• Title/Summary/Keyword: Organ Transplantation

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Transplantation Immunology from the Historical Perspective (이식면역학의 역사적 고찰)

  • Park, Chung-Gyu
    • IMMUNE NETWORK
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    • v.4 no.1
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    • pp.1-6
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    • 2004
  • Transplantation would be the only way to cure the end-stage organ failure involving heart, lung, liver, kidney and pancreas. The replacement of the parts of the body damaged to lose its function or lost to trauma must be a dream of human-being. Human history is replete with chimeras, from sphinxes to mermaids, making one wonder if the ancients might actually have dreamed of what now is called 'xenotransplantation'. In the 20th century, the transplantation of organs and tissues to cure disease has become a clinical reality. The development in the fields of surgical techniques, physiology and immunology attributed to the successful transplantation in human. In the center of the successful transplantation lies the progress in understanding the cellular and molecular biology of immune system which led to the development of immunosuppressive drugs and the invention of the concept of immunological tolerance. The mandatory side effects of immunosuppressive drugs including infection and cancer forced us to search alternative approaches along with the development of new immunosuppressive agents. Among the alternative approaches, the induction of a state of immunologic tolerance would be the most promising and the most generic applicability as a future therapy. Recent reports documenting long-term graft survival without immunosuppression suggest that tolerance-based therapies may become a clinical reality. Last year, we saw the epoch making success of overcoming hyperacute rejection in porcine to primate xenotransplantation which will lead porcine to human xenotransplantation to clinical reality. In this review, I dare to summarize the development of transplantation immunology from the perspective of history.

Outcome of Extracorporeal Ventricular Assist Device for Cardiogenic Shock as a Bridge to Transplantation

  • Kim, Hyo-Hyun;Shin, Jung-Hoon;Kim, Jung-Hwan;Youn, Young-Nam
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.368-374
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    • 2020
  • Background: The extracorporeal ventricular assist device (e-VAD) system is designed for left ventricular support using a permanent life support console. This study aimed to determine the impact of temporary e-VAD implantation bridging on posttransplant outcomes. Methods: We reviewed the clinical records of 6 patients with the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1, awaiting heart transplantation, who were provided with temporary e-VAD from 2018 to 2019. The circuit comprised a single centrifugal pump without an oxygenator. The e-VAD inflow cannula was inserted into the apex of the left ventricle, and the outflow cannula was positioned in the ascending aorta. The median follow-up duration was 8.4±6.9 months. Results: After e-VAD implantation, lactate dehydrogenase levels significantly decreased, and Sequential Organ Failure Assessment scores significantly improved. Bedside rehabilitation was possible in 5 patients. After a mean e-VAD support duration of 14.5±17.3 days, all patients were successfully bridged to transplantation. After transplantation, 5 patients survived for at least 6 months. Conclusion: e-VAD may reverse end-organ dysfunction and improve outcomes in INTERMACS I heart transplant patients.

Overview of Gingival Overgrowth in Transplant Patients

  • Park, Seo-Jin;Park, Jun-Beom;Ko, Young-Kyung
    • Journal of Korean Dental Science
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    • v.5 no.1
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    • pp.1-6
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    • 2012
  • Patients with gingival overgrowth are easily seen in dental clinics. Cyclosporin-A (CsA), a widely prescribed immunosuppressant induces gingival overgrowth in up to 35% of patients with medical history of organ transplantation. The immunosuppressant CsA can transform genetic expression of gingival fibroblasts, resulting in gingival overgrowth. Meticulous plaque control is recommended for treatment of gingival overgrowth. Substitution of the drug or surgical procedures such as gingivectomy and periodontal flaps should be considered after re-evaluation. Azithromycin is often recommended as a supplementary drug to reduce this side effect. Recent studies show that tacrolimus can be a more economic, efficient and safe substitute for CsA.

