Solid Organ Transplantation in Korea: 1998

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Abstract

Total 1,151 solid organ transplantations (Tplx) were performed at 43 centers during the year of 1998 in Korea: 1012 kidney Tplx (at 43 centers), 100 liver Tplx (11), 30 heart Tplx (5), and 9 pancreas Tplx (2). There were no lung nor heart-lung Tplx in 1998. (Kidney) There were 1012 kidney Tplx including 36 re-Tplx (3.6%) and 2 en-bloc Tplx. Living related donors were 450 (44.5%), living unrelated donors 329 (32.5%), and cadaveric donors 233 (23.0%). Cadaveric donor kidneys were procured at the same transplant center in 192 (82.4%). Multiorgan procurement technique was used in 133 cases (57.1%). The most common cause of donor death was traffic accident (43.3%). Chronic GN was the most frequent disease for ESRD (34.4%). HLA 3 or less antigen mismatch was more than half in all cases (61.0%). Cadaveric donor Tplx was performed within 12 hours of cold ischemia time in 97.8%. Triple regimen immunosuppression (CSA+MMF+PDS) was used most frequently (34.6%). Acute rejection occurred in 228 patients (22.5%). Overall response rate with anti-rejection therapies was 78.9%. Among 1012 patients, 34 patients were dead with 6 (0.6%) operative mortality. Forty-nine grafts (4.8%) were lost. (Liver) There were 100 liver Tplx. Living related partial liver Tplx was performed in 41. Cadaveric donor liver was obtained from the same transplant center in 40 (67.8%). The most frequent cause of hepatic failure was chronic viral hepatitis (46) in adults and biliary atresia (14) in children. Status 3 was the most common medical status of recipients (61%). All cadaver donor liver transplantation was performed within 12 hours after harvest. Immunosuppression with cyclosporine and predinisolone was most frequently used (42%). Acute rejection occurred in 20 patients. Overall response rate with anti-rejection therapies were 61.1%. Among 100 patients, 23 were dead with 17 operative mortality. (Heart) There were 30 heart Tplx. Heart was obtained from the same transplant center in 11 (36.7%). The most frequent cause of heart failure was idiopathic Acute rejection occurred in 9 patients with 50% response rate. Among 30 patients, 5 were dead with 1 operative mortality. (Pancreas) There were 9 pancreas Tplx (simultaneous pancreas-kidney Tplx in 5, pancreas Tplx alone in 4). All were juvenile diabetes patients. Cold ischemia time was less than 12 hours and quadruple immunosuppression was performed in all. Two patients were dead and six patients are in insulin-independent state. (2-year follow up results of transplantations in 1996) In 941 kidney Tplx performed in 1996, 2-year actual graft and patient survival rates were 93.6%, 97.0% respectively. Cadaveric donor Tplx showed comparable results to those of living related donor (95.8% vs. 95.2%). Living unrelated donors had lower graft survival rate than other donor sources (90.8%). In 48 liver Tplx, 18 patients (37.5%) were dead with 15 (31.3%) operative mortality. 2-yr actual graft (patient) survival rate was 58.3%. Kidney Tplx showed comparable survival rates to those of western countries, however, other organ transplantations seem to need more time periods and efforts for the good outcomes.