279 results on '"Suk Kyun Hong"'
Search Results
152. Optimal bile duct division using real‐time indocyanine green near‐infrared fluorescence cholangiography during laparoscopic donor hepatectomy
- Author
-
Nam-Joon Yi, Kwang-Woong Lee, Hyeyoung Kim, Kyung Chul Yoon, Jin Yong Choi, Kyung-Suk Suh, Sung-Woo Ahn, Hyo-Sin Kim, and Suk Kyun Hong
- Subjects
Adult ,Indocyanine Green ,Male ,medicine.medical_specialty ,Biliary Tract Diseases ,medicine.medical_treatment ,Urology ,Near infrared fluorescence ,030230 surgery ,Liver transplantation ,Fluorescence ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,Postoperative Complications ,0302 clinical medicine ,Cholangiography ,Living Donors ,medicine ,Hepatectomy ,Humans ,Prospective Studies ,Coloring Agents ,Donor hepatectomy ,Transplantation ,Hepatology ,medicine.diagnostic_test ,Bile duct ,business.industry ,General surgery ,Optical Imaging ,Liver Transplantation ,medicine.anatomical_structure ,chemistry ,Tissue and Organ Harvesting ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,Surgery ,Bile Ducts ,business ,Indocyanine green - Published
- 2017
153. PARIETAL PERITONEUM AS A NOVEL SUBSTITUTE FOR MIDDLE HEPATIC VEIN RECONSTRUCTION DURING LIVING-DONOR LIVER TRANSPLANTATION
- Author
-
Suk Kyun Hong, Nam-Joon Yi, Jae-Hyung Cho, Jeong-Moo Lee, Kwangpyo Hong, Eui Soo Han, Kwang-Woong Lee, and Kyung-Suk Suh
- Subjects
Transplantation - Published
- 2020
154. Chronological improvement in long-term outcomes of surgical resection for patients with hepatocellular carcinoma: two large-volume center studies
- Author
-
Yun Bin Lee, Jeonghoon Lee, Hyo Young Lee, Cheol-Hyung Lee, Minseok Albert Kim, Heejoon Jang, Hyunwoo Oh, Sun Woong Kim, Suk Kyun Hong, Eun Ju Cho, Su Jong Yu, Nam-Joon Yi, Kwang-Woong Lee, Jong Man Kim, Yoon Jun Kim, Kyung-Suk Suh, and Jung-Hwan Yoon
- Subjects
Hepatology - Published
- 2020
155. Macrovascular invasion is not an absolute contraindication for living donor liver transplantation
- Author
-
Suk Kyun Hong, Kyung Chul Yoon, Hyeyoung Kim, YoungRok Choi, Kyung-Suk Suh, Kyung Bun Lee, Suk Won Suh, Jaehong Jeong, Nam-Joon Yi, Kwang-Woong Lee, and Hyo Sin Kim
- Subjects
Male ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Liver transplantation ,Gastroenterology ,0302 clinical medicine ,Risk Factors ,Living Donors ,Venous Thrombosis ,Portal Vein ,Liver Neoplasms ,Middle Aged ,Prognosis ,Vascular Neoplasms ,Survival Rate ,Venous thrombosis ,Treatment Outcome ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Tissue and Organ Harvesting ,Female ,Prothrombin ,030211 gastroenterology & hepatology ,alpha-Fetoproteins ,Adult ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Standardized uptake value ,Disease-Free Survival ,03 medical and health sciences ,Internal medicine ,medicine ,Carcinoma ,Humans ,Neoplasm Invasiveness ,Protein Precursors ,Contraindication ,Survival rate ,Aged ,Retrospective Studies ,Transplantation ,Hepatology ,business.industry ,Contraindications ,Patient Selection ,Retrospective cohort study ,medicine.disease ,Liver Transplantation ,Surgery ,Neoplasm Recurrence, Local ,business ,Biomarkers - Abstract
The indication of liver transplantation (LT) for the treatment of advanced hepatocellular carcinoma (HCC) is expanding. However, portal vein tumor thrombus (PVTT) has been still accepted as an absolute contraindication. We experienced an unexpectedly good prognosis in selected patients. Therefore, we tried to identify the prognostic factors after LT for HCC with major PVTT. Among 282 patients who underwent living donor liver transplantation (LDLT) for HCC from January 2009 to December 2013, 11 (3.9%) patients with major PVTT that was preoperatively diagnosed were investigated. The 1-, 3-, and 5-year recurrence-free survival rates were 63.6%, 45.5%, and 45.5%, respectively, and all recurrent cases showed intrahepatic and extrahepatic recurrence. The 1-, 3-, and 5-year overall survival rates were 72.7%, 63.6%, and 63.6%, respectively, and 2 patients with delayed recurrence survived approximately 5 years after LT. Main portal vein (PV) invasion (P
- Published
- 2016
156. Living donor liver transplantation for hepatocellular carcinoma in Seoul National University
- Author
-
Kwang-Woong Lee, Kyung Chul Yoon, Suk Kyun Hong, Nam-Joon Yi, Hyo-Sin Kim, and Kyung-Suk Suh
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Liver transplantation ,Milan criteria ,University hospital ,medicine.disease ,Gastroenterology ,digestive system diseases ,Surgery ,Original Article on Liver Transplantation for Hepatocellular Carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Risk groups ,Positron emission tomography ,030220 oncology & carcinogenesis ,Internal medicine ,Hepatocellular carcinoma ,medicine ,030211 gastroenterology & hepatology ,Living donor liver transplantation ,business ,Survival rate - Abstract
Liver transplantation is an effective treatment modality for hepatocellular carcinoma (HCC). Due to deceased organ shortage, living donor liver transplantation (LDLT) accounts for the majority of liver transplants in Korea. The aim of this study is to evaluate the recent trend of LDLT for HCC, and to suggest guidelines and criteria for selecting the appropriate candidates for LDLT.Between January 2000 and December 2015, 532 patients underwent LDLT for HCC. Clinicopathologic data were analyzed as well as overall survival rate (SR) and disease-free survival rate (DFSR) according to the Milan criteria based on explant pathology, positron emission tomography (PET) positivity, and serum alpha-fetoprotein (AFP) level.The 5-year overall SR and DFSR were 81.5% and 75.5% respectively. According to our previously reported combination of AFP and PET [Seoul National University Hospital (SNUH) criteria]; low risk group [AFP200 ng/mL, PET (-)], intermediate risk group [AFP200 ng/mL, PET (-) or AFP200 ng/mL, PET (+)], and high risk group [AFP200 ng/mL, PET (+)], the 5-year DFSR of low risk group was 86.1%, intermediate risk group was 79.0%, and high risk group was 18.5% (P0.001). Within the Milan criteria, the 5-year DFSR of low risk group was 88.4%, intermediate risk group was 79.9%, and high risk group was 60.0% (P=0.016). Beyond the Milan criteria, the 5-year DFSR of low, intermediate, and high risk group was 80.3%, 77.7%, and 9.1%, respectively (P0.001).In conclusion, our data and experience suggest that a continued paradigm shift from a conventional size based criteria to a biological marker based criteria is indicated when evaluating LDLT candidates with HCC.
- Published
- 2016
157. Pure Laparoscopic Versus Open Left Hepatectomy Including the Middle Hepatic Vein for Living Donor Liver Transplantation
- Author
-
Jeong Moo Lee, Nam-Joon Yi, Kyung Ae Kim, Jae-Hyung Cho, Kyung-Suk Suh, Suk Kyun Hong, and Kwang-Woong Lee
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Liver transplantation ,Hepatic Veins ,Postoperative Complications ,Interquartile range ,Living Donors ,Medicine ,Hepatectomy ,Humans ,Vein ,Laparoscopy ,Retrospective Studies ,Donor hepatectomy ,Transplantation ,Hepatology ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Surgery ,Liver Transplantation ,medicine.anatomical_structure ,Tissue and Organ Harvesting ,business ,Living donor liver transplantation - Abstract
Pure laparoscopic donor hepatectomy (PLDH) has become increasingly accepted in the era of minimally invasive surgeries. However, the outcomes of pure laparoscopic donor left hepatectomy (PLDLH) are relatively less known than for left lateral sectionectomy or right hepatectomy. This study aimed to report our experience with and the outcomes of PLDLH including the middle hepatic vein (MHV) and to compare these outcomes with conventional donor left hepatectomy (CDLH). The medical records of living liver donors between January 2010 and January 2018 at Seoul National University Hospital were retrospectively reviewed. Donors who underwent left hepatectomy including the MHV were included. To minimize selection bias, donors who underwent CDLH after the initiation of the PLDH program were excluded. Finally, there were 18 donors who underwent CDLH and 8 who underwent PLDLH. The median (interquartile range [IQR]) warm ischemia time (11 [10-16] minutes versus 4 [2-7] minutes; P = 0.001) was longer in the PLDLH group than the CDLH group. The total operation time (333 [281-376] minutes versus 265 [255-308] minutes; P = 0.09) and time to remove the liver (245 [196-276] minutes versus 182 [172-205] minutes; P = 0.08) were also longer in PLDLH although not statistically significant. The length of postoperative hospital stay was significantly shorter in the PLDLH group (7 [7-8] days versus 9 [8-10] days; P = 0.01). There were no postoperative complications in the PLDLH group. The rate of complications in recipients was similar in both groups. In conclusion, PLDLH including the MHV appears to be safe and feasible. Further analysis including longterm outcomes is needed.
