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Over 500 Liver Transplants Including More Than 400 Living-Donor Liver Transplants in 2019 at Asan Medical Center

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Abstract
Background. More than 400 liver transplants were performed at Asan Medical Center (AMC) in 2011, and over 500 liver transplants including 420 living-donor liver transplants (LDLTs) were performed in 2019. Herein, we report the methodology of these procedures.

Methods. Since the first adult LDLTs at AMC using the left and right lobes were successfully performed, various innovative techniques and approaches have been developed: modified right lobe, dual graft, donor exchange for ABO incompatibility, expansion of indications and no-touch techniques for hepatocellular carcinoma, intraoperative cine-portogram and additional intervention for large collaterals, management of portal vein thrombosis (PVT) and stenosis, salvage LDLT after major hepatectomy, and timely LDLT for patients with acute-on-chronic liver failure.

Results. Four hundred twenty LDLTs in 403 adult and 17 pediatric patients and 85 deceased-donor liver transplants in 74 adult and 11 pediatric patients were performed. The number of deceased-donor liver transplants remained constant since 2011, but the number of LDLTs increased steadily. One hundred thirty patients (25.7%) required urgent liver transplantations and 24 patients with acute-on-chronic liver failure underwent LDLT. PVT including grade 1,2,3, and 4 was reported in 91 patients (18.0%), and Yerdel's grade 2, 3, and 4 PVT was reported in 47 patients (51.6%); all patients with PVT were successfully treated. Adult LDLTs for hepatocellular carcinoma and ABO incompatibility accounted for 52.6% and 24.3% of the cases, respectively. In-hospital mortality in 2019 was 2.97%.

Conclusion. Continual efforts to overcome challenging problems in LDLT with various innovations and dedication of the team members during the perioperative period to improve patient outcomes were crucial in increasing the number of liver transplantations at Asan Medical Center.
Author(s)
강상현강우형고기영권동일김기훈김민재김상훈김성한나병곤문덕복문영진박길춘성규보송기원송준걸안철수오동욱윤영인이상오이성구이승규전인구정동환정용규정이지조휘동최진욱하태용허진원황규삼황신
Issued Date
2021
Type
Article
Keyword
AdultChildrenChinaDonation of organstissuesetcFemaleHealth aspectsHumansLiverLiver diseasesLiver Transplantation - methodsLiver Transplantation - statistics & numerical dataLiving DonorsMaleMedical centersMiddle AgedTransplantationYoung Adult
DOI
10.1016/j.transproceed.2020.08.027
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7842
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2448636260&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Over%20500%20Liver%20Transplants%20Including%20More%20Than%20400%20Living-Donor%20Liver%20Transplants%20in%202019%20at%20Asan%20Medical%20Center&offset=0&pcAvailability=true
Publisher
TRANSPLANTATION PROCEEDINGS
Location
미국
Language
영어
ISSN
0041-1345
Citation Volume
53
Citation Number
1
Citation Start Page
83
Citation End Page
91
Appears in Collections:
Medicine > Medicine
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