• Korean journal of dermatology
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• v.56 no.10
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• pp.603-608
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• 2018

Background: It is well known that skin cancer and precancerous disease develop more frequently in patients undergoing solid organ transplantation than normal populations in the normal population in Western countries. However, to date, the clinical and demographic features of skin cancer and precancerous disease after solid organ transplantation are not established in Asian countries. We evaluated the clinical and demographic features of primary skin cancer and precancerous lesions after solid organ transplantation and compared these with the trends observed in Western countries. Methods: We retrospectively reviewed the medical records of patients who underwent kidney, liver, heart, and lung transplantation between January 1995 and April 2017 and who developed skin cancer or precancerous lesions after transplantation. The various lesions observed were squamous and basal cell carcinoma, malignant melanoma, Kaposi sarcoma, Bowen's disease, and actinic keratosis. Results: We identified 4604 patients who received organ transplant. The mean age of patients was 44.8 years (male, 64.6%; female, 35.4%), and the sum of the person-year of observation time was 31,024 person-years. The incidence rate per 100,000 person-years was 29.01 for squamous cell carcinoma, 19.34 for basal cell carcinoma, 6.45 for malignant melanoma 3.22 for Kaposi sarcoma, and 74.17 for Bowen's disease and actinic keratosis. The incidence rate per 100,000 person-years was the highest in patients undergoing heart transplantation (610.50), followed by those who underwent kidney transplantation (136.54) and liver transplantation (90.15). Koreans showed lower incidence rates than those observed in Westerners. Conclusion: The incidence of primary skin cancer and precancerous lesions after solid organ transplantation in Koreans was lower than that in Westerners. Squamous cell carcinoma was the most common skin cancer in patients undergoing solid organ transplantation and the incidence rate of skin cancer and precancerous lesions was the highest in patients undergoing heart transplantation.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.4
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• pp.386-394
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• 2022

Splenic artery steal syndrome (SASS) is a cause of graft hypoperfusion leading to the development of biliary tract complications, graft failure, and in some cases to retransplantation. Its management is still controversial since there is no universal consensus about its prophylaxis and consequently treatment. We present a case of SASS that occurred 48 hours after orthotopic liver transplantation (OLTx) in a 56-year-old male patient with alcoholic cirrhosis and severe portal hypertension, and who was successfully treated by splenic artery embolization. A literature search was performed using the PubMed database, and a total of 22 studies including 4,789 patients who underwent OLTx were relevant to this review. A prophylactic treatment was performed in 260 cases (6.2%) through splenic artery ligation in 98 patients (37.7%) and splenic artery banding in 102 (39.2%). In the patients who did not receive prophylaxis, SASS occurred after OLTx in 266 (5.5%) and was mainly treated by splenic artery embolization (78.9%). Splenic artery ligation and splenectomies were performed, respectively, in 6 and 20 patients (2.3% and 7.5%). The higher rate of complications registered was represented by biliary tract complications (9.7% in patients who received prophylaxis and 11.6% in patients who developed SASS), portal vein thrombosis (respectively, 7.3% and 6.9%), splenectomy (4.8% and 20.9%), and death from sepsis (4.8% and 30.2%). Whenever possible, prevention is the best way to approach SASS, considering all the potential damage arising from an arterial graft hypoperfusion. Where clinical conditions do not permit prophylaxis, an accurate risk assessment and postoperative monitoring are mandatory.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.1
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• pp.34-41
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• 2024

Backgrounds/Aims: Liver transplantation (LT) provides a favorable outcome for patients with hepatocellular carcinoma (HCC) and was launched in Vietnam in 2004. In this study, we evaluated the short-term and long-term outcomes of LT and its risk factors. Methods: This retrospective study analyzed HCC patients who underwent LT at Viet Duc University hospital, Vietnam, from 01/2012-03/2022. The following data were gathered: demographics, virus infection, tumor characteristics, alpha-fetoprotein (AFP) level, Child-Pugh and MELD scores, selection criteria, type of LT, complications, 30-day mortality, and disease-free and overall survival (DFS and OS). Results: Fifty four patients were included, the mean age was 55.39 ± 8.46 years. Nearly 90% had hepatitis B virus-related HCC. The median (interquartile range) AFP level was 16.2 (88.7) ng/mL. The average MELD score was 10.57 ± 5.95; the rate of Child-Pugh A and B were 70.4% and 18.5%, respectively. Nearly 40% of the patients were within Milan criteria, brain-dead donor was 83.3%. Hepatic and portal vein thrombosis occurred in 0% and 1.9%, respectively; hepatic artery thrombosis 1.9%, biliary leakage 5.6%, and postoperative hemorrhage 3.7%. Ninety-day mortality was 5.6%. Five-year DFS and OS were 79.3% and 81.4%, respectively. MELD score and ChildPugh score were predictive factors for DFS and OS (p < 0.05). In multivariate analysis, Child-Pugh score was the only significant factor (p < 0.05). Conclusions: In Vietnam, LT is an effective therapy for HCC with an acceptable complication rate, mortality rate, and good survival outcomes, and should be further encouraged.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.8009-8013
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• 2015