- Published
- 2019
158. Different prognostic factors and strategies for early and late recurrence after adult living donor liver transplantation for hepatocellular carcinoma
- Author
-
Hyeyoung Kim, Hyo Sin Kim, Kwang-Woong Lee, Kyung Chul Yoon, Jeong Moo Lee, Sung Woo Ahn, Kyung Suk Suh, Suk Kyun Hong, Nam Joon Yi, and Jae-Hyung Cho
- Subjects
Surgical resection ,Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,030230 surgery ,Gastroenterology ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Late Recurrence ,Republic of Korea ,medicine ,Biomarkers, Tumor ,Living Donors ,Humans ,Retrospective Studies ,Transplantation ,Tumor size ,business.industry ,Incidence ,Liver Neoplasms ,Middle Aged ,medicine.disease ,Prognosis ,Liver Transplantation ,Survival Rate ,Hepatocellular carcinoma ,030211 gastroenterology & hepatology ,Female ,Hepatectomy ,Neoplasm Recurrence, Local ,Living donor liver transplantation ,business ,Follow-Up Studies - Abstract
Background Some patients with hepatocellular carcinoma (HCC) recurrence after LT show good long-term survival. We aimed to determine the prognostic factors affecting survival after recurrence and to suggest treatment strategies. Methods Between January 2000 and December 2015, 532 patients underwent adult living donor liver transplantation (LDLT) for HCC. Among these, 92 (17.3%) who experienced recurrence were retrospectively reviewed. Results The 1-, 3-, and 5-year survival rates after recurrence were 59.5%, 23.0%, and 11.9%, respectively. In multivariate analysis, time to recurrence >6 months and surgical resection after recurrence were related to longer survival after recurrence, while multi-organ involvement at the time of primary recurrence was related to poorer survival. We classified patients into early (≤6 months) and late (>6 months) recurrence groups. In the early recurrence group, tumor size >5 cm in the explant liver, liver as the first detected site of recurrence, and multiple organ involvement at primary recurrence were related to survival on multivariate analysis. In the late recurrence group, mammalian target of rapamycin inhibitor (mTORi) usage and multi-organ involvement were significantly associated with the prognosis on multivariate analysis. Conclusions Various therapeutic approaches are needed depending on the period of recurrence after LT and multiplicity of involved organs.
- Published
- 2019
159. Clinical Significance of De Novo Malignancy After Liver Transplant: A Single-Center Study
- Author
-
Sara Kim, Kwang-Woong Lee, Berik Rovgaliyev, Kyung-Suk Suh, Suk Kyun Hong, Kyung Chul Yoon, Jeong Moo Lee, Jae-Hyung Cho, and Nam-Joon Yi
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Seoul ,Kaplan-Meier Estimate ,Single Center ,Immunocompromised Host ,Postoperative Complications ,Risk Factors ,Internal medicine ,Neoplasms ,medicine ,Humans ,Survival analysis ,Cause of death ,Retrospective Studies ,Transplantation ,business.industry ,Incidence ,Cancer ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Lymphoma ,Liver Transplantation ,Hepatocellular carcinoma ,Surgery ,Female ,business - Abstract
Background Several studies have reported that solid organ transplant recipients have a high risk for malignant tumors because the suppressed immune system fails in preventing malignant transformations. De novo malignancy after transplantation is the most common cause of death in the late period after liver transplant (LT). This study investigated the clinical significance of de novo malignancy after LT, and it is the largest study based in Korea to report long-term follow-up results associated with de novo malignancy after LT. Methods Data of 1793 adults who underwent LT in Seoul National University Hospital were retrospectively collected, and medical charts and data from the Ministry of Public Administration and Security were reviewed to examine the causes of death and de novo malignancy status. The Fisher exact test and Kaplan-Meier survival analysis were used to analyze the data. Results Of the 1793 recipients, 27 died of de novo malignancies. Of 875 hepatocellular carcinoma (HCC) patients, 12 died, and of 918 non-HCC patients, 15 died. De novo malignancy was the main cause of death at 5 years after LT but was not in the initial 5 years. In Korea the most common cancers that developed after LT were gastric cancer (21.4%) and lymphoma (14.3%). De novo HCC in non-HCC cases was found in 2 patients. Conclusion De novo malignancy is a key factor affecting long-term survival after LT. Therefore, regular screening and education are important for improving long-term survival and quality of life in these patients after LT.
- Published
- 2019
160. A Tailored Strategy for Recipient Hepatectomy: Left Portal Flow Preserving High Hilar Dissection
- Author
-
Jaehong Jeong, Jeong Moo Lee, Suk Kyun Hong, Ahmed Shehta, Kwang-Woong Lee, Jae Hyung Cho, Kyung-Suk Suh, and Nam-Joon Yi
- Subjects
Right hepatic vein ,medicine.medical_specialty ,Left portal vein ,business.industry ,Portal Vein ,medicine.medical_treatment ,Dissection ,Gastroenterology ,Portal vein ,Vena Cava, Inferior ,Dissection (medical) ,Anastomosis ,Hepatic Veins ,medicine.disease ,Inferior vena cava ,Surgery ,medicine.vein ,medicine ,Hepatectomy ,Humans ,business ,Shunt (electrical) - Abstract
Lee et al. (Liver Transpl 10(9):1158–1162, 2004) reported high hilar dissection (HHD) technique as a novel method for recipient hepatectomy to overcome limitations of conventional hilar dissection (CHD). HHD allowed performing multiple tension-free biliary anastomoses and easy reconstruction of double portal vein orifices. However, longer anhepatic phase is its main drawback. We describe a new modification of original HHD, called left portal vein flow preserving HHD (LFP-HHD). The new technique aims to gain the balance between CHD and original HHD. The detailed technique of recipient hepatectomy by LFP-HHD is shown in the electronic video file. It involves high intrahepatic division of hilar structures while maintaining portal drainage through maintained left portal vein (LPV). Control of right hemi-liver inflow allows for division of right hepatic vein, and safe dissection of inferior vena cava (IVC) and hilar structures. According to coordination with donor surgery, the liver could be easily explanted. LFP-HHD has the same principle of original HHD allowing for multiple tension-free well-vascularized biliary anastomoses. LFP-HHD allows for shortening of anhepatic phase duration as portal venous drainage is continued through maintained LPV avoiding prolonged total portal clamping with bowel edema or the need for temporary porto-caval shunt. On the other hand, the number and the length of the hilar structures can be decreased compared with the original HHD technique. However, the level of division of the hilar structures is acceptable in most of the cases. LFP-HHD is a novel simple technique for recipient hepatectomy that can be tailored for certain clinical conditions.
- Published
- 2019
161. Optimal Biliary Drainage for Patients With Biliary Anastomotic Strictures After Right Lobe Living Donor Liver Transplantation
- Author
-
Kyung-Suk Suh, Min Su You, Kwang-Woong Lee, Ji Kon Ryu, Bang Sup Shin, Suk Kyun Hong, Yong-Tae Kim, Young Hoon Choi, Sang Hyub Lee, Nam-Joon Yi, and Woo Hyun Paik
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Constriction, Pathologic ,030230 surgery ,Anastomosis ,Liver transplantation ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Interquartile range ,medicine ,Living Donors ,Humans ,Duodenoscopes ,Drainage ,Retrospective Studies ,Cholangiopancreatography, Endoscopic Retrograde ,Transplantation ,Endoscopic retrograde cholangiopancreatography ,Hepatology ,medicine.diagnostic_test ,business.industry ,Mortality rate ,Anastomosis, Surgical ,Middle Aged ,Allografts ,Lobe ,Surgery ,Liver Transplantation ,medicine.anatomical_structure ,Treatment Outcome ,Liver ,030211 gastroenterology & hepatology ,Female ,Stents ,Bile Ducts ,business ,Complication ,Follow-Up Studies - Abstract
Right lobe (RL) living donor liver transplantation (LDLT) usually includes 2 bile duct anastomosis sites, namely, the right anterior and the right posterior segmental ducts. This study aimed to evaluate the optimal treatment for biliary strictures following RL LDLT with respect to unilateral or bilateral drainage techniques. From January 2005 to December 2017, 883 patients at Seoul National University Hospital underwent RL LDLT. Of these, 110 patients were enrolled who had 2 duct-to-duct anastomosis sites and who were considered at risk of developing biliary anastomotic strictures. Unilateral or bilateral biliary drainage during the follow-up period was identified by endoscopic retrograde cholangiopancreatography (ERCP) and/or percutaneous transhepatic biliary drainage (PTBD). The clinical success, complication, and 180-day mortality rates were compared between the unilateral and bilateral biliary drainage groups according to the initial ERCP findings. The mean age at the time of LDLT was 54.2 ± 8.2 years. The median time from LDLT to initial biliary anastomotic strictures was 177 (interquartile range, 18-1085) days. At the initial ERCP, unilateral drainage was performed in 55 (50.0%) patients, and bilateral drainage was performed in 11 (10.0%) patients. Of the patients who underwent unilateral drainage, 35 (63.6%) patients required conversion to bilateral drainage during follow-up. Overall, 71 (64.5%) patients required bilateral drainage more than once, whereas only 27 (24.5%) patients reached a resolution with unilateral biliary drainage. In this study, most patients required bilateral biliary drainage more than once during follow-up. An active attempt should be made to drain bilaterally in patients with biliary anastomotic strictures following RL LDLT.
