• Title/Summary/Keyword: Living Donors

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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.

Donor Specific Antibody Negative Antibody-Mediated Rejection after ABO Incompatible Liver Transplantation

  • Lee, Boram;Ahn, Soomin;Kim, Haeryoung;Han, Ho-Seong;Yoon, Yoo-Seok;Cho, Jai Young;Choi, Young Rok
    • Korean Journal of Transplantation
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    • v.32 no.4
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    • pp.108-112
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    • 2018
  • Antibody-mediated rejection (AMR) is a major complication after ABO-incompatible liver transplantation. According to the 2016 Banff Working Group on Liver Allograft Criteria for the diagnosis of acute AMR, a positive serum donor specific antibody (DSA) is needed. On the other hand, the clinical significance of the histological findings of AMR in the absence of DSA is unclear. This paper describes a 57-year-old man (blood type, O+) who suffered from hepatitis B virus cirrhosis with hepatocellular carcinoma. Pre-operative DSA and cross-matching were negative. After transplantation, despite the improvement of the liver function, acute AMR was observed in the protocol biopsy on postoperative day 7; the cluster of differentiation 19+ (CD19+) count was 0% and anti-ABO antibody titers were 1:2. This paper presents the allograft injury like AMR in the absence of DSA after ABOi living donor liver transplantation with low titers of anti-ABO antibody and depleted serum CD19+ B cells.

Measurements of the Hepatectomy Rate and Regeneration Rate Using Deep Learning in CT Scan of Living Donors (딥러닝을 이용한 CT 영상에서 생체 공여자의 간 절제율 및 재생률 측정)

  • Sae Byeol, Mun;Young Jae, Kim;Won-Suk, Lee;Kwang Gi, Kim
    • Journal of Biomedical Engineering Research
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    • v.43 no.6
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    • pp.434-440
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    • 2022
  • Liver transplantation is a critical used treatment method for patients with end-stage liver disease. The number of cases of living donor liver transplantation is increasing due to the imbalance in needs and supplies for brain-dead organ donation. As a result, the importance of the accuracy of the donor's suitability evaluation is also increasing rapidly. To measure the donor's liver volume accurately is the most important, that is absolutely necessary for the recipient's postoperative progress and the donor's safety. Therefore, we propose liver segmentation in abdominal CT images from pre-operation, POD 7, and POD 63 with a two-dimensional U-Net. In addition, we introduce an algorithm to measure the volume of the segmented liver and measure the hepatectomy rate and regeneration rate of pre-operation, POD 7, and POD 63. The performance for the learning model shows the best results in the images from pre-operation. Each dataset from pre-operation, POD 7, and POD 63 has the DSC of 94.55 ± 9.24%, 88.40 ± 18.01%, and 90.64 ± 14.35%. The mean of the measured liver volumes by trained model are 1423.44 ± 270.17 ml in pre-operation, 842.99 ± 190.95 ml in POD 7, and 1048.32 ± 201.02 ml in POD 63. The donor's hepatectomy rate is an average of 39.68 ± 13.06%, and the regeneration rate in POD 63 is an average of 14.78 ± 14.07%.

Living-Related Liver Transplantation with Heterozygote Carrier Graft in Children with Wilson Disease (윌슨병 환아에서 이형 접합 보인자 공여간을 이용한 혈연간 생체 부분 간이식)

  • Kim, Jin-Taek;Chang, Soo-Hee;Choi, Bo-Hwa;Kim, Kyung-Mo;Yoo, Han-Wook;Lee, Young-Joo;Lee, Sung-Gyu
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.161-166
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    • 2003
  • Purpose: The purpose of this study was to evaluate the efficiency of treatment of living-related liver transplantation (LRLT) with the parental heterozygote carrier graft in children with Wilson disease. Methods: We retrospectively evaluated 7 children with Wilson disease who had received liver transplantation from 1994 to 2002 at Asan Medical Center. All the donors were parental. Liver functions, Kayser-Fleischer ring, and other factors regarding to copper metabolism were analyzed. Results: Of the 7 children, 5 had fulminant hepatitis and 2 had decompensated liver cirrhosis irresponsive to medical therapy. All donors being parental, all grafts came to be heterozygote carrier grafts. Survival rate was 100% in those 7 children, 87% in all children with liver transplantation in the same period, and 84% in children with non-metabolic liver disease. After liver transplantation, all 7 children could stop low copper diet and penicillamine therapy and their AST, total bilirubin and prothrombin time were recovered to normal. After liver transplantation, ceruloplasmin and serum copper levels were also recovered to normal. A marked reduction in 24 hr-urinary copper excretion was observed in all recipients after transplantation. During follow-up, Kayser-Fleischer rings resolved completely after LRLT in 5 children and partially in 1 child. Conclusion: We concluded that living-related liver tranplantation in children with Wilson disease with parental heterozygote carrier graft is an effective treatment modality.