Artificial Organ Transplantation With 4D Printing (4D 프린팅을 이용한 인공장기이식)

  • Yeo, Da-Hye;Lim, Da-Geom;Park, Cheol-Woo
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2021.07a
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    • pp.343-345
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    • 2021
  • 본 논문에서는 4D 프린팅을 이용한 인공장기이식에 대해 소개한다. 여러 외부적 요인에 대처할 수 없었던 3D 바이오 프린팅의 단점을 보완하여 자가변환 및 자가조립이 가능한 재료를 3D프린터로 찍어낸 다음, 그 물체가 주변환경에 의해 스스로 모양이 변화하는 기술인 4D 프린팅을 이용한다. 또한, 4D 프린팅은 변형이 가능한 특수 소재를 사용함으로써 시간이 지나면 출력한 결과물의 모양이 변하게 되고, 시간 및 온도·습도·압력 등의 외부적인 요인에 스스로 능동적으로 대처할 수 있다. 본 논문에서는 4D 프린팅 기술로 제작한 작은 인공장기를 인체에 삽입함으로써 수술 후 감염 및 합병증 등의 부작용을 최소화할 수 있고 수술 시간을 크게 단축할 수 있다는 면에서 우수함을 보인다.

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Mastopexy Performed in a Liver Transplantation Recipient: A Case Report (간이식 수용자에서 시행한 유방 고정술의 증례보고)

  • Lee, Kang-Woo;Lee, Taik-Jong
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.527-530
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    • 2011
  • Purpose: Liver transplantation is a groundbreaking section in the field of surgery. Nowadays over 90% of success rate is accomplished and life expectancy of the patients has been elongated. Patients are now seeking for surgical procedures including cosmetic plastic surgery. But these patients take immunosuppressive medication and steroids, which can increase the risk of wound infection, and delay wound healing. By reviewing the case of a 21-year-old liver transplant recipient who underwent mastopexy due to breast ptosis, we discussed about the matters we should consider when performing surgery in liver transplantation recipients. Methods: The patient was a 21-year-old female who received liver transplantation from her father. She was exposed to massive amount of steroids and immunosuppressants, which led to breast ptosis. The vertical and short horizontal incision mastopexy using a medial-based pedicle was done, 29 months after the liver transplantation. Results: On postoperative day 1, she was discharged. On day 10, sutures were removed and taping was applied. There was no sign of wound infection, wound dehiscence, hematoma or bleeding. The patient was followed up at 3, 6 and 9 months after the operation. Mild recurrence of the glandular ptosis was observed but revision was not required. Conclusion: We were able to successfully operate without any complications in the liver transplant recipient. With special attention and consideration, cosmetic plastic surgery can be safely performed in organ transplantation recipients.

Public's Attitude to Organ Transplants and Factors Influencing Attitudes (장기이식에 대한 일반인의 태도 및 영향요인)

  • Shon Young-Hee;Cho Chung-Min
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.9 no.2
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    • pp.279-287
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    • 2002
  • Purpose: This study was done to Identify attitude and factors influencing attitudes to organ transplants. Method: Study participants were 165 people over the age of 18 and living in Seoul. The instrument used for this study was the descriptive questionnaire developed by Ju (1995). Analysis of the data was done with SPSS Win 10.0 with descriptive statistics. t-test. ANOVA and stepwise multiple regression. Results : 1. The scores on attitude toward organ transplants ranged from 14 to 70. and had a mean score of 49.26. There were statistically significant differences in scores on attitude to organ transplants according to age (p= .03). marital status (p= 00), monthly income (p=.02) and experience of having education about organ transplants (p= .00). 2. The factors influencing attitudes to organ transplants were having the experience of education on transplants and marital status. These two variables explained 20.1% of the variance. 3. Reasons given for no written pledge to donate one's organs were 'fear on organ donation', 'not knowing the way of' how to do'. 'plan to give my organs to a family member when needed'. 'physical condition' and 'religious belief'. Conclusion: Experience with education for organ transplant and marital status were identified as important variables in attitudes to organ transplants.

