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Ex) Article Title, Author, Keywords

Review Article

Liver transplantation in Wilson’s disease: A systematic review

Wilson’s disease (WD) is a rare genetic disorder affecting the metabolism of copper that may present with neurological symptoms. In cases leading to hepatic failure, liver transplantation (LT) may be necessary. The aim of this paper is to examine the literature on LT cases related to WD in terms of disease characteristics, the neurological conditions of patients and survival rates. The keywords “Wilson and transplant*” were used to perform a title and abstract search across three databases...
Review Article

Impact of COVID-19 on the number of deceased donors and organ transplantation in Western countries

The severe acute respiratory syndrome coronavirus 2 disease 2019 (COVID-19) pandemic has an impact on all facets of our health care system, including life-saving procedures. The COVID-19 in 2020 has a substantial impact on the transplant community. This study aimed to assess the impact of COVID-19 on the number of deceased donors and organ transplantation in Western countries by analyzing literature review. In Spain, the COVID-19 pandemic has posed significant challenges to the Spanish donation ...
Original Article

Analysis of nationwide volume of liver transplantation in Korea during 2020 shows no definitive decrease during COVID-19 outbreak

Background: Recent outbreak of Coronavirus disease 2019 (COVID-19) has discouraged organ donation. To determine its impact on liver transplantation (LT) at Korean transplant centers, it is necessary to analyze the incidence and type of LT in each center. Methods: The number of deceased donor LT (DDLT) and living donor LT (LDLT) operations performed during the year 2020 were analyzed using the Korean Network for Organ Sharing (KONOS) database. Results: During the 21-year period from 2000 to 2020,...

Minimal-incision donor right hepatectomy for living donor liver transplantation

For living donors, the second most important concern after the donor safety is the cosmetic aspect of abdominal incision. The present study aimed to present the technical details of minimal-incision laparotomy (MIL) in a case of living donor right hepatectomy with an eight minutes video clip. The recipient was a 57-year-old patient with alcoholic liver cirrhosis and the donor was his 28-year-old daughter of the recipient. The epigastrium area was narrow and the subcostal cartilages were elongate...

Current Issue Vol.4 No.1, May, 2024

  • Review Article

    Ann Liver Transplant 2024; 4(1): 1-9


    Abstract : Risk factors contributing to chronic kidney disease (CKD) after liver transplantation (LT) are multifaceted, involving episodes of acute kidney injury (AKI), donor-related factors, and immunosuppressive medication, notably calcineurin inhibitors (CNIs). AKI is a common complication post-LT, affecting nearly half of all patients, with approximately 15% requiring kidney replacement therapy. Recipient factors such as metabolic syndrome, diabetes, obesity, age, ethnicity, hepatitis C infection, and prior malignancy contribute to post-transplant CKD. Maintenance immunosuppressive regimens, particularly early CNI administration, may exacerbate CKD progression by inducing chronic vasoconstriction of kidney arterioles. Early detection of risk factors, addressing modifiable ones, and minimizing perioperative AKI are essential focuses for high-risk individuals. Prioritizing strategies targeting CKD management, diabetes, and hypertension, along with the utilization of Kidney Disease Improving Global Outcomes (KDIGO) recommendations, is crucial for effective management. Blood pressure targets, pharmacological interventions, and timely referral to nephrologists for access creation are integral components of CKD management. Additionally, optimization of immunosuppressive protocols, primarily through CNI minimization or withdrawal, and considering alternative agents like mammalian target of rapamycin (mTOR) inhibitors or antimetabolites, play pivotal roles in preserving renal function. Adjusting the immunosuppressive regimen, particularly by minimizing CNIs in the first post-transplant year, can slow kidney dysfunction progression. Identifying and addressing risk factors for renal dysfunction, optimizing perioperative care, and tailoring immunosuppressive regimens are essential steps to enhance long-term outcomes following LT.

  • Review Article

    Ann Liver Transplant 2024; 4(1): 10-15


    Abstract : Liver transplantation (LT) has significantly improved long-term survival rates, but recipients face increased risks of de novo malignancy (DNM) due to immunosuppression. DNM patterns differ worldwide, with post-transplant lymphoproliferative disorder common in Western countries, while South Korea sees more gastric and colorectal cancers. Risk factors include immunosuppressive drugs, underlying conditions, and lifestyle factors. Screening strategies should be tailored to regional DNM patterns, with regular surveillance crucial for early detection and management. Minimizing immunosuppressant usage and prompt local treatment upon DNM detection offer favorable outcomes for LT recipients.