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Policy implications for up-scaling of off-grid solar PV for increasing access to electricity in rural areas of Nepal: Best practices and lessons learned

  • Sapkota, Surya Kumar
    • Bulletin of the Korea Photovoltaic Society
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    • v.6 no.1
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    • pp.8-20
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    • 2020
  • Nepal has huge potential of hydro and other renewable energy resources including solar energy. However, only 70% of the total population have access to electricity despite the long history of hydropower development in the country. Still more than 37% population in rural areas and around 73% population in Karnali Province, one of the least developed provinces, are living without access to electricity despite taking several initiatives and implementing various policies by government supporting electrification in off-grid rural areas. Government together with donors and private sector has extensively been promoting the off-grid solar photovoltaic (PV) echnology in un-electrified areas to increase electricity access. So far, more than 900,000 households in rural areas of Nepal are getting electricity from stand-alone solar PV systems. However, there are many challenges including financial, technical, institutional, and governance barriers in Nepal. This study based on extensive review of literatures and author's own long working experiences in renewable energy sector in Nepal, shares the best practices and lessons of off-grid solar PV for increasing access to electricity in rural areas of Nepal. This study suggests that flexible financial instruments, financial innovations, bundling of PV systems for concentrating energy loads, adopting standards process, local capacity building, and combination of technology, financing and institutional aspects are a key for enhancing effectiveness of solar PV technology in rural areas of Nepal.

Evaluation of Effect of Renal Transplantation on Growth in Children with Chronic Renal Failure (소아 신장이식 후 성장에 대한 평가)

  • Lee, Ji-Woong;Kim, Jung-Soo;Kim, Yang-Wook;Kim, Young-Hoon;Yoon, Young-Chul;Chung, Woo-Yeong
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.219-227
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    • 2006
  • Purpose : We aim to identify the clinical and demographic characteristics in children who underwent renal transplantation(RTx) and to evaluate the influence on growth of RTx in children. Methods : We reviewed 17 medical records of chronic renal failure patients who underwent RTx from April 1992 and June 2004 at Busan Paik Hospital. Age and sex distribution, cause of disease, donor analysis, patient and graft survival rate, and the status of growth after RTx were analysed by retrospective study. Results : Eighteen RTx were performed in 17 patients(8 boys, 9 girls). The mean age at the time of RTx was $15.8{\pm}3.5$ years and the mean duration of dialysis therapy before RTx was $22.4{\pm}18.0$ months. The 1 year and 5 year patient survival rate were each 100%, and the 1 year and 5 year graft survival rate were 88%, 36% respectively. The most common cause of graft failure was chronic rejection. The mean final height of male patients was $162.8{\pm}10.0$ cm(143.0-172.5 cm) and of female patients was $154.5{\pm}12.1$ cm(135.8-160.0 cm). The mean height standard deviation score(Ht SDS) increased after RTx from -1.95 to -1.53 but the increment rate was not statistically significant. Similar changes were noted in individual patient analysis. Also there was no significant difference between the living-related donors and cadaveric donors. Conclusion : Our data shows that even successful RTx rarely results in full growth rehabilitation. To overcome retarded growth in children with chronic renal failure, appropriate combined management of metabolic and nutritional problems, correction of anemia, proper use of recombinant growth hormone therapy, early renal transplantation and shortening of the duration of dialysis would be necessary.

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Hepatic Vessel Segmentation using Edge Detection (Edge Detection을 이용한 간 혈관 추출)

  • Seo, Jeong-Joo;Park, Jong-Won
    • 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.

Intraspecific Androgenesis in Mud Loach (Misgurnus mizolepis): II. Diploid Restoration and Viability Assessment (미꾸라지(Misgurnus mizolepis)의 웅성발생성 처녀생식: II. 웅성발생성 이배체 유도 및 생존능력 평가)

