Solid Organ Transplantation in Korea: 1996

Ha, Jong Won; Kim, Sang Joon

Abstract

During the year of 1996, total 1,013 solid organ transplantations were performed at 38 centers in Korea: 941 kidney transplantation at 36 centers, 48 liver transplantation at 13 centers, 20 heart transplantation at 7 centers, 2 pancreas transplantation at 2 centers, and 2 lung transplantation at 2 centers. (Kidney) There were 941 kidney transplantations including 42 retransplantations. Living related donors were 544 (57.8%), living unrelated donors were 286 (30.4%), and cadaver donors were 111 (11.8%). Twenty centers of 36 performed kidney transplantation less than 20 cases. Numbers of donors and recipients were the most at 4th decade group. Cadaver donor kidneys were procured at the same transplant center in 97 (87.4%). Multiorgan procurement technique was used in 39 cases. The most common cause of donor death was traffic accident (57.4%). Chronic GN was the most frequent disease in recipient nephropathy (36.9%). Three antigen mismatch of HLA was the most frequent group (43.1%). Cadaver donor transplantation was performed within 12 hours of cold ischemia time in 86.5%. Triple regimen immunosuppression was used in 65.4%. Acute rejection occurred in 217 cases. Overall recovery rate with antirejection therapies was 70.9%. Among 941 patients, 17 patients succumbed with 0.5% of operative mortality. Graft loss was 37 (3.9%.). (Liver) There were 48 liver transplantations including 1 retransplantation. Living related partial liver transplantation was performed in 19 (39.6%). Donors were the most frequent in the third decade group. Recipients were the most frequent in the first decade group. Cadaver donor liver was obtained from the same transplant center in 20 (69.0%). The most frequent cause of hepatic failure was chronic viral hepatitis (22) in adult and biliary atresia (13) in child. Status 3 was the most common medical status of recipient. Cadaver donor liver transplantation was performed within 12 hours of cold ischemia time in 86.2%. Triple regimen immunosuppression was used in 64.6% and FK506 based regimen in 20.8%. Acute rejection occurred in 12 cases. Overall recovery rate with antirejection therapies were 71.4%. Among 48 patients, 17 were dead with 31.3% of operative mortality. (Heart) There were 20 heart transplantations. Donors were the most frequent in the third decade group. Recipients were the most frequent in the fourth decade group. Heart was obtained from the same transplant center in 9 (45%). The most frequent cause of heart failure was idiopathic cardiomyopathy (14). All heart transplantations were performed within 4 hours of cold ischemia time. Triple regimen immunosuppression was used in 95%. Acute rejection occurred in 5 cases with 100% recovery rate. Among 20 patients, 5 were dead with 10% of operative mortality. (Pancreas) There were two pancreas transplantations. One was juvenile diabetes patient and the other was adult onset diabetes patient. Both were simultaneous pancreas-kidney transplantations. Both were obtained by multiorgan procurement technique, one at the same transplant center and the other was shared. Cold ischemia time was less than 4 hours and quadruple immunosuppression was performed in all. One of them died and one living patient does not need insulin treatment. (Lung) The first case of lung transplantation was performed in 1996 and two lung transplantations were performed. One was single lung transplantation and the other was double lung transplantation. Causes of lung disease were idiopathic pulmonary fibrosis and lymphangioadenomyomatosis each. Both lungs were procuredat the same transplant center with multiorgan harvest technique. Cold ischemia time was less than 4 hours and quadruple immunosuppression was performed in all. Both were dead with 50% operative mortality. Kidney transplantation showed comparable results to those of western countries, however, other organ transplantations seem to need more time periods for the good results.