- Published
- 2019
162. Antiviral therapy may decrease HBx, affecting cccDNA and MSL2 in hepatocarcinogenesis
- Author
-
Kwang-Woong Lee, Kyung-Suk Suh, Xue Li Jin, Suk Kyun Hong, Nam-Joon Yi, Hwajung Kim, and Sun Kyung Lee
- Subjects
0301 basic medicine ,Cancer Research ,Oncogene ,business.industry ,cccDNA ,Articles ,Cell cycle ,Hepatitis B ,medicine.disease_cause ,medicine.disease ,digestive system diseases ,03 medical and health sciences ,HBx ,030104 developmental biology ,0302 clinical medicine ,Real-time polymerase chain reaction ,Oncology ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,medicine ,Cancer research ,Carcinogenesis ,business - Abstract
Chronic hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC). Covalently closed circular DNA (cccDNA) is an intermediate in the life cycle of HBV. HBV-encoded X protein (HBx), a key viral oncoprotein, can be specifically ubiquitylated by male specific lethal 2 (MSL2), which causes upregulation of HBx activity and promotes transcription, cell proliferation and tumor growth. The present study compared the levels of cccDNA, MSL2 mRNA and HBx mRNA in tumor and peri-tumor tissues, and clarified the effect of antiviral therapy on these indicators. Levels of intrahepatic cccDNA, MSL2 mRNA and HBx mRNA were determined using quantitative PCR in patients with HBV-associated HCC who had undergone liver surgery. A total of 50 patients were included in the present study. Prior to surgery, 31 patients had undergone antiviral treatment. Intrahepatic cccDNA levels were significantly higher in the tumor tissues compared with the peri-tumor tissues (P=0.001), particularly in the hepatitis B e antigen-positive (P=0.008), tumor recurrence (P=0.002) and
- Published
- 2018
163. The learning curve in pure laparoscopic donor right hepatectomy: a cumulative sum analysis
- Author
-
Suk Kyun Hong, Nam-Joon Yi, Jeong Moo Lee, Kyung Chul Yoon, Kwang-Woong Lee, Jae-Hyung Cho, and Kyung-Suk Suh
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Operative Time ,CUSUM ,Liver transplantation ,03 medical and health sciences ,0302 clinical medicine ,Republic of Korea ,medicine ,Hepatectomy ,Humans ,Laparoscopy ,Retrospective Studies ,Donor hepatectomy ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Single surgeon ,Tissue Donors ,Surgery ,Liver Transplantation ,Learning curve ,030220 oncology & carcinogenesis ,Tissue and Organ Harvesting ,Feasibility Studies ,030211 gastroenterology & hepatology ,Female ,business ,Learning Curve ,Abdominal surgery - Abstract
Although the use of pure laparoscopic donor hepatectomy (PLDH) is increasingly common, it remains limited to a few experienced centers and no data on the learning curve are currently available. The aim of this study is to evaluate the learning curve associated with the use of pure laparoscopic donor right hepatectomy (PLDRH). Data from donors undergoing PLDRH performed by a single surgeon between November 2015 and October 2017 were retrospectively reviewed. The learning curve was evaluated using the cumulative sum (CUSUM) method based on duration of surgery. Of 100 donors evaluated, none required transfusion or conversion to open hepatectomy and no irreversible disability or mortality was reported. The mean operative time was 320.7 ± 51.8 min, and all grafts were successfully transplanted. The CUSUM analysis demonstrated a learning curve of approximately 60 cases of PLDRH. Estimated total liver volume > 1400 cm3 and double portal vein orifices were seen to be risk factors for longer surgery time. Having adjusted for case mix with these factors, the risk-adjusted CUSUM analysis demonstrated a learning curve of 65–70 cases of PLDRH. In conclusion, PLDRH is a feasible and safe procedure with a learning curve of 65–70 cases.
- Published
- 2018
164. Hepatic fibrosis grading with extracellular volume fraction from iodine mapping in spectral liver CT
- Author
-
Kwang-Woong Lee, Nam Joon Yi, Jeong Min Lee, Kyung Suk Suh, Suk Kyun Hong, Jae Hyun Kim, Haeryoung Kim, Kyoung Bun Lee, and Jeong Hee Yoon
- Subjects
Liver Cirrhosis ,Male ,medicine.medical_specialty ,Cirrhosis ,chemistry.chemical_element ,Iodine ,Gastroenterology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Internal medicine ,Hounsfield scale ,Biopsy ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Grading (tumors) ,Aged ,Retrospective Studies ,Extracellular volume fraction ,medicine.diagnostic_test ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,chemistry ,030220 oncology & carcinogenesis ,Tomography, X-Ray Computed ,Hepatic fibrosis ,business - Abstract
To determine whether hepatic extracellular volume fraction (ECV) obtained from iodine density map (ECV-iodine) can be used to estimate hepatic fibrosis grade and to compare performance with ECV measured using Hounsfield units (ECV-HU).From December 2016 to March 2019, patients who underwent liver resection or biopsy within four weeks after spectral liver CT were included. ECV-iodine and ECV-HU were calculated using the equilibrium phase. Within each of these, comparison of ECVs was made for different fibrosis grades (F0 - 1 vs. F2 - 3 vs. F4) and also for patients with compensated and decompensated cirrhosis. The diagnostic performance of ECVs in detecting clinically significant fibrosis (≥ F2) and cirrhosis (F4) was assessed using ROC analysis.A total of 144 patients (men = 98, mean age 58.1 ± 11.5 years) were included. The ECV-iodine value was significantly higher in cirrhosis (33.6 ± 6.8 %) than those with F0 - 1 (25.0 ± 3.7 %) or F2 - 3 (28.3 ± 3.4 %, P0.001 for all). It was significantly higher in decompensated cirrhosis than those with compensated cirrhosis (36.5 ± 7.2 % vs. 30.7 ± 5.0 %, respectively; P0.001). The AUC of ECV-iodine was 0.82 for detecting F2 or above (cut-off value,26.9 %) and 0.81 for detecting cirrhosis (cut-off value,29 %). ECV-iodine had a significantly higher AUC than ECV-HU for detecting F2 or above (AUC: 0.69, P 0.001) and cirrhosis (AUC: 0.74, P = 0.04).ECV-iodine from spectral CT was able to detect clinically significant hepatic fibrosis and cirrhosis.
- Published
- 2021
165. Long-term Survival of 10,116 Korean Live Liver Donors.
- Author
-
Suk Kyun Hong, Sunho Choe, Nam-Joon Yi, Aesun Shin, Eun Kyung Choe, Kyung Chul Yoon, Kwang-Woong Lee, and Kyung-Suk Suh
- Abstract
Objective: To evaluate the long-term mortality of Korean live liver donors using data from a national donor registry by comparing it with the mortality of the general population. Summary of background data: Although live liver donors generally have a healthy status, their long-term mortality has not been properly addressed in a large donor registry. Methods: Data of 10,116 live liver donors were drawn from a mandated national registry of Korean live liver donors between 2000 and 2015. Matched controls were selected from the Korean National Health Insurance System-National Sample Cohort (NHIS-NSC). Median (range) follow-up of liver donors was 5.7 (0-15.9) years. Donors were 1:3 individually matched to controls by sex and 5-year age group; potential controls were from the whole NHIS-NSC (Control 1) or from NHIS-NSC after excluding people with contraindications to be organ donors (Control 2) (donor, n = 7538; Control 1, n = 28,248; Control 2, n = 28,248). Results: Fifty-three deaths occurred after donation. Ten-year cumulative mortality of live liver donors was 0.9%. The most common cause of death was suicide (n = 19) followed by cancer (n = 9) and traffic accident (n = 7). In the matched control analysis, overall risk of death was significantly lower in donors than in Control 1 (P < 0.001), but higher than in Control 2 (P < 0.001). Conclusions: Liver donors have increased long-term mortality risk compared to similar healthy controls without contraindications to be organ donors. Therefore, long-term follow-up, including psychosocial support, is needed for live liver donors. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
166. Demarcating the Exact Midplane of the Liver Using Indocyanine Green Near-Infrared Fluorescence Imaging during Laparoscopic Donor Hepatectomy
- Author
-
Kwang-Woong Lee, Nam-Joon Yi, Jae-Hyung Cho, Jeesun Kim, Kyung Suk Suh, Suk Kyun Hong, Jeong-Moo Lee, and Jieun Lim
- Subjects
Donor hepatectomy ,Transplantation ,chemistry.chemical_compound ,Near-Infrared Fluorescence Imaging ,Nuclear magnetic resonance ,Hepatology ,chemistry ,business.industry ,Gastroenterology ,Medicine ,business ,Indocyanine green - Published
- 2021
167. Pure Laparoscopic versus Open Right Hepatectomy in Live Liver Donors: A Propensity Score Matched Analysis
- Author
-
Suk Kyun Hong, Jae-Hyung Cho, Kwang-Woong Lee, Jeong-Moo Lee, Kyung Suk Suh, Lapisatepun Worakitti, Ming Yuan Tan, and Nam Joon Yi
- Subjects
Transplantation ,medicine.medical_specialty ,Hepatology ,business.industry ,medicine.medical_treatment ,Medical record ,Significant difference ,Background data ,Gastroenterology ,Warm Ischemic Time ,University hospital ,Surgery ,Propensity score matching ,Liver donors ,Medicine ,Hepatectomy ,Living donor liver transplantation ,business ,Complication - Abstract
OBJECTIVE The aim of the study was to present the safety and feasibility of pure laparoscopic donor right hepatectomy (PLDRH) in comparison with those of conventional donor right hepatectomy. SUMMARY BACKGROUND DATA Although the use of PLDRH is gradually spreading worldwide, its outcomes, including the long-term outcomes in both donors and recipients, have not yet been evaluated in a large comparative study. METHODS We retrospectively reviewed the medical records of 894 donors who underwent living donor liver transplantation between January 2010 and September 2018 at Seoul National University Hospital. We performed 1:1 propensity score matching between the PLDRH and conventional donor right hepatectomy groups. Subsequently, 198 donor-recipient pairs were included in each group. RESULTS The total operation time (P < 0.001), time to remove the liver (P < 0.001), and warm ischemic time (P < 0.001) were longer in the PLDRH group. None of the donors required intraoperative transfusion or experienced any irreversible disabilities or mortalities. The length of postoperative hospital stay was significantly shorter in the PLDRH group (P < 0.001). The rate of complications in donors was similar between the 2 groups. Although other complication rates in recipients were, however, similar, the rates of early (P = 0.019) and late (P < 0.001) biliary complications in recipients were higher in the PLDRH group. There was no significant difference in overall survival and graft survival between the 2 groups. CONCLUSIONS PLDRH is feasible when performed at an experienced living donor liver transplantation center. Further studies on long-term recipient outcomes including biliary complications are needed to confirm the safety.