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Successful Heart Transplantation Despite Rhesus Blood Type Mismatch: A Case Report

  • Ji Hong Kim;Yu-Rim Shin
    • Journal of Chest Surgery
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    • v.57 no.2
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    • pp.217-219
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    • 2024
  • Matching for the rhesus (Rh) blood group is currently not taken into account in the organ allocation system. However, in Rh-mismatched transplantation, the primary concern is the potential for RhD-negative recipients to develop sensitization and produce anti-D antibodies if they receive a transfusion of RhD-positive blood. It is estimated that over 80% of RhD-negative recipients may experience Rh allosensitization when exposed to RhD-positive blood, although this occurrence is less common in recipients of solid organs. In theory, RhD-negative recipients who receive organs from RhD-positive donors are at risk of alloimmunization and the production of anti-D antibodies, which could complicate future blood product transfusions. However, our understanding of the impact of donor-recipient Rh mismatch on transplant outcomes, particularly in heart transplantation, is limited. We report a case of successful Rh-mismatched heart transplantation, which was effectively managed through the use of preoperative RhD immunoglobulin and plasmapheresis.

Anti-inflammatory Effects of UDCA on Splenocytes Exposed to PMA/Ionomycin

  • Park, So-Young;Woo, Jong-Shick;Jung, Yu-Jin;Won, Tae-Joon;Hih, Yun-Ju;Lee, Chan-Woo;Kim, Hyo-Shin;Joo, Seong-Soo;Lee, Do-Ik;Hwang, Kwang-Woo
    • Biomolecules & Therapeutics
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    • v.16 no.2
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    • pp.126-131
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    • 2008
  • Immunosuppressive therapy after organ transplantation is routinely used to prevent rejection of the organ, because this decreases the risk of adverse events, infection, and malignancies. Recently, ursodeoxycholic acid (UDCA), which is isolated from the dried bile of adult Chinese bears, has been shown to reduce the incidence and severity of acute rejection of liver allograft during early phase of liver transplantation. Therefore, in this study, we investigated the effect of UDCA on the proliferation of splenocytes exposed to PMA plus ionomycin. Our results demonstrated that UDCA decreased the splenocytes' proliferation in a dose-dependent manner. The decreased cell proliferation was accompanied with the decreased secretion of cytokines such as IL-2, IFN-${\gamma}$ and TNF-${\alpha}$. In addition, the pretreatment of UDCA on splenocytes stimulated with PMA plus ionomycin decreased the mRNA levels of cytokines (IL-2, IFN-${\gamma}$ and TNF-${\alpha}$) and costimulatory molecules (B7.2 and PD-L1). These results suggest the beneficial effect of UDCA on organ transplantation by decreasing lymphocyte proliferation.

Genome-wide Analysis of Aberrant DNA Methylation for Identification of Potential Biomarkers in Colorectal Cancer Patients

  • Fang, Wei-Jia;Zheng, Yi;Wu, Li-Ming;Ke, Qing-Hong;Shen, Hong;Yuan, Ying;Zheng, Shu-Sen
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1917-1921
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    • 2012
  • Background: Colorectal cancer is one of the leading causes of mortality worldwide. Genome wide analysis studies have identified sequence mutations causing loss-of-function that are associated with disease occurrence and severity. Epigenetic modifications, such DNA methylation, have also been implicated in many cancers but have yet to be examined in the East Asian population of colorectal cancer patients. Methods: Biopsies of tumors and matched non-cancerous tissue types were obtained and genomic DNA was isolated and subjected to the bisulphite conversion method for comparative DNA methylation analysis on the Illumina Infinium HumanMethylation27 BeadChip. Results: Totals of 258 and 74 genes were found to be hyper- and hypo-methylated as compared to the individual's matched control tissue. Interestingly, three genes that exhibited hypermethylation in their promoter regions, CMTM2, ECRG4, and SH3GL3, were shown to be significantly associated with colorectal cancer in previous studies. Using heatmap cluster analysis, eight hypermethylated and 10 hypomethylated genes were identified as significantly differentially methylated genes in the tumour tissues. Conclusions: Genome-wide methylation profiling facilitates rapid and simultaneous analysis of cancerous cells which may help to identify methylation markers with high sensitivity and specificity for diagnosis and prognosis. Our results show the promise of the microarray technology in identification of potential methylation biomarkers for colorectal cancers.