of sorbitan methacrylate from 1,4-sorbitan via the manipulation of an immobilized biocatalyst (Novozym 435) and acryl donors (methacrylic acid and vinyl methacrylate) was evaluated.

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Pre and Post Operative management of Living Kidney donor - Focus on bioethical aspect - (생체신 공여자의 수술전후 관리에 대한 연구 -윤리적인 측면을 중심으로-)

  • Kim Myung-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.2
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    • pp.139-154
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    • 1995
  • The purpose of this study was presented basic data for management of living kidney donor to make bioethical decision. The research subjects were the documents and progress notes of Doctor's and Nurses in medical records related to kidney donation and nephrectomy of 20 kidney donors who received nephretomy at 4 general hospitals in Pusan. The result of this study, a desirable documents to help the living kidney donor might include following : 1st, identification of the donor and the guardian. 2nd, confirmation of the intension of kidney donor which is based on humanity or not and 3rd, a written oath about Nephrectomy. Especially it is more desirable to participate of paramedical personnels such as the religious, the social workers, the counsellors, and etc when assess the motivation of kidney donor and to use of a formulated visual educational materials about renal angiography and nephrectomy which required written consent of kidney donor. Further more, the donor should be educated sufficiently about the kidney itself and procedure for nephrectomy-the anatomical position of kidney, the function of the kidney, the operative maneaver, pre and post operative complication, the prevention of the complication, the possiblity of rejection phenomenon and loss of the transplanted kidney etc. In conclusion, medical team members for kidney transplantation must suggest not only physical problem but also psychological problem And the educated donor ought to have enough time before a making decision and all these process should be recorded in medical records

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Automatic Liver Segmentation on Abdominal Contrast-enhanced CT Images for the Pre-surgery Planning of Living Donor Liver Transplantation

  • Jang, Yujin;Hong, Helen;Chung, Jin Wook
    • Journal of International Society for Simulation Surgery
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    • v.1 no.1
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    • pp.37-40
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    • 2014
  • Purpose For living donor liver transplantation, liver segmentation is difficult due to the variability of its shape across patients and similarity of the density of neighbor organs such as heart, stomach, kidney, and spleen. In this paper, we propose an automatic segmentation of the liver using multi-planar anatomy and deformable surface model in portal phase of abdominal contrast-enhanced CT images. Method Our method is composed of four main steps. First, the optimal liver volume is extracted by positional information of pelvis and rib and by separating lungs and heart from CT images. Second, anisotropic diffusing filtering and adaptive thresholding are used to segment the initial liver volume. Third, morphological opening and connected component labeling are applied to multiple planes for removing neighbor organs. Finally, deformable surface model and probability summation map are performed to refine a posterior liver surface and missing left robe in previous step. Results All experimental datasets were acquired on ten living donors using a SIEMENS CT system. Each image had a matrix size of $512{\times}512$ pixels with in-plane resolutions ranging from 0.54 to 0.70 mm. The slice spacing was 2.0 mm and the number of images per scan ranged from 136 to 229. For accuracy evaluation, the average symmetric surface distance (ASD) and the volume overlap error (VE) between automatic segmentation and manual segmentation by two radiologists are calculated. The ASD was $0.26{\pm}0.12mm$ for manual1 versus automatic and $0.24{\pm}0.09mm$ for manual2 versus automatic while that of inter-radiologists was $0.23{\pm}0.05mm$. The VE was $0.86{\pm}0.45%$ for manual1 versus automatic and $0.73{\pm}0.33%$ for manaual2 versus automatic while that of inter-radiologist was $0.76{\pm}0.21%$. Conclusion Our method can be used for the liver volumetry for the pre-surgery planning of living donor liver transplantation.

Influences of Prednisone on Muscle Strength and Instrumental Activities of Daily Living in Patients of Kidney Transplantation from Brainstem Dead Heart-beating Donors in Korea (뇌사자로부터 공여받은 신장이식자의 근력과 일상생활활동에 프레드니손(Prednisone)이 미치는 영향)

  • An, Gyeong-Ju;Choe, Myoung-Ae
    • Journal of Korean Biological Nursing Science
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    • v.9 no.1
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    • pp.59-69
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    • 2007
  • 목적: 본 연구의 목적은 뇌사자로부터 공여받은 신장을 이식한 대상자들이 프레드니손을 생체이식 대상자들보다 더 많이 투여받는 임상상황에서 프레드리손이 근력과 일상생활활동에 영향을 주는지 규명하기 위함이다. 방법: 연구 대상은 뇌사자로터 신장을 응급으로 수여받은 32명이었으며 모두 혈액투석을 하고 있었다. 이식 수술 전날, 환자의 일반적인 정보, 근력, 일상생활활동에 대해 조사하였으며 이식수술 후 12주째 되는 날 외래에서 근력과 일상생활활동을 다시 조사하였다. 프레드니손 용량은 임상기록지를 통해 수집하였다. 연구결과: 신장이식술 후 12주의 근력은 고관절 신전근력을 제외하고는 유의하게 감소되지 않았다. 그러나 신장이식 후 12주의 일상생활활동은 수술 직전보다 유의하게 감소된 것으로 나타났다. 근력은 혈액투석을 시행한 기간에 의한 영향을 더 받았으며 일상생황활동의 저하는 3개월간 활동을 제한하는 퇴원교육의 영향이 큰 것으로 볼 수 있다. 결론: 본 연구에서 대상자의 근력과 일상생활활동은 프레드니손 투약의 영향을 받지 않았으며 오히려 혈액투석을 시행했던 기간에 따라 영향을 받은 것으로 나타났다. 따라서 혈액투석 환자들의 근력 증진을 위한 간호중재 개발이 필요하다.