Background: Orthotopic organ transplantation, a treatment option for irreversible organ dysfunction according to organ failure, severe damaged organ or malignancy in situ, was usually accompanied with massive blood loss thus transfusion was required. We aimed to evaluate the adverse impact of blood transfusion on solid organ transplantation. Materials and Methods: From January, 2009 to December, 2014, patients who received orthotopic organ transplantation at Far Eastern Memorial Hospital medical center were enrolled. Clinical data regarding anemia status and red blood cell (RBC) transfusion before, during and after operation, as well as patient outcomes were collected for further univariate analysis. Results: A total of 105 patients who underwent orthotopic transplantation, including liver, kidney and small intestine were registered. The mean hemoglobin (Hb) level upon admission and before operation were $11.6{\pm}1.8g/dL$ and $11.7{\pm}1.7g/dL$, respectively; and the nadir Hb level post operation and the final Hb level before discharge were $8.3{\pm}1.6g/dL$ and $10.2{\pm}1.6g/dL$, respectively. The median units (interquartile range) of RBC transfusion in pre-operative, peri-operative and post-operative periods were 0 (0-0), 2 (0-12), and 2 (0-6) units, respectively. Furthermore, the median (interquartile range) length of hospital stay (LHS) from admission to discharge and from operation to discharge were 28 (17-44) and 24 (16-37) days, respectively. Both peri-operative and post-operative RBC transfusion were associated with longer LHS from admission to discharge and from operation to discharge. Furthermore, it increased the risk of post-operative septicemia. While peri-operative RBC transfusion elevated the risk of acute graft rejection in patients who received orthotopic transplantation. Conclusions: Worse outcome could be anticipated in those who had received massive RBC transfusion in transplantation operation. Hence, peri-operative RBC transfusion should be avoided as much as possible.

• Journal of Korean Medical Science
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• v.33 no.50
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• pp.326.1-326.10
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• 2018

Background: This retrospective study analyzed the causes of failure in the management process from the identification of brain-dead potential organ donors to actual donation in Korea over the past 5 years. Methods: Data of 8,120 potential brain deaths reported to the Korea Organ Donation Agency were used, including information received at the time of reporting, donation suitability evaluation performed by the coordinator after the report, and data obtained from interviews of hospital medical staff and the donor's family. Results: From January 2012 to December 2016, the total number of brain-dead potential organ donors in Korea was 8,120, of which 2,348 (28.9%) underwent organ procurement surgery with designated recipients. While the number of transplant donors has increased over time, the ratio of transplant donors to medically suitable brain-dead donors has decreased. The common causes of donation failure included donation refusal (27.6%), non-brain death (15.5%), and incompatible donation (11.6%); 104 potential donors (7.8%) were unable to donate their organs because they were not pronounced brain dead. Conclusion: The rate of successful organ donation may be increased by analyzing the major causes of failure in the brain-dead organ donation management process and engaging in various efforts to prevent such failures.

• International Journal of Computer Science & Network Security
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• v.22 no.9
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• pp.307-315
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• 2022

The review of known decision-making support systems and technologies regarding the possibility of donation and transplantation showed that currently there are no systems and technologies of decision-making support regarding the possibility of donation and transplantation considering civil law. The paper models the decision-making support process regarding the possibility of donation and transplantation, which is a theoretical basis for the development of rules, methods and technology of decision-making support regarding the possibility of donation and transplantation considering civil law. The paper also developed the technology of decision-making support regarding the possibility of donation and transplantation considering civil law as a component of the Unified State Information System for Organ and Tissue Transplantation, which automatically and free of charge determines the possibility/impossibility of donation and transplantation. In the case of the possibility of donation, the admissible type of donation is also determined - over-life or after-life donation - and data about potential donor is entered in the relevant Donor Register. In the case of the possibility of transplantation, if the recipient needs a transplant of one of the paired organs or a part of the organ/tissue, then data about potential recipient are entered in the Transplantation List from both over-life and after-life donor, otherwise, if the recipient needs a transplant of a non-paired organ or both paired organs, then data about potential recipient are entered only in the Transplantation List from after-life donor.