- Published
- 2021
168. Auxiliary partial orthotopic liver transplantation in pre-eclampsia
- Author
-
Eui Soo Han, Kyung-Suk Suh, Kwang-Woong Lee, YounRok Choi, Jeong-Moo Lee, Sanggyun Suh, Suk Kyun Hong, Kwangpyo Hong, and Nam-Joon Yi
- Subjects
medicine.medical_specialty ,Eclampsia ,Orthotopic liver transplantation ,business.industry ,Urology ,Medicine ,business ,medicine.disease - Published
- 2020
169. Study on patients without underlying chronic liver disease to improve survival outcome in pediatric liver transplantation
- Author
-
Suk Kyun Hong, Kwangpyo Hong, Nam-Joon Yi, Kwang-Woong Lee, Kyung-Suk Suh, Eui Soo Han, Jeong-Moo Lee, and YoungRok Choi
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Internal medicine ,medicine ,Liver transplantation ,business ,Chronic liver disease ,medicine.disease ,Gastroenterology ,Survival outcome - Published
- 2020
170. Pure laparoscopic versus open right hepatectomy in living liver donors: which is longer bench-surgery time
- Author
-
Kwangpyo Hong, Suk Kyun Hong, Eui Soo Han, Kwang-Woong Lee, Sanggyun Suh, Su Young Hong, Jeong-Moo Lee, Kyung-Suk Suh, Nam-Joon Yi, and YoungRok Choi
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Portal vein ,University hospital ,Surgery ,Liver graft ,medicine.anatomical_structure ,Liver donors ,Medicine ,Hepatectomy ,business ,Living donor liver transplantation ,Vein - Abstract
Background: The aim of the study was to measure bench-surgery time in pure laparoscopic donor right hepatectomy (PLDRH) in comparison with those of conventional donor right hepatectomy (CDRH). Methods: We retrospectively reviewed the medical records of 514 donors who underwent living donor liver transplantation be tween January 2012 and December 2019 at Seoul National University Hospital. We divided it into two periods: when almost only CDRH was performed and the second period during which PLDRH was standardized. Results: The mean bench-surgery time (49.3 vs. 39.5 minutes; P=0.00) was longer in the PLDRH group than the CDRH group. We performed the analysis while excluding the factors affecting the bench-surgery time in both groups. First, we analyzed except the patients who had undergone direct venoplasty or Y-graft patch reconstruction of two portal veins. After that, we excluded the pa tients who had reconstruction of more than three openings of middle hepatic vein tributaries and no reconstruction of those (right hemi-liver graft). Lastly, we excluded the patients who underwent venoplasty of inferior hepatic vein(s) in back-table procedures. In all three subgroup analyses, the mean bench-surgery time was also longer in the PLDRH group than the CDRH group (47.4 vs. 38.4 minutes, P=0.00; 48.7 vs. 37.4 minutes, P=0.00; 48.3 vs. 36.6 minutes, P=0.00). Conclusions: The bench-surgery time takes longer in the PLDRH group regardless of reconstruction of type II or III portal vein variations and liver graft outflow or not.
- Published
- 2020
171. Difficulty scoring system of pure laparoscopic donor right hemihepatectomy
- Author
-
Kyung-Suk Suh, Eui Soo Han, Kwangpyo Hong, Kwang-Woong Lee, Jeong-Moo Lee, YoungRok Choi, Suk Hee Ko, Eunhye Shin, Nam-Joon Yi, and Suk Kyun Hong
- Subjects
medicine.medical_specialty ,Scoring system ,business.industry ,Medicine ,Right hemihepatectomy ,business ,Surgery - Published
- 2020
172. Machine-learning models to predict tacrolimus dosage in liver transplant recipients
- Author
-
Jae Hyung Cho, Soo Bin Yoon, Chul Woo Jung, Kwang-Woong Lee, Hyung Chul Lee, Jeong-Moo Lee, Suk Kyun Hong, and Nam-Joon Yi
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Medicine ,business ,Tacrolimus - Published
- 2020
173. Redo hepatic artery reconstruction for thrombosis can save grafts and patients without retransplantation: lessons learned from 1,355 adult living donor liver transplantations
- Author
-
Nam-Joon Yi, Hak Chang, Kwang-Woong Lee, Kyung Won Minn, Suk Kyun Hong, Jeong-Moo Lee, Kyung-Suk Suh, YoungRok Choi, Su Young Hong, and Ung Sik Jin
- Subjects
medicine.medical_specialty ,business.industry ,Medicine ,Artery reconstruction ,business ,medicine.disease ,Thrombosis ,Living donor ,Surgery - Published
- 2020
174. Long-term outcome after prevention of de novo hepatitis B in recipients of core antibody-positive livers with hepatitis B immunoglobulin only
- Author
-
Eui Soo Han, Suk Kyun Hong, Kyung Chul Yoon, Kwang-Woong Lee, Kwangpyo Hong, Nam-Joon Yi, Jeong-Moo Lee, YoungRok Choi, Hye-Sol Jung, and Kyung-Suk Suh
- Subjects
Hepatitis B virus ,medicine.medical_specialty ,HBsAg ,biology ,business.industry ,medicine.medical_treatment ,Incidence (epidemiology) ,virus diseases ,Liver transplantation ,Hepatitis B ,medicine.disease ,medicine.disease_cause ,Occult ,Gastroenterology ,digestive system diseases ,Internal medicine ,medicine ,biology.protein ,Seroconversion ,Antibody ,business - Abstract
Background: Anti-HBc positive donors represent an important source of organs in hepatitis B virus (HBV) endemic areas despite the risk of occult HBV infection. We analyzed long-term outcome of prevention for de novo HBV with hepatitis B immunoglobulin (HBIG) only after liver transplantation (LT) using core-positive grafts. Methods: We retrospectively reviewed the prospective collected data of 1,479 recipients between 1988 and 2018 at Seoul Nation al University Hospital. 1,458 were eligible and enrolled. If either donor or recipient had core antibody, HBIG 4000 IU was adminis trated 4 times until postoperative day 3. Results: Of 1,458 LTs, 478 (32.8%) used anti-HBc positive grafts. Three hundred twenty-six (68.2%) was allocated to hepatitis B surface antigen (HBsAg)-positive recipients, with 152 (31.8%) to HBs-negative recipients. 21 (13.8%) of de novo HBV infection occurred in 152 core-positive grafts. One (25%), 11 (22.4%), 0, 9 (9.2%) was diagnosed of de novo HBV infection in 4 of hepatitis B surface antigen (HBcAb) and HBsAb negative, 49 of HBcAb-negative and HBsAb-positive, 1 of HBcAb-positive and HBsAb-neg ative, 98 of HBcAb and HBsAb positive recipients respectively. Anti-HBc negative recipients were more likely to develop de novo HBV infection compared with anti-HBc positive recipients (22.6% vs. 9.1%, P=0.021). Incidence of de novo HBV infection did not differ by recipient HBsAb status (P=0.530). The median follow-up time was 69 months (range, 29-165 months). The median time to detection of HBsAg seropositivity was 18 months (range, 8-55 months). Two had no treatment, twelve were treated with nu cleoside analogs (NA) monotherapy, and seven were treated with NA plus HBIG. The median treatment duration was 41 months. Seven acquired seroconversion. There were 42 (8.8%) of graft losses in study period. The 1-, 5-, 10-year patient survival with an ti-HBc positive liver were 97.5%, 93.2%, and 90.5%. No patient died of de novo HBV infection. Conclusions: De novo HBV did not affect patient survival. However, HBIG only prophylaxis was not enough to prevent de novo HBV development in the era of NA.
