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28. Successful defibrotide treatment of a patient with veno-occlusive disease after living-donor liver transplantation

Author

Lee, Tae Beom, Yang, Kwangho, Ko, Hyo Jung, Shim, Jae Ryong, Choi, Byung Hyun, Lee, Jung Hee, and Ryu, Je Ho

Subjects
Adult, Graft Rejection, liver transplantation, Liver Cirrhosis, Biliary, Biopsy, Hepatic Veno-Occlusive Disease, defibrotide, Allografts, Polydeoxyribonucleotides, Treatment Outcome, Liver, Living Donors, case report, Humans, Female, Clinical Case Report, veno-occlusive disease, Research Article
Abstract

Rationale: Veno-occlusive disease (VOD) is characterized by painful hepatomegaly, ascites, weight gain, and jaundice with nonthrombotic, fibrous obliteration of the centrilobular hepatic veins. VOD after liver transplantation is a rare complication, with an incidence of approximately 2%; however, it can be life-threatening in severe cases. The precise etiology and mechanism of VOD after liver transplantation remains unclear. Acute cellular rejection, antibody-mediated rejection, and treatment with tacrolimus or azathioprine may be associated with the development of VOD after liver transplantation. Additionally, the optimal treatment of VOD after liver transplantation has not yet been established and focuses on supportive care. Defibrotide is an anti-ischemic and antithrombotic drug with no systemic anticoagulant effects. Moreover, only a few reports have investigated the use of defibrotide for VOD after liver transplantation, which has shown promising results. Patient concerns: A 39-year-old woman with primary biliary cholangitis underwent living-donor liver transplantation at our center. She experienced right upper quadrant pain with increased ascites, pleural effusion, and weight gain on postoperative day 14. Diagnoses: Imaging and pathological tests showed no evidence of rejection or vessel complications. VOD was diagnosed clinically based on the findings of weight gain, ascites, jaundice, and pathological biopsy. Interventions: Defibrotid, 25 mg/kg/day, was administered intravenously for 21 days. Outcomes: She showed complete clinical resolution of the VOD. Lessons: Herein, we report a case of successful defibrotide treatment of VOD after living-donor liver transplantation.

Published
2021

36. Buddhist responses to modern transformation of society in Korea

Author

Shim Jae-ryong

Subjects
Korea -- Religious aspects, Buddhism and culture, Regional focus/area studies
Abstract

Korean Buddhism, more specifically minjung Buddhism, is experiencing a reincarnation in that country. This most recent religious paradigm shift is the fourth the country has undergone, and leaves Korean religion a mixture of Shamanism, Buddhism, Confucianism and Christianity. Buddhist responses to modernization and efforts by the minjung to re-incorporate Buddhism into everyday Korean life are discussed.

Published
1993

42. Eosinophil‐to‐monocyte ratio is an excellent predictor of acute cellular rejection in pancreas transplant alone recipients.

Author

Ryu, Je Ho, Ko, Hyo Jung, Shim, Jae Ryong, Lee, Tae Beom, Yang, Kwang Ho, Lee, Jung Hee, Lee, Hyun Ji, Kim, Taeun, and Choi, Byung Hyun

Subjects
PANCREATIC enzymes, GRAFT rejection, BLOOD cell count, RECEIVER operating characteristic curves, AMYLASES
Abstract

Serum pancreatic enzymes (serum amylase and lipase) are sensitive markers for monitoring acute rejection in pancreatic transplant recipients. However, those enzymes are not specific, as their levels are elevated in other conditions. We evaluated the eosinophil‐to‐monocyte ratio (EMR) in peripheral blood as a biomarker of acute rejection in the clinical setting in recipients of pancreatic transplant alone. We performed 32 cases of pancreatic transplantation alone since 2015. Nine patients were diagnosed with rejection. Serum amylase and lipase levels and eosinophil and monocytes counts were analyzed and compared retrospectively between the non‐rejection and rejection groups. The serum eosinophil count, eosinophil fraction of the complete blood count, and serum amylase and lipase levels were significant predictors of rejection according to the receiver operation characteristic (ROC) curve. However, the EMR was the best indicator of rejection based on the ROC curve (area under the curve 0.918, sensitivity 100%, specificity 76.2% at the cutoff value 0.80, P <.001). The combination of EMR and the lipase level had 100% sensitivity and 90.5% specificity. The EMR is a simple and excellent predictor of acute rejection in recipients of pancreatic transplant alone. [ABSTRACT FROM AUTHOR]

Published
2020
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