• 대한이식학회지
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• 제31권4호
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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.

• 보험의학회지
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• 제29권2호
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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.

• 기본간호학회지
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• 제2권2호
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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

• 한국보건간호학회지
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• 제19권1호
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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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권6호
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• pp.528-534
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• 2021

Purpose: Living-donor liver transplant emerged as an alternative treatment for end stage liver disease due to the lack of cadaveric organs availability that met the demand. In Portugal, pediatric living-donor liver transplant (P-LDLT) was initiated in 2001 in Portugal in order to compensate for the scarcity of cadaveric organs for such cases. The aim of this study was to retrospectively analyze the morbi-mortality of the 28 donors included in P-LDLT program performed at Coimbra's Pediatric Hospital (CHUC), a Portuguese reference center. Methods: We retrospectively collected pertinent donor data and stratified complications according to Clavien's scoring system. Results: In total, 28.6% (n=8) of the donors had surgical complications. According to Clavien-Dindo's classification, two donors had major complications (Clavien grade ≥3), four donors had grade 2 complications, and two donors had grade 1 complications. There were no P-LDLT-related mortalities in the present case series. The most common verified complications were biliary tract injuries and superficial incisional infections, which are consistent with the complications reported in worldwide series. Conclusion: These patients from CHUC shows that donor hepatectomy in P-LDLT is a safe procedure, with low morbidity and without mortality.

• 정신신체의학
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• 제31권2호
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• pp.43-49
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• 2023

우리나라의 경우, 이식 대기자에 비해 공여 장기 수가 부족하여 생체 장기기증에 대한 의존도가 높으며, 생체 장기기증 건수도 지속적으로 증가하고 있다. 특히, 생체 신장 이식 건수는 전 세계적으로 높기 때문에 생체 신장 공여자에 대한 이식 전 정신사회적 평가의 중요성이 부각되고 있다. 이전 연구에 따르면 이식 전 공여자 평가 시 사전 동의 여부 및 수술 위험성에 대한 인지 여부를 파악하는 것이 중요하며 이를 위해 다음과 같은 평가 도구들을 시행할 수 있다. 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). 이식 전 정신사회적 평가 도구에 관한 문헌을 검토한 후, 한국의 생체 신장 기증자에 대한 법적 고려 사항을 살펴본 후 생체 신장 공여자에 대한 효과적인 이식 전 선별 평가 방법을 제안하려 한다.

• 대한간호학회지
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• 제51권1호
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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.

• Journal of International Society for Simulation Surgery
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• 제1권1호
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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.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.75-80
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• 2001

Purpose : We have evaluated the morbidity of donor site after transfer of free fibular osseous and osteocutaneous flap to defect site of bone and soft tissue due to chronic osteomyelitis of long tubular bone, open fracture with bony defect, bone or soft tissue tumor and congenital anomaly. Materials and methods : The 54 cases of 79 cases to be carried out from May, 1982 to May, 2001 which could be followed up were reviewed. There were forty nine in male and five in female. The mean age was 35(4 to 66)years old and mean follow up period is 21.3 month(12 to 72). We have retrospectively analyzed the various postoperative complications such as compartment syndrome, donor site infection, skin defect, hypesthesia, hammer toes, ankle instability and activity of daily living by help of questionnaire, telephone, physical examination, follow up x-ray study and chart. Results : In the total 54 cases the medication period for pain control after operation were classified into three groups under 2 weeks(49 cases), from 2 weeks to 6 weeks(3 cases) and over 6 weeks(2 cases). The postoperative morbidity were occurred in total 12 cases(compartment syndrome: 0, infection : 2, skin defect: 1, hypesthesia: 5, hammer toe: 2 ankle pain: 2 discomfort in activity of daily living: 0), and also the morbidity rates of donor site were 23.5% in osseous flap and 21.6% in osteocutaneous flap were occurred. There was no statistical significonce in morbidity between osseous and osteocutaneous free fibular flap transfer(P>0.05). Discussion : In general the morbidity of free fibular flap transfer was relatively high but it did not have any effect on daily activity of living. We think that the meticulous operation technique, detailed wound care and early range of motion exercise will reduce the morbidity of donor site of flap.

• Archives of Reconstructive Microsurgery
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• 제7권2호
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• pp.88-94
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• 1998

Free vascularized fibular transplantation is one of the most useful living bone reconstructive procedure in microsurgical field. Concerning about donor site morbidity, the donor has minor problems of ankle stability and muscle power weakness and transient peroneal nerve symptoms. That problems can be minimized with longitudinal splitted osteotomy on the donor fibula if the bone defect in recipient site is not so large. Half splitted fibula with peroneal arterial pedicle which contains nutrient artery and periosteal vessels, grafted bone can survive with those vascular supplies. Authors underwent five cases of half splitted free vascularized fibular transplantation from 1985. There were no evidence of devascularization in all cases, we can minimized donor morbidity with leaving half fibula intact on donor site. The problem of that technique is technically demanding in longitudinal splitting of bone without damage to peroneal nutrient vessels and periosteal soft tissues which attached to the bone. Authors can propose longitudinal half fibular transplantation is one of modification in free vascularized bone transplantation that minimize donor defect.