- Published
- 2020
175. Long term outcomes of abdominal wall closure with ePTFE Gore-Tex Mesh in pediatric liver transplantation
- Author
-
Nam-Joon Yi, Eui Soo Han, Jeong-Moo Lee, Kwang-Woong Lee, Kyung-Suk Suh, Ji Young Kim, Suk Kyun Hong, and Kwangpyo Hong
- Subjects
Abdominal wall closure ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Long term outcomes ,Medicine ,Liver transplantation ,business ,Surgery - Published
- 2020
176. Pure 3‐dimensional laparoscopic extended right hepatectomy in a living donor
- Author
-
Suk Kyun Hong, Hyeyoung Kim, Kwang-Woong Lee, Nam-Joon Yi, Hyo-Sin Kim, Kyung Chul Yoon, and Kyung-Suk Suh
- Subjects
Donor hepatectomy ,Transplantation ,medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,business.industry ,Extended right hepatectomy ,medicine.medical_treatment ,Magnetic resonance imaging ,030230 surgery ,Liver transplantation ,Living donor ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine ,030211 gastroenterology & hepatology ,Hepatectomy ,business ,Laparoscopy - Published
- 2016
177. Risk Factors Affecting Outcomes in Pediatric Liver Transplantation: A Real-World Single-Center Experience.
- Author
-
Suk Kyun Hong, Nam-Joon Yi, Kwangpyo Hong, Eui Soo Han, Jeong-Moo Lee, YoungRok Choi, Kwang-Woong Lee, and Kyung-Suk Suh
- Published
- 2021
- Full Text
- View/download PDF
178. Outcomes of Pediatric Liver Transplantation in Korea Using Two National Registries
- Author
-
Jae Geun Lee, Suk Kyun Hong, Kyung-Suk Suh, Nam-Joon Yi, Kwang-Woong Lee, Koo Jeong Kang, Kwangpyo Hong, Eui Soo Han, Shin Hwang, Kyung Chul Yoon, Jeong Moo Lee, Sang Hoon Lee, Je Ho Ryu, and Myoung Soo Kim
- Subjects
medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,graft survival ,lcsh:Medicine ,complication ,030230 surgery ,Liver transplantation ,survival ,Article ,Organ transplantation ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Biliary atresia ,Internal medicine ,medicine ,business.industry ,lcsh:R ,Retrospective cohort study ,General Medicine ,medicine.disease ,Disease control ,pediatric liver transplantation ,030211 gastroenterology & hepatology ,business ,Complication - Abstract
Background: This retrospective study aimed to evaluate overall survival and the risk factors for mortality among Korean pediatric liver transplantation (LT) patients using data from two national registries: the Korean Network Organ Sharing (KONOS) of the Korea Centers for Disease Control and Prevention and the Korean Organ Transplantation Registry (KOTRY). Methods: Prospectively collected data of 755 pediatric patients who underwent primary LT (KONOS, February 2000 to December 2015, KOTRY, May 2014 to December 2017) were retrospectively reviewed. Results: The 1-, 5-, 10-, and 15-year survival rates were 90.6%, 86.7%, 85.8%, and 85.5%, respectively, in KONOS, and the 1-month, 3-month, 1-year, and 2-year survival rates were 92.1%, 89.4%, 89.4%, and 87.2%, respectively, in KOTRY. There was no significant difference in survival between the two registries. Multivariate analysis identified that body weight &ge, 6 kg (p <, 0.001), biliary atresia as underlying liver disease (p = 0.001), and high-volume center (p <, 0.001) were associated with better survival according to the KONOS database, while hepatic artery complication (p <, 0.001) was associated with poorer overall survival rates according to the KOTRY database. Conclusion: Long-term pediatric patient survival after LT was satisfactory in this Korean national registry analysis. However, children with risk factors for poor outcomes should be carefully managed after LT.
- Published
- 2020
179. Sirolimus and MMF are insufficient immunosuppressants for regulation of the proliferation of CD133+EpCAM+ cell populations in HCC cell lines
- Author
-
Suk Kyun Hong, Min Young Park, Kwang-Woong Lee, Kyung Chul Yoon, Seung Cheol Oh, Nam-Joon Yi, Kyung-Suk Suh, Sooin Seo, Hwajung Kim, and Xue Li Jin
- Subjects
0301 basic medicine ,Cell ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Cancer stem cell ,medicine ,General Pharmacology, Toxicology and Pharmaceutics ,neoplasms ,business.industry ,General Neuroscience ,Articles ,General Medicine ,Cell cycle ,medicine.disease ,Molecular medicine ,digestive system diseases ,Tacrolimus ,030104 developmental biology ,medicine.anatomical_structure ,Apoptosis ,030220 oncology & carcinogenesis ,Sirolimus ,Hepatocellular carcinoma ,cardiovascular system ,Cancer research ,business ,medicine.drug - Abstract
Studies on effective immunosuppressive strategies for the management of patients undergoing a liver transplantation (LT) due to hepatocellular carcinoma (HCC) are limited. In the present study, immunosuppressive candidates predicted to exhibit beneficial immunosuppressive and tumor-suppressive effects in patients with HCC were assessed using Huh7 and HEP3B HCC cells, which have high proportions of CD133+EpCAM+ cancer stem cell (CSC) populations. The immunosuppressants assessed were sirolimus, tacrolimus, cyclosporine A and mycophenolate mofetil (MMF), and their activities were assessed on CSCs. Sirolimus and MMF reduced the proliferation of Huh7 and HEP3B cells; however, the proportion of CD133+EpCAM+ was notably increased in treated Huh7 cells. Sirolimus treatment alone resulted in G0-G1 cell cycle arrest at all doses in all Huh7 and CD133-EpCAM- populations; however, CD133+EpCAM+ populations showed only slight G1 arrest at higher doses only. In contrast, S-phase arrest was induced at all doses in the Huh7, CD133-EpCAM- and CD133+EpCAM+ populations by MMF. Sirolimus and MMF effectively reduced the proliferation of Huh7 and HEP3B cells, but did not exert a notable effect on the CD133+EpCAM+ cells. Therefore, therapeutic strategies utilizing Sirolimus and MMF should be further studied in vivo for regulation of CSC populations in order to reduce HCC recurrence rates.
- Published
- 2020
180. Effect of CYP3A5 on the Once-Daily Tacrolimus Conversion in Stable Liver Transplant Patients
- Author
-
Suk Kyun Hong, Kwangho Yang, Jong Man Kim, Je Ho Ryu, Young A. Kim, Ju-Yeun Lee, Kyung-Suk Suh, Kwang-Woong Lee, Gyu-Seong Choi, Choon Hyuck David Kwon, Nam-Joon Yi, Jae-Won Joh, and Chong Woo Chu
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Cmax ,lcsh:Medicine ,chemical and pharmacologic phenomena ,030230 surgery ,030226 pharmacology & pharmacy ,Gastroenterology ,03 medical and health sciences ,Cmin ,0302 clinical medicine ,Pharmacokinetics ,Internal medicine ,medicine ,tacrolimus ,immunosuppression ,business.industry ,lcsh:R ,Area under the curve ,Immunosuppression ,General Medicine ,Tacrolimus ,surgical procedures, operative ,Trough level ,Liver function ,business ,pharmacokinetics - Abstract
Cytochrome P450 (CYP) 3A5 polymorphism influences tacrolimus metabolism, but its effect on the drug pharmacokinetics in liver transplant recipients switched to once-daily extended-release formulation remains unknown. The aim of this study is to analyze the effect of CYP3A5 polymorphism on liver function after once-daily tacrolimus conversion in liver transplant patients. A prospective open-label study included 60 stable liver transplant recipients who underwent 1:1 conversion from twice-daily tacrolimus to once-daily tacrolimus. All participants were genotyped for CYP3A5 polymorphism. The study was registered at ClinicalTrials.gov (NCT 02882113). Twenty-eight patients were enrolled in the CYP3A5 expressor group and 32 in the non-expressor group. Although there was no statistical difference, incidence of liver dysfunction was higher in the expressor group than in the non-expressor group when converted to once-daily extended-release tacrolimus (p = 0.088). No biopsy-proven acute rejection, graft failure, and mortality were observed in either group. The decrease in dose-adjusted trough level (&minus, 42.9% vs. &minus, 26.1%) and dose/kg-adjusted trough level of tacrolimus (&minus, 40.0% vs. &minus, 23.7%) was significantly greater in the expressor group than in the non-expressors after the conversion. A pharmacokinetic analysis was performed in 10 patients and tacrolimus absorption in the non-expressor group was slower than in the expressor group. In line with this observation, the area under the curve for once-daily tacrolimus correlated with trough level (Cmin) in the non-expressors and peak concentration (Cmax) in the expressors. CYP3A5 genotyping in liver transplant recipients leads to prediction of pharmacokinetics after switching from a twice-daily regimen to a once-daily dosage form, which makes it possible to establish an appropriate dose of tacrolimus.