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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.

The First Living-Donor Lobar Lung Transplantation in Korea: a Case Report

  • Choi, Sehoon;Park, Seung-Il;Lee, Geun Dong;Kim, Hyeong Ryul;Kim, Dong Kwan;Jung, Sung-Ho;Yun, Tae-Jin;Kim, In Ok;Choi, Dae-Kee;Choi, In-Cheol;Song, Jong-Min;Hong, Sang-Bum;Shim, Tae Sun;Jo, Kyung-Wook;Lee, Sang-Oh;Do, Kyung-Hyun;Chae, Eun Jin
    • Journal of Korean Medical Science
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    • v.33 no.43
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    • pp.282.1-282.6
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    • 2018
  • Lung transplantation is the only treatment for end-stage lung disease, but the problem of donor shortage is unresolved issue. Herein, we report the first case of living-donor lobar lung transplantation (LDLLT) in Korea. A 19-year-old woman patient with idiopathic pulmonary artery hypertension received her father's right lower lobe and her mother's left lower lobe after pneumonectomy of both lungs in 2017. The patient has recovered well and is enjoying normal social activity. We think that LDLLT could be an alternative approach to deceased donor lung transplantation to overcome the shortage of lung donors.

A Bioethical Study of the Informed Consent for Organ Donor (장기공여를 위한 사전동의의 생의윤리학적 고찰)

  • Um, Young-Rhan;Han, Sung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.475-487
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    • 1998
  • This is a study to search for the ethical basis for valid informed consent of organ donors. It is an admirable action that a person give his own body part or organ as a gift to another person. The organ for transplantation can be removed only when the donor consents voluntarily to donation. It is recently proposed as the need for organ transplantation is increased that organs can be harvested although the consent of deceased cannot be obtained. This may raise many moral issues because human beings all have an unalienable right to control their own bodies. The principle of autonomy is usually regarded as an ethical basis for informed consent. However, some people criticize that the principle of autonomy requires a person and his decision to be autonomous (but there are many patients who aren't autonomous due to their confusion or unconscious condition in a clinical situation). or this principle can foster indifference to patients needing help: thus respect for principles of care and beneficence is necessary. When we consider the complexity of making a decision about organ donation. the principle of autonomy should be replaced by the principle of respect for individual autonomy. as expressed by Childress (1990). This principle requires the care givers to respect the client's individual decisions. The elements of informed consent are threshold elements: competence to understand and decide. voluntariness in deciding: information elements: disclosure of material information. recommendation of a plan. understanding of disclosure and recommendation: and consent elements: decision in favor of a plan. authorization of the chosen plan. In cases of living donors. the elements of competence and voluntariness are more important than the others. So only an adult can give a recipient his own body part. but it should be forbidden to harvest from minors or protected adults (i.e. developmentally disabled person However. when organs are removed from a cadaver donor. we ought to respect the donor's decision. So we ought to try to seek donor cards or any documents expressing the donor's opinion about organ transplant. All health care givers ought to disclose donor information about organ transplantation clearly enough for the donor to understand it and to be able to weigh the harms and benefits. We are going to propose 'the subjective standard' as the ethical standard of disclosure. This standard will assure that patients have enough information to be able to decide autonomously from their own position. Care givers have to consider the method of disclosure because donors can be influenced by it positively or negatively, Establishment of the Hospital Committee is recommended. because medical professionals will have a chance to discuss the procedure of decision and the validity of harvesting a organ from a person.

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Clinical Outcomes and Contributors in Contemporary Kidney Transplantation: Single Center Experience (근래의 신장이식 임상성적과 관련인자들: 단일기관 연구)

  • Ahn, Jae-Sung;Park, Kyung Sun;Park, Jongha;Chung, Hyun Chul;Park, Hojong;Park, Sang Jun;Cho, Hong Rae;Lee, Jong Soo
    • Korean Journal of Transplantation
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    • v.31 no.4
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    • pp.182-192
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    • 2017
  • Background: In recent years, introduction of novel immunosuppressive agents and its proper implementation for clinical practice have contributed to improving clinical outcomes of kidney transplantation (KT). Here, we report clinical outcomes of KTs and related risk factors. Methods: From July 1998 to June 2016, 354 KTs (182 from living and 172 from deceased donors) have been performed at Ulsan University Hospital. We retrospectively reviewed the clinical characteristics and outcomes of KT recipients, then estimated graft and patient survival rate were estimated and analyzed risk factors using Cox-regression. Results: The median follow-up period was 53 months (range; 3 to 220 months). The mean ages of recipients and donors were 45.0 years (SD, 12.5) and 44.7 years (SD, 13.6) years, respectively. During follow-up, 18 grafts were lost and 5- and 10-year death-censored graft survival was 96.7% and 91.5%, respectively. Biopsy-proven acute rejection (BPAR) occurred in 71 patients (55 cases of acute cellular rejection and 16 of antibody-mediated rejection). Cox-regression analysis showed that BPAR was a risk factor related to graft loss (hazard ratio [HR], 14.38; 95% confidence interval [CI], 3.79 to 54.53; P<0.001). In addition, 15 patients died, and the 5- and 10-year patient survival was 97.2% and 91.9%, respectively. Age ≥60 years (HR, 6.03; 95% CI, 1.12 to 32.61; P=0.037) and diabetes (HR, 6.18; 95% CI, 1.35 to 28.22; P=0.019) were significantly related to patient survival. Conclusions: We experienced excellent clinical outcomes of KT in terms of graft failure and patient survival despite the relatively high proportion of deceased donors. Long-term and short-term clinical outcomes have improved in the last two decades.