• Journal of Korean Medical Science
• /
• v.33 no.43
• /
• pp.282.1-282.6
• /
• 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.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.23 no.4
• /
• pp.389-397
• /
• 2017

Purpose: This study was conducted to examine awareness of biomedical ethics, and to identify affecting factors of the awareness of biomedical ethics in nursing students. Methods: The subjects consisted of 266 nursing students their third and fourth years of study. The data were collected from October to December, 2015 by self-report using questionnaires. Data analysis was performed using SPSS/WIN 18.0, descriptive statistics, t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson correlation coefficient, and multiple regression analysis. Results: The mean score of the awareness of biomedical ethics was $2.81{\pm}0.22$, perception of death was $3.15{\pm}0.36$, and knowledge of brain death, organ donation, and organ transplant was $12.12{\pm}3.02$. The prediction factors of awareness of biomedical ethics were gender (${\beta}=.29$, p<.001), participation in religious activity (${\beta}=.23$, p=.015), and perception of death (${\beta}=.20$, p=.016). The explanation power was 17.1%. Conclusion: These results showed that education about biomedical ethics is necessary for nursing students, and the development of biomedical ethics educational programs should reflect affecting factors.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.11
• /
• pp.137-147
• /
• 2018

This study is a descriptive evaluation of the differences in biomedical ethics consciousness, related knowledge, awareness, and attitude of nursing college students according to the completion of biomedical ethics education. The data were collected from 112 nursing students using self-report questionnaires and analyzed by t-test, Chi-Square test, Fisher's exact probability test and Pearson's correlation coefficient using SPSS 21.0. There were significant differences between the two groups in the sub-domains of biomedical ethics consciousness, artificial insemination, euthanasia and organ transplantation. The biomedical ethics consciousness was positively correlated with attitudes toward human tissue donation and transplantation, awareness of death, and awareness of hospice palliative care. The results of this study showed that after participating in the biomedical ethics education, nursing college students had statistically significant differences in the consciousness of artificial insemination, euthanasia, and organ transplantation. Moreover, the consciousness of biomedical ethics was related to attitude toward human tissue donation and transplantation and awareness of hospice palliative care. Based on the results of this study, we would like to suggest the need for development of various curricula related to death, hospice palliative care, human tissue donation and transplantation in the biomedical ethics curriculum. In addition, as the study was conducted in a single college, it is difficult to generalize the results; therefore, additional studies at different facilities are recommended.

• Archives of Plastic Surgery
• /
• v.44 no.3
• /
• pp.238-242
• /
• 2017

The most common anatomic variant seen in donor kidneys for renal transplantation is the presence of multiple renal arteries, which can cause an increased risk of complications. Accessory renal arteries should be anastomosed to the proper source arteries to improve renal perfusion via the appropriate vascular reconstruction techniques. In microsurgery, 2 kinds of vascular augmentation methods, known as 'supercharging' and 'turbocharging,' have been introduced to ensure vascular perfusion in the transferred flap. Supercharging uses a distant source of the vessels, while turbocharging uses vascular sources within the same flap territory. These technical concepts can also be applied in renal transplantation, and in this report, we describe 2 patients who underwent procedures using supercharging and turbocharging. In one case, the ipsilateral deep inferior epigastric artery was transposed to the accessory renal artery (supercharging), and in the other case, the accessory renal artery was anastomosed to the corresponding main renal artery with a vascular graft (turbocharging). The transplanted kidneys showed good perfusion and proper function. No cases of renal failure, hypertension, rejection, or urologic complications were observed. These microsurgical techniques can be safely utilized for renal transplantation with donor kidneys that have multiple arteries with a lower complication rate and better outcome.

• Tuberculosis and Respiratory Diseases
• /
• v.82 no.4
• /
• pp.348-356
• /
• 2019

Background: Recently, the number of lung transplants in South Korea has increased. However, the long-term outcome data is limited. In this study, we aimed to investigate the long-term outcomes of adult lung transplantation recipients. Methods: Among the patients that underwent lung transplantation at a tertiary referral center in South Korea between 2008 and 2017, adults patient who underwent deceased-donor lung transplantation with available follow-up data were enrolled. Their medical records were retrospectively reviewed. Results: Through eligibility screening, we identified 60 adult patients that underwent lung (n=51) or heart-lung transplantation (n=9) during the observation period. Idiopathic pulmonary fibrosis (46.7%, 28/60) was the most frequent cause of lung transplantation. For all the 60 patients, the median follow-up duration for post-transplantation was 2.6 years (range, 0.01-7.6). During the post-transplantation follow-up period, 19 patients (31.7%) died at a median duration of 194 days. The survival rates were 75.5%, 67.6%, and 61.8% at 1 year, 3 years, and 5 years, respectively. Out of the 60 patients, 8 (13.3%) were diagnosed with chronic lung allograft dysfunction (CLAD), after a mean duration of $3.3{\pm}2.8years$ post-transplantation. The CLAD development rate was 0%, 17.7%, and 25.8% at 1 year, 3 years, and 5 years, respectively. The most common newly developed post-transplantation comorbidity was the chronic kidney disease (CKD; 54.0%), followed by diabetes mellitus (25.9%). Conclusion: Among the adult lung transplantation recipients at a South Korea tertiary referral center, the long-term survival rates were favorable. The proportion of patients who developed CLAD was not substantial. CKD was the most common post-transplantation comorbidity.