- Published
- 2020
181. FACTORS ASSOCIATED WITH SURVIVAL OF PATIENTS WITH HIGH MODEL FOR END-STAGE LIVER DISEASE SCORES ≥ 35: DECEASED DONOR VS. LIVING DONOR LIVER TRANSPLANTATION
- Author
-
Nam-Joon Yi, Ho-Seong Han, Suk Kyun Hong, Jeong-Moo Lee, YoungRok Choi, Boram Lee, Hae Won Lee, Kwang-Woong Lee, Kyung-Suk Suh, and Jai Young Cho
- Subjects
Transplantation ,medicine.medical_specialty ,Deceased donor ,Model for End-Stage Liver Disease ,business.industry ,Internal medicine ,medicine ,business ,Living donor liver transplantation ,Gastroenterology - Published
- 2020
182. SUCCESSFUL LUNG AND LIVER CO-TRANSPLANTATION IN PEDIATRIC PATIENT WITH DYSKERATOSIS CONGENITA
- Author
-
Samina Park, Jeong-Moo Lee, Nam-Joon Yi, Suk Kyun Hong, and Young Tae Kim
- Subjects
Co transplantation ,Transplantation ,Pediatric patient ,medicine.medical_specialty ,Lung ,medicine.anatomical_structure ,business.industry ,Medicine ,business ,medicine.disease ,Dyskeratosis congenita ,Surgery - Published
- 2020
183. OUTCOME OF PEDIATRIC LIVER TRANSPLANTATION AND RISK FACTORS AFFECTING OVERALL SURVIVAL: USING TWO KOREAN NATIONAL REGISTRY DATA
- Author
-
Kyung-Suk Suh, Jeong-Moo Lee, Suk Kyun Hong, Kwang-Woong Lee, Eui Soo Han, Nam-Joon Yi, and Kwangpyo Hong
- Subjects
Transplantation ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine.medical_treatment ,medicine ,Overall survival ,National registry ,Liver transplantation ,business ,Outcome (game theory) - Published
- 2020
184. THE IMPACT OF CHARLSON COMORBIDITY INDEX ON SURVIVAL IN RECIPIENTS AGED 65 YEARS OR OLDER AFTER LIVER TRANSPLANTATION
- Author
-
Ho-Seong Han, Kwang-Woong Lee, Hae Won Lee, Nam-Joon Yi, Kyung-Suk Suh, Boram Lee, Suk Kyun Hong, Jeong-Moo Lee, YoungRok Choi, and Jai Young Cho
- Subjects
Transplantation ,medicine.medical_specialty ,business.industry ,Internal medicine ,Charlson comorbidity index ,medicine.medical_treatment ,medicine ,Liver transplantation ,business - Published
- 2020
185. LONG-TERM PROGNOSIS OF LIVER TRANSPLANTATION FOR COMBINED HEPATOCELLULAR AND CHOLANGIOCARCINOMA: 2010 WHO CLASSIFICATION-BASED ANALYSIS
- Author
-
Kwang-Woong Lee, Hae Won Lee, Jai Young Cho, Ho-Seong Han, Nam-Joon Yi, Jeong-Moo Lee, Kyung-Suk Suh, YoungRok Choi, Boram Lee, and Suk Kyun Hong
- Subjects
Transplantation ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine.medical_treatment ,medicine ,Liver transplantation ,Who classification ,business ,Gastroenterology ,Term (time) - Published
- 2020
186. Various techniques for bile duct division in pure laparoscopic donor hepatectomy
- Author
-
Eui Soo Han, Kwangpyo Hong, Suk Kyun Hong, Kwang-Woong Lee, Kyung-Suk Suh, Jeong-Moo Lee, and Nam-Joon Yi
- Subjects
Donor hepatectomy ,medicine.medical_specialty ,medicine.anatomical_structure ,Bile duct ,business.industry ,medicine ,Urology ,Radiology, Nuclear Medicine and imaging ,Surgery ,Division (mathematics) ,business - Published
- 2020
187. Acute appendicitis after liver transplantation: A single center experience and review of the literature
- Author
-
Nam Joon Yi, Kwangpyo Hong, Kwang-Woong Lee, Suk Kyun Hong, Indah Jamtani, Sara Kim, Kyung Suk Suh, Eui Soo Han, and Jeong-Moo Lee
- Subjects
Acute appendicitis ,education.field_of_study ,medicine.medical_specialty ,Liver transplantation ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Population ,medicine.disease ,Single Center ,Appendicitis ,Surgery ,Transplantation ,medicine ,Appendectomy ,Original Article ,Laparoscopy ,General Materials Science ,Leukocytosis ,medicine.symptom ,education ,business - Abstract
Backgrounds/aims Acute appendicitis is one of the most common emergent disease in the general population requiring surgical treatment. However, only a few cases of appendicitis after liver transplantation (LT) were reported. We described experiences of acute appendicitis after LT in single center. Methods From March 1988 to July 2019, we reviewed retrospectively all the patients who diagnosed with acute appendicitis after LT at the Seoul National University Hospital. We described and analyzed clinical outcomes of appendectomy after LT. Results A total of 12 patients out of 2,237 LT patients underwent appendectomy due to acute appendicitis. The mean age was 48±12 years. Nine patients (75%) underwent deceased donor liver transplantation (DDLT) and three patients (25%) underwent living donor liver transplantation (LDLT). The mean days from transplantation to the onset of acute appendicitis was 739 (range 57-4,496) days. Every patients underwent appropriate appendectomy within 1 days after visiting hospital. Leukocytosis was seen in three patients (25%). Seven patients (58%) underwent laparoscopic appendectomy and five patients (42%) underwent open appendectomy. The total operative time was 47.5 (range 25-135) minutes. The median postoperative hospitalization was 4 (range 2-11) days. There was no postoperative complications documented. There was no significant difference of clinical outcomes between laparoscopic appendectomy group and open appendectomy group. Conclusions Early surgical management achieved satisfactory postoperative results without graft dysfunction after LT. Laparoscopic appendectomy also could be applicable with safe and feasible outcomes even in post-LT recipients.
- Published
- 2020
188. Does meeting the Milan criteria at the time of recurrence of hepatocellular carcinoma after curative resection have an impact on prognosis?
- Author
-
Hyo-Sin, Kim, Nam-Joon, Yi, Jong Man, Kim, Suk Kyun, Hong, Choon Hyuck David, Kwon, Jae-Won, Joh, Kwang-Woong, Lee, and Kyung-Suk, Suh
- Subjects
Cohort Studies ,Male ,Survival Rate ,Carcinoma, Hepatocellular ,Risk Factors ,Liver Neoplasms ,Humans ,Female ,Middle Aged ,Neoplasm Recurrence, Local ,Prognosis ,Aged - Abstract
The survival outcomes of recurrent hepatocellular carcinoma (HCC) after curative resection remain unclear due to lack of clear basis for the selection of treatment option. We investigated overall survival (OS) after intrahepatic recurrence and re-recurrence free survival (rRFS) of the patients with recurrent HCC, and whether Milan criteria (MC) status at resection and recurrence impacts on OS and rRFS.We enrolled 959 patients who experienced recurrence after primary hepatic resection for HCC. We divided the cohort into four groups according to MC at two periods: IN-rIN MC (HCC within MC at the time of resection-recurrence within MC), IN-rOUT MC (HCC within MC at the time of resection-recurrence outside MC), OUT-rIN MC (HCC outside MC at the time of resection-recurrence within MC), and OUT-rOUT MC (HCC outside MC at the time of resection-recurrence outside MC).In the entire cohort, 1-, 3-, and 5-year OS after recurrence was 81.0%, 55.7%, and 45.8%, respectively, while rRFS was 63.7%, 46.1%, and 42.0%, respectively. The IN-rIN MC group had the best outcomes (5-year OS and rRFS, 54.5% and 45.7%, respectively). The IN-rOUT and OUT-rIN MC groups had better 5-year OS outcomes than the OUT-rOUT MC group (46.5%, 38.6%, and 24.8%, respectively; P 0.05). However, 5-year rRFS did not differ among the three groups (37.5%, 36.6%, and 31.9%, respectively; P 0.05).Survival after first recurrence following curative primary resection for HCC was affected by MC at both time of resection and recurrence. Both the IN-rOUT and OUT-rIN MC groups with similar survival outcomes can be saved via curative treatment.