• Korean Journal of Adult Nursing
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• v.25 no.6
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• pp.690-700
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• 2013

Purpose: Liver transplantation (LT) is the best treatment for patients with end-stage liver disease and most patients with LT return to their normal life. However, pregnancy and childbirth for women with LT are less common, mainly because it is considered to be dangerous for their health. The purpose of this study was to describe how Korean women after LT experience their pregnancy and childbirth. Methods: This study was designed to explore the experiences of pregnancy and childbirth of women with LT. Data were collected by individual in-depth interviews with four women who were pregnant and gave birth following LT in 2009. All interviews were audio-taped and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. Results: Four themes emerged as a result of analysis: recovery of lost feminity and marriage; fulfilling roles through pregnancy; life-risking pregnancy; and perfect family achieved by childbirth. These themes describe in detail about challenges and concerns the women with LT faced for their pregnancy and childbirth as well as many emotionally touching experiences. Conclusion: The results of this study would support health professionals to be better prepared to help women with LT for pregnancy and childbirth by providing in-depth and insightful information.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.4
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• pp.571-579
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• 2010

The advancement of medical technology has made it possible to treat various incurable diseases. Especially organ transplantation can give another life to the patients who have organ failure and could not find any other ways to treat their diseases. According to the development of medical technology and immunosuppressive drugs, the rate and extent of organ transplantation is increasing these days. New medical technologies like organ transplantation brought on critical issues and these have changed the way of thinking and morals that has been the fundamental rules in our society. Bioethics is already an important field of medicine and oriental medicine should investigate the problem caused by the development of medical technology and life science and should form a view of life in oriental medicine. Oriental medicine is East Asian traditional medicine based on "Huangdi-Neijing", constructed by the system of Jangfu and meridian. The traditional therapies of oriental medicine have completed a scientific system on the point of view that looks on human and nature equally. This process continued to form a new medical theory as the environment was changed and the new diseases were appeared since "Huangdi-Neijing" and "Shoganron" showed a new scope to investigate human and diseases. Therefore, it is important to develop the point of view of oriental medicine as the medical situation was changed. Oriental medicine has a holistic view that considers human as a little cosmos resonated by a big cosmos and regards the possibility to recover and to regulate the energy in our body. This theory is a basic idea of oriental philosophy. Oriental medicine focuses on the balance of yin and yang of the body and tries to harmonize the imbalance of yin and yang caused by the life style and environment. This can solve many problems that cannot be settled by modern medicine and this can accomplish the new paradigm of oriental medicine that is needed these days.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.19 no.2
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• pp.158-167
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• 2012

Purpose: To determine the mediating as well as moderating effect on both the emotional labor and burnout of professional self-concept perspective organ transplantation coordinators (OTC)'. Method: A self-report questionnaire was collected from 86 OTCs nationwide. The data were analyzed using t-test, ANOVA, Scheffe' test, Pearson' Correlation Coefficients, AMOS 20.0, and multiple regression. Results: For effects of professional self-concept on emotional labor and burnout, higher emotional labor was related to higher burnout. When professional self-concept was mediated, emotional labor had a greater effect on burnout however, a partial mediating effect was detected. From the regression analysis with the independent variables of emotional labor (A) and professional self-concept (B), adding relation of both variables ($A{\times}B$) increased the explained variance to 56.3% ($p$<.05). It was confirmed that professional self-concept had a moderating effect on emotional labor and burnout. Conclusion: The results of this study indicate that, when professional self-concept was mediated emotional labor of an OTC decreased, and burnout decreased when professional self-concept was high. Also, by controlling professional self-concept, emotional labor and burnout decreased. Therefore, it's necessary to map out the environment and develop strategies to reduce emotional labor and burnout in organ transplantation coordinators.

• Archives of Plastic Surgery
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• v.48 no.4
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• pp.373-377
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• 2021

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently described form of T-cell non-Hodgkin lymphoma now formally recognized by the World Health Organization classification of lymphoid neoplasms. The aim of this paper is to report the first case of BIA-ALCL diagnosed in a pregnant patient. It is well known that BIA-ALCL appears as an indolent lymphoma with a good prognosis when diag-nosed at early stages and clinical guidelines for its management have been clearly published. Nevertheless, they lack a standardized approach for BIA-ALCL during pregnancy. With limited experience in our case, treatment has been safely postponed after term without affecting patient's overall prognosis and without fetal complication. The fact that the disease was diagnosed at an early stage (stage I) undoubtedly influenced the course of treatment. A multidisciplinary approach weighing the risks and benefits of treatment is of paramount importance in order to ensure the best possible outcome for both the mother and her child and clinical update guidelines should be issued.