  • Nam, Yoon-Kwon;Bang, In-Chul;Noh, Choong-Hwan;Cho, Young-Sun;Kim, Dong-Soo
    • Journal of Aquaculture
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    • v.19 no.4
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    • pp.281-287
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    • 2006
  • Intraspecific diploid androgenesis was achieved in mud loach (Misgurnus mizolepis) by the inhibition of the first mitotic division using combined thermal treatment. A combined thermal treatment (heat shock at $40.5\;^{\circ}C$ for 120 sec followed by cold treatment at $1\;^{\circ}C$ for 45 min) applied to the 1st metaphase of cell division (28 min post insemination at $25\;^{\circ}C$) successfully recovered viable androgenetic diploidy. Mean hatching success of the androgenetic diploid group was 29.6%, and the average yield out of total eggs taken was about 7% assessed at 1 week of age. However, relatively large variations in the yield of diploid androgenesis were observed among different egg batches used as cytoplasmic donors. Successful diploidization was confirmed by flow cytometric analysis, and parthenogenic reproduction in a paternal exclusive manner was verified with transgene dosage. Significant mortality was found in most androgenetic groups especially from hatch to 1 month of age, although such mortality was stabilized later.

Efficacy of Living Donor Liver Transplantation in Patients with Methylmalonic Acidemia

  • Jang, Jae Guk;Oh, Seak Hee;Kim, Yu Bin;Kim, Seo Hee;Yoo, Han-Wook;Lee, Beom Hee;Namgoong, Jung-Man;Kim, Dae Yeon;Kim, Ki-Hun;Song, Gi-Won;Moon, Deok-Bog;Hwang, Shin;Lee, Sung-Gyu;Kim, Kyung Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.3
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    • pp.288-294
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    • 2021
  • Purpose: Despite aggressive medical and nutritional management, patients with methylmalonic acidemia (MMA) often suffer from multi-organ damage. Early deceased donor liver transplantation (DDLT) has emerged as an intervention to prevent disease progression. We investigated the efficacy of living donor LT (LDLT) with a potential carrier of MMA and a small volume of graft in patients with MMA as an alternative to DDLT. Methods: Of five patients (three male, two female; median age 5.7 years; range, 1.3-13.7 years), four underwent carrier LDLT, while one underwent non-carrier auxiliary LDLT. All patients received pre- and post-LT continuous renal replacement therapy and were provided with minimal restriction diet according to serum MMA level after LT. MMA levels in the serum and urine, the incidence of metabolic crisis, and clinical findings before and after LT were compared. Results: The survival rate was 100% during 2.2 years of follow up period after LT. In all five cases, MMA titer in the serum after transplantation decreased with less restrictive diet. Metabolic crisis was not observed during the follow-up period. In addition, no patient showed progression of severe renal impairment requiring hemodialysis. Progression of delayed cognitive development was not observed. Social functioning with improved neuropsychiatric development was observed. Conclusion: This study showed that LDLT achieved improved quality of life with less restrictive diet, therefore it could be a feasible alternative option to DDLT for the treatment of patients with MMA, even with an auxiliary LT.

Effect of OPU Session Periods on the Efficiency of In Vitro Embryo Production in Elite Korean Native Cow

  • Choi, Byung-Hyun;Song, Seok-Hwan;Park, Bun-Young;Kong, Rami;Son, Mi-Ju;park, Chan-Sang;Shin, Nyeon-Hak;Cheon, Hye-Young;Lee, Sung-Hoon;Jin, Jong-In;Lee, Jung-Gyu;Kong, Il-Keun
    • Journal of Embryo Transfer
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    • v.33 no.4
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    • pp.265-270
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    • 2018
  • Up-to-date artificial insemination (AI) using frozen sperm consider as the most widely using technology for improvement of Korean Native Cow (Hanwoo) embryo production. However, it is time consuming, required at least 15~20 years to make more than 6 generations, and their offspring number is limited. To overcome such limitations, superovulation and in vitro fertilization have been developed. For superovulation, the number of produced embryos are not enough for commercialization and donor cows need rest period. This led to use of slaughterhouse ovary for in vitro fertilization, but it is impossible to repeat the collection from the same individual and it only can improve the genetic merits of offspring for one generation. Production of embryos using Ovum Pick-Up (OPU) technique, where oocytes can be repeatedly collected from living elite donor, might overcome these limitations. In this study, we investigated the possibility of using OPU technique from donors at different age and different session periods for mass-embryo-production. Oocytes were collected from 26 donor cows twice per week, 3 - 4 months per year, between 2013 and 2016. Results showed that, the average number of embryo produced in first year used donor was significantly higher than that in second year used donor ($3.89{\pm}2.85$ vs $3.29{\pm}2.70$), however, there was no significant difference between third year used donor ($3.51{\pm}3.32$) and other groups. Taken together, our data showed that repeated using of donor up to three years is possible for in vitro embryo mass-production. Moreover, OPU can be used as suitable embryo producing technique for livestock breed improvement.