- Published
- 2018
189. Preformed donor-specific antibodies do not affect the 1-year allograft survival in living donor liver transplantation
- Author
-
Kwang-Woong Lee, Hae Won Lee, Eun Young Song, Kyung Suk Suh, Hyeyoung Kim, Kyung Chul Yoon, Kyoung Bun Lee, Suk Kyun Hong, Nam Joon Yi, and Hye Young Ahn
- Subjects
Adult ,Male ,medicine.medical_specialty ,Graft dysfunction ,medicine.medical_treatment ,030230 surgery ,Liver transplantation ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Antigen ,Isoantibodies ,Internal medicine ,Allograft survival ,medicine ,Complement C4b ,Living Donors ,Humans ,Adverse effect ,Aged ,Retrospective Studies ,Transplantation ,biology ,business.industry ,Donor specific antibodies ,Histocompatibility Testing ,Liver Diseases ,Graft Survival ,Middle Aged ,Allografts ,Prognosis ,Peptide Fragments ,Liver Transplantation ,biology.protein ,030211 gastroenterology & hepatology ,Female ,Antibody ,Living donor liver transplantation ,business ,Follow-Up Studies - Abstract
The effect of preformed donor-specific antibodies (DSAs) on liver transplantation (LT) remains unclear, especially in the field of living donor LT (LDLT). Herein, we evaluated the prevalence of preformed DSAs and their effect on graft outcome in LDLT in the first year following surgery. Using the Luminex® Single Antigen assay, we analyzed the preoperative sera of 61 adult LDLT recipients between 2014 and 2015. Clinical outcomes and pathologic findings including complement component 4d (C4d) expression in the first year after LT were retrospectively reviewed. Regardless of the class of DSA, DSAs with mean fluorescence intensity (MFI) ≥1000 were defined as positive and preformed DSA with MFI ≥5000 was defined as strongly positive. Fifteen patients (24.6%) had preformed DSAs, and 8 patients (13.1%) showed strongly positive preformed DSAs. Among 15 DSA positive patients, 2 (13.3%) showed persistent DSAs after LDLT. No de novo DSAs were noted in patients without preformed DSAs. Preformed DSAs were not related to graft dysfunction, laboratory values, or C4d expression or other pathologic findings in the first year of LDLT. In conclusion, preformed DSAs persisted during follow-up in 13.3% of cases and did not have adverse effect on histologic or clinical outcomes in the first year of LDLT.
- Published
- 2018
190. New Technique for Management of Separate Right Posterior and Anterior Portal Veins in Pure 3D Laparoscopic Living Donor Right Hepatectomy
- Author
-
Jeong Moo Lee, Kwang-Woong Lee, Jae-Hyung Cho, Nam-Joon Yi, Suk Kyun Hong, and Kyung-Suk Suh
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Operative Time ,Portal vein ,Living donor ,03 medical and health sciences ,0302 clinical medicine ,Living Donors ,medicine ,Hepatectomy ,Humans ,Laparoscopy ,Donor hepatectomy ,Sutures ,medicine.diagnostic_test ,Portal Vein ,business.industry ,Anatomic Variation ,Gastroenterology ,Middle Aged ,Liver Transplantation ,Surgery ,Transplantation ,surgical procedures, operative ,030220 oncology & carcinogenesis ,Liver donors ,Tissue and Organ Harvesting ,Right posterior ,030211 gastroenterology & hepatology ,business - Abstract
Pure laparoscopic donor hepatectomy, including right hepatectomy, is being increasingly performed at experienced centers (Kim et al. Transplantation 101:1106-1110, 2017; Han et al. Medicine (Baltimore) 96:e8076, 2017; Suh et al. Am J Transplant 18:434-443, 2018; Hong et al. Br J Surg 105:751-759, 2018; Lee et al. Transplantation 102:1878-1884, 2018). However, anatomical variations in the portal vein remain major challenges and are regarded as contraindications by some centers. Using a stapler or clip in donors with these anatomical variations may result in kinking of the remnant portal vein due to the thick linear bite, as well as a reduction in the length of the graft portal vein. This report describes a liver donor with separate right posterior and anterior portal veins who underwent pure 3D laparoscopic donor right hepatectomy, focusing on a new technique of managing separate two portal veins.A 45-year-old man offered to donate part of his liver to his father, who required a liver transplant for alcoholic liver cirrhosis. The father's Child-Pugh score was 7 and his Model for End-Stage Liver Disease score was 10.7. Donor height was 175.4 cm, body weight was 79.9 kg, and body mass index was 26.0 kg/mThe total operation time was 365 min, with no transfusion and no intraoperative complications. The portal veins were divided safely without any torsion or stricture. The stumps of the portal veins were sutured after retrieval of the liver graft, with suturing requiring about 12 min. The donor was discharged on postoperative day 7 with no complications.The SNUH technique, consisting of temporary clipping, intracorporeal suturing, and clip removal is safe and useful for pure laparoscopic right hepatectomy in donors with anatomic variations in the portal vein.
- Published
- 2019
191. No touch isolation technique for the prevention of postoperative recurrence of hepatocellular carcinoma after liver transplantation-combined with Trans-arterial Radioembolization
- Author
-
Jae-Hyung Cho, Suk Kyun Hong, Nam-Joon Yi, Kwang-Woong Lee, Kyung-Suk Suh, and Jeong-Moo Lee
- Subjects
medicine.medical_specialty ,Hepatology ,Isolation (health care) ,business.industry ,medicine.medical_treatment ,Internal medicine ,Hepatocellular carcinoma ,Gastroenterology ,medicine ,Liver transplantation ,medicine.disease ,business - Published
- 2019
192. Parietal Peritoneum as an Autologous Substitute for Middle Hepatic Vein Reconstruction During Living-Donor Liver Transplantation
- Author
-
Kyung-Suk Suh, Kwang-Woong Lee, Jeong-Moo Lee, Suk Kyun Hong, Nam-Joon Yi, and Jae-Hyung Cho
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Parietal peritoneum ,Gastroenterology ,medicine ,business ,Living donor liver transplantation ,Vein reconstruction ,Surgery - Published
- 2019
193. Long Term Outcomes of ABO Incompatible Living Donor Liver Transplantation with Customized Desensitization Protocol: Single Center Experience
- Author
-
Kyung-Suk Suh, Jeong-Moo Lee, Kwang-Woong Lee, Eui Soo Han, Kwang Pyo Hong, Nam-Joon Yi, and Suk Kyun Hong
- Subjects
Pediatrics ,medicine.medical_specialty ,Hepatology ,business.industry ,ABO blood group system ,medicine.medical_treatment ,Gastroenterology ,Long term outcomes ,Medicine ,Living donor liver transplantation ,Single Center ,business ,Desensitization (medicine) - Published
- 2019
194. Pure laparoscopic donor hepatectomy: Korean multicenter experience
- Author
-
Choon Hyuck David Kwon, Young Seok Han, Ho-Seong Han, Gyu-Seong Choi, Kyung-Suk Suh, Kwang-Woong Lee, Suk Kyun Hong, Ki-Hun Kim, Sung-Gyu Lee, and Jai Young Cho
- Subjects
Donor hepatectomy ,medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,medicine ,business ,Surgery - Published
- 2019
195. Surgical tips of pure 3D laparoscopic donor right hemihepatectomy obtained from initial experience and complications
- Author
-
Kyung-Suk Suh, Suk Kyun Hong, Kwang-Woong Lee, Nam-Joon Yi, Jeong-Moo Lee, and Jae-Hyung Cho
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,medicine ,Right hemihepatectomy ,business ,Surgery - Published
- 2019
196. Survival Outcomes in Split Compared With Whole Liver Transplantation
- Author
-
Kwang-Woong Lee, Kyung-Suk Suh, Myoung Soo Kim, Kyung Chul Yoon, Eunkyoung Jwa, Ok-kyoung Kim, Sanghee Song, Jong Man Kim, Suk-Koo Lee, Suk Kyun Hong, Nam-Joon Yi, Sang Hoon Lee, and Shin Hwang
- Subjects
Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Subgroup analysis ,030230 surgery ,Liver transplantation ,Malignancy ,Gastroenterology ,Severity of Illness Index ,Donor Selection ,End Stage Liver Disease ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Internal medicine ,parasitic diseases ,Severity of illness ,Republic of Korea ,Medicine ,Humans ,Survival rate ,Retrospective Studies ,Transplantation ,Hepatology ,business.industry ,Patient Selection ,Graft Survival ,Retrospective cohort study ,Organ Size ,Middle Aged ,Whole liver transplantation ,medicine.disease ,Allografts ,Liver Transplantation ,Survival Rate ,Treatment Outcome ,Liver ,030211 gastroenterology & hepatology ,Surgery ,Female ,business - Abstract
Split-liver transplantation (SLT) should be cautiously considered because the right trisection (RTS) graft can be a marginal graft in adult recipients. Herein, we analyzed the outcomes of RTS-SLT in Korea, where75% of adult liver transplantations are performed with living donor liver transplantation. Among 2462 patients who underwent deceased donor liver transplantations (DDLTs) from 2005 to 2014, we retrospectively reviewed 86 (3.5%) adult patients who received a RTS graft (RTS-SLT group). The outcomes of the RTS-SLT group were compared with those of 303 recipients of whole liver (WL; WL-DDLT group). Recipient age, laboratory Model for End-Stage-Liver Disease (L-MELD) score, ischemia time, and donor-to-recipient weight ratio (DRWR) were not different between the 2 groups (P0.05). However, malignancy was uncommon (4.7% versus 36.3%), and the donor was younger (25.2 versus 42.7 years) in the RST-SLT group than in the WL-DDLT group (P0.05). The technical complication rates and the 5-year graft survival rates (89.0% versus 92.8%) were not different between the 2 groups (P0.05). The 5-year overall survival (OS) rate (63.1%) and graft-failure-free survival rate (63.1%) of the RTS-SLT group were worse than that of the WL-DDLT group (79.3% and 79.3%; P0.05). The factors affecting graft survival rates were not definite. However, the factors affecting OS in the RTS-SLT group were L-MELD score30 and DRWR ≤1.0. In the subgroup analysis, OS was not different between the 2 groups if the DRWR was1.0, regardless of the L-MELD score (P0.05). In conclusion, a sufficient volume of the graft estimated from DRWR-matching could lead to better outcomes of adult SLTs with a RTS graft, even in patients with high L-MELD scores.