  • Original Article

    Carbapenem-resistant gram-negative rod bacteremia in the early postoperative period following liver transplantation

    Eun-Ki Min , Deok-Gie Kim , Minyu Kang , Hwa-Hee Koh , Jae Geun Lee , Dong Jin Joo , Myoung Soo Kim

    Ann Liver Transplant 2024; 4(1): 16-22


    Abstract : Background: Carbapenem-resistant gram-negative rod bacteremia (CRGNR-B) is emerging as a formidable challenge, complicating patient management and outcomes in liver transplantation (LT). This study aimed to investigate the incidence, mortality, and risk factors associated with CRGNR-B within 90 days following LT. Methods: A retrospective nested case-control study was conducted using single centric LT data (n=1,379). CRGNR-B cases were matched 1:5 with control patients for analyzing survival and risk factors for CRGNR-B. Results: The incidence of CRGNR-B within 90 days post-LT was 6.5% (n=87). The CRGNR-B group showed significantly lower 1-year post-LT survival compared to the control group (37.9% vs. 90.0%, p

  • Original Article

    Ann Liver Transplant 2024; 4(1): 23-29


    Abstract : Background: The study aims to elucidate the relationship between cytomegalovirus (CMV) infection and graft survival, as well as to identify risk factors for CMV infection in deceased donor liver transplantation (DDLT) recipients without prophylaxis. Methods: A retrospective study was conducted on 465 DDLT recipients at Severance Hospital, South Korea, employing a nested case-control design to explore CMV infection risk factors. Results: All study population showed CMV antibody seropositivity and did not received CMV prophylaxis. CMV infection was observed in 38.6% of DDLT recipients within the first year. Patients with CMV infection showed reduced graft survival rates within 5 years after matched time points compared to those without infection (57.9% vs. 67.5%, p=0.039), which confirmed in multivariable analysis (hazard ratio 1.44, p=0.047). Risk factor analysis revealed that Child-Pugh class C, donor liver macrovesicular steatosis ≥20%, and elevated pretransplant neutrophil levels were independently associated with an increased risk of CMV infection. Conclusion: This study confirms that CMV infection post-DDLT is a significant predictor of reduced graft survival. Addressing risk factors of CMV infection through targeted interventions could potentially improve patient management and post-transplant outcomes after DDLT.

  • Original Article

    Outcomes of living donor liver transplantation using graft with multiple hepatic arteries on the graft: Propensity score-matched analysis

    Minyu Kang , Hwa-Hee Koh , Deok-Gie Kim , Seung Hyuk Yim , Mun Chae Choi , Eun-Ki Min , Jae Geun Lee , Dong Jin Joo , Myoung Soo Kim

    Ann Liver Transplant 2024; 4(1): 30-36


    Abstract : Background: This study aims to analyze the outcomes of living donor liver transplantation (LDLT) using grafts with multiple hepatic arteries (HAs), compared to those with a single HA. Methods: A retrospective analysis was conducted on 1,059 LDLT patients from July 2005 to December 2022 at Severance Hospital, South Korea. Patients were categorized into multiple-HA and single-HA groups. Propensity score matching was employed to balance baseline characteristics, with primary outcomes being graft survival and secondary outcomes including HA, biliary, and total vascular complications. Results: The study included 27 patients in the multiple-HA group and 925 in the single-HA group before matching. After propensity score matching, no significant difference in 5-year graft survival rates was observed between the groups (60.4% for multiple-HA vs. 72.8% for single-HA, p=0.172). However, the multiple-HA group exhibited a higher incidence of bile duct complications (80.0% vs. 48.3%, p=0.038). Multivariable Cox regression analysis did not find multiple HAs to be a significant predictor of graft loss but confirmed their association with increased bile duct complications. Conclusion: LDLT using grafts with multiple HAs does not adversely affect overall graft survival compared to single-HA grafts. Nevertheless, the increased risk of bile duct complications associated with multiple HAs necessitates careful surgical planning and postoperative management to mitigate this risk.

The Korean Liver Transplantation Society

Vol.4 No.1
May 2024

pISSN 2765-5121
eISSN 2765-6098

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Aims and Scope

Annals of Liver