• Archives of Plastic Surgery
• /
• v.38 no.3
• /
• pp.245-250
• /
• 2011

Purpose: Composite tissue allotransplantation has emerged as a new therapeutic modality to reconstruct major tissue defects of the head, neck and extremities. A questionnaire-based instrument, the Louisville Instrument for Transplantation (LIFT), has been developed to objectively assess the risk-versus-benefit ratio for composite tissue allotransplantation procedures. The objective of this study is to assess if the LIFT is a useful, reliable and valid tool to apply to the Korean population. Methods: Seventy-three medical students and 60 lay public completed the LIFT questionnaire (translated to Korean) over the period from February 2010 to April 2010. Internal consistency was assessed using Cronbach's alpha. Test-retest reliability was analyzed using Pearson's correlation coefficient. Construct validity was assessed by comparing Pearson's correlation coefficients between perceived improvements in quality of life and responses to risk tolerance questions concerning organ transplants. Results: Measurements of the test-retest reliability showed that Pearson's correlation coefficients ranged from 0.241 to 0.902, and Cronbach's alphas ranged from 0.52 to 0.80 for medical students and from 0.63 to 0.83 for the lay public. Pearson's correlation coefficients showed significant correlations between perceived improvements in quality of life and responses to risk tolerance questions concerning organ transplants. Hand transplant showed a significant correlation in medical students. Foot, hand, two hands, larynx, partial face transplants showed significant correlations for the lay public. Conclusion: The applicability of the LIFT to the Korean population was found to be reliable and valid. The LIFT may serve as a useful tool for clinical application in the Korean population.

• Journal of Chest Surgery
• /
• v.34 no.12
• /
• pp.956-959
• /
• 2001

The Iymphoproliferative disease after the organ transplantation is more commonly seen with the increase according to the increasing number of the organ transplantations and it occurs more frequently in the cases of heart and lung transplantations that needs more aggressive immunosuppression. It demands urgent evaluation and management because of poor prognosis. We transplanted left lung of a man to the woman who suffered from severe dyspnea due to terminal pulmonary emphysema in discrepancy of ABO blood type. Postoperatively, We used triple regimen immunotherapy(cyclosporin, azathioprine, prednisolone) and followed up in the out patient clinic. During the follow up, we found abnormal mass lesion on the transplanted lung and performed gun biopsy. We confirmed malignant lymphoma on the pathollgic examination and two cycled chemotherapy was given after reducing dose of immunosupression. The patient died of sudden onset of pulmonary edema of the transplanted lung.

• Journal of Hospice and Palliative Care
• /
• v.21 no.3
• /
• pp.92-103
• /
• 2018

Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.

• Childhood Kidney Diseases
• /
• v.21 no.2
• /
• pp.75-80
• /
• 2017

Purpose: To investigate the frequency, presentation, management, and outcome of cytomegalovirus (CMV) infection in pediatric patients who underwent renal transplantation. Methods: We performed a retrospective chart review of 70 patients under the age of 18, who underwent renal transplantation between January 1990 and November 2014. A diagnosis of CMV infection was based on serology, molecular assays, antigenemia assays, and culture. CMV infection was defined as detection of virus and CMV disease was diagnosed when clinical signs and symptoms were present. Results: The number of patients with CMV infection was 18 (25.7% of renal transplant recipients). Twelve were male (66.7%), and the $mean{\pm}standard$ deviation (SD) age at infection was $13.3{\pm}3.9$ years. Median time of infection after renal transplantation was 4 months (range 1.0-31.0 months). Pretransplantation CMV status in the infected group was as follows: donor (D)+/recipient (R)+, 11 (61.1%); D+/R-, 7 (38.9%); D-/R+, 0; and D-/R- 0. Nine patients had CMV disease with fever, leukopenia, thrombocytopenia, or organ involvement such as enteritis, hepatitis, and pneumonitis. The age of disease occurrence was $13.1{\pm}3.9$ years and the median time to disease onset after renal transplantation was 8 months (range 1.0-31.0). Immunosuppressive agents were reduced or discontinued in 14 patients (77.8%), antiviral agents were used in 11 patients (61.1%), and all patients with CMV infection were controlled. Conclusions: A quarter of the patients had CMV infection about 4 months after renal transplantation. CMV infection was successfully treated with reduction of immunosuppressants or with antiviral agents.

• Journal of Digital Convergence
• /
• v.18 no.5
• /
• pp.375-382
• /
• 2020

The purpose of this study was to analyze the prevalence, and determine factors associated with metabolic syndrome risk among kidney transplantation recipients. This study data were collected by means of retrospective chart reviews for 111 kidney recipients at an organ transplantation center in South Korea. Data were analyzed using descriptive statistics, t-test or chi-squared test, and Pearson's correlation or Point biserial correlation. The prevalence of metabolic syndrome in our subjects was 65.8%. Metabolic syndrome was related with age, body mass index of before and after Kidney transplantation, and smoking. Study results indicate that intervention for modifying individual lifestyle behaviors is required to prevent and reduce their prevalence of metabolic syndrome after kidney transplantation.