- Published
- 2017
197. The rate of hepatic artery complications is higher in pediatric liver transplant recipients with metabolic liver diseases than with biliary atresia
- Author
-
Hak Chang, Sung Woo Ahn, Kyung Chul Yoon, Nam-Joon Yi, Hyeyoung Kim, Kwang-Woong Lee, Kyung-Suk Suh, Seong Oh Park, Ung Sik Jin, Kyung Won Minn, Hyo Sin Kim, and Suk Kyun Hong
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,030230 surgery ,Liver transplantation ,Gastroenterology ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Hepatic Artery ,Postoperative Complications ,Metabolic Diseases ,Biliary atresia ,Biliary Atresia ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Pediatric end-stage liver disease ,Child ,Survival rate ,Retrospective Studies ,business.industry ,Liver Diseases ,Case-control study ,Infant ,Retrospective cohort study ,General Medicine ,medicine.disease ,Liver Transplantation ,Survival Rate ,medicine.anatomical_structure ,Treatment Outcome ,Case-Control Studies ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,030211 gastroenterology & hepatology ,Surgery ,Female ,business ,Cohort study ,Artery - Abstract
Liver transplantation (LT) is an excellent treatment option for patients with biliary atresia (BA) who fail portoenterostomy surgery. LT is also increasingly performed in patients with metabolic liver diseases. This study compared the outcomes in pediatric patients who underwent LT for metabolic liver diseases and BA.Data from 237 pediatric patients who underwent primary LT at Seoul National University Hospital from 1988 to 2015, including 33 with metabolic liver diseases and 135 with BA, were retrospectively analyzed.Compared with children with BA, children with metabolic liver diseases were significantly older at the time of LT (121.3 vs. 37.3 months; P 0.001), and had lower Child-Pugh (7.1 vs. 8.4; P = 0.010) and Pediatric End-stage Liver Disease (6.5 vs. 12.8; P = 0.042) scores. Overall survival rates were similar (87.8% vs. 90.8%; P = 0.402), but hepatic artery (HA) complications were significantly more frequent in children with metabolic liver diseases (12.1% vs. 1.5%; P = 0.014).Despite similar overall survival, children with metabolic liver diseases had a higher rate of HA complications.Original article, Case control study, Retrospective.III.
- Published
- 2017
198. Pediatric Living Donor Liver Transplantation Using a Monosegment Procured by Pure 3D Laparoscopic Left Lateral Sectionectomy and In situ Reduction
- Author
-
Kyung Chul Yoon, Suk Kyun Hong, Kyung-Suk Suh, Kwang-Woong Lee, Hyeyoung Kim, Nam-Joon Yi, Hyo Sin Kim, and Sung Woo Ahn
- Subjects
Adult ,Indocyanine Green ,medicine.medical_specialty ,medicine.medical_treatment ,Biliary cirrhosis ,030230 surgery ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Cholangiography ,Biliary atresia ,medicine ,Living Donors ,Hepatectomy ,Humans ,Laparoscopy ,Coloring Agents ,Reduction (orthopedic surgery) ,medicine.diagnostic_test ,business.industry ,Bile duct ,Gastroenterology ,medicine.disease ,Surgery ,Liver Transplantation ,medicine.anatomical_structure ,chemistry ,Liver ,Tissue and Organ Harvesting ,030211 gastroenterology & hepatology ,Female ,Bile Ducts ,business ,Indocyanine green - Abstract
Improvements in laparoscopic imaging systems and instruments have increased the performance of pure laparoscopic living donor hepatectomy. This operation is no longer limited to left lateral sectionectomy but is used for left hepatectomy and right hepatectomy.1-5 This report describes a donor who underwent pure laparoscopic left lateral sectionectomy and in situ reduction using 3D laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography to obtain a monosegment. A 43-year-old woman offered to donate part of her liver to her daughter, who required a transplant for acute liver failure after a Kasai operation for biliary cirrhosis caused by biliary atresia. Donor height was 150.4 cm, body weight was 56.8 kg, and body mass index was 25.1 kg/m2. Liver dynamic CT showed a left lateral liver volume of 223 cm3, and an estimated graft-to-recipient weight ratio (GRWR) of 4.4%. The entire procedure including in situ reduction was performed under 3D laparoscopic view. The optimal bile duct division point was determined by real time ICG fluorescence cholangiography. The total operation time was 320 min, with no transfusion required and no intraoperative complications. Intraoperative real time ICG fluorescence cholangiography revealed the donor’s bile duct anatomy and identified the optimal division point. The final graft weighed 167 g, 48 g being reduced in situ, with a GRWR of 3.3%. The donor was discharged on postoperative day 8 with no complications. Pure 3D laparoscopic left lateral sectionectomy and in situ reduction are feasible for obtaining a donor monosegment for pediatric living donor liver transplantation.
- Published
- 2017
199. Expert Consensus Guidelines on Minimally Invasive Donor Hepatectomy for Living Donor Liver Transplantation From Innovation to Implementation: A Joint Initiative From the International Laparoscopic Liver Society (ILLS) and the Asian-Pacific...
- Author
-
Cherqui, Daniel, Ciria, Ruben, Kwon Choon Hyuck, David, Ki-Hun Kim, Broering, Dieter, Go Wakabayashi, Samstein, Benjamin, Troisi, Roberto I., Ho Seong Han, Rotellar, Fernando, Soubrane, Olivier, Briceño, Javier, Alconchel, Felipe, Ayllón, María Dolores, Berardi, Giammauro, Cauchy, Francois, Luque, Irene Gómez, Suk Kyun Hong, Young-Yin Yoon, and Hiroto Egawa
- Abstract
Objective: The Expert Consensus Guidelines initiative on MIDH for LDLT was organized with the goal of safe implementation and development of these complex techniques with donor safety as the main priority. Background: Following the development of minimally invasive liver surgery, techniques of MIDH were developed with the aim of reducing the short- and long-term consequences of the procedure on liver donors. These techniques, although increasingly performed, lack clinical guidelines. Methods: A group of 12 international MIDH experts, 1 research coordinator, and 8 junior faculty was assembled. Comprehensive literature search was made and studies classified using the SIGN method. Based on literature review and experts opinions, tentative recommendations were made by experts subgroups and submitted to the whole experts group using on-line Delphi Rounds with the goal of obtaining >90% Consensus. Pre-conference meeting formulated final recommendations that were presented during the plenary conference held in Seoul on September 7, 2019 in front of a Validation Committee composed of LDLT experts not practicing MIDH and an international audience. Results: Eighteen Clinical Questions were addressed resulting in 44 recommendations. All recommendations reached at least a 90% consensus among experts and were afterward endorsed by the validation committee. Conclusions: The Expert Consensus on MIDH has produced a set of clinical guidelines based on available evidence and clinical expertise. These guidelines are presented for a safe implementation and development of MIDH in LDLT Centers with the goal of optimizing donor safety, donor care, and recipient outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
200. Sirolimus and MMF are insufficient immunosuppressants for regulation of the proliferation of CD133+EpCAM+ cell populations in HCC cell lines.
- Author
-
HWAJUNG KIM, KWANG-WOONG LEE, SEUNG CHEOL OH, MIN-YOUNG PARK, SOOIN SEO, XUE-LI JIN, SUK KYUN HONG, KYUNG CHUL YOON, NAM-JOON YI, and KYUNG-SUK SUH
- Subjects
RAPAMYCIN ,CELL populations ,CELL proliferation ,CELL lines ,IMMUNOSUPPRESSIVE agents - Abstract
Studies on effective immunosuppressive strategies for the management of patients undergoing a liver transplantation (LT) due to hepatocellular carcinoma (HCC) are limited. In the present study, immunosuppressive candidates predicted to exhibit beneficial immunosuppressive and tumor-suppressive effects in patients with HCC were assessed using Huh7 and HEP3B HCC cells, which have high proportions of CD133+EpCAM+ cancer stem cell (CSC) populations. The immunosuppressants assessed were sirolimus, tacrolimus, cyclosporine A and mycophenolate mofetil (MMF), and their activities were assessed on CSCs. Sirolimus and MMF reduced the proliferation of Huh7 and HEP3B cells; however, the proportion of CD133+EpCAM+ was notably increased in treated Huh7 cells. Sirolimus treatment alone resulted in G0-G1 cell cycle arrest at all doses in all Huh7 and CD133-EpCAM- populations; however, CD133+EpCAM+ populations showed only slight G1 arrest at higher doses only. In contrast, S-phase arrest was induced at all doses in the Huh7, CD133-EpCAM- and CD133+EpCAM+ populations by MMF. Sirolimus and MMF effectively reduced the proliferation of Huh7 and HEP3B cells, but did not exert a notable effect on the CD133+EpCAM+ cells. Therefore, therapeutic strategies utilizing Sirolimus and MMF should be further studied in vivo for regulation of CSC populations in order to reduce HCC recurrence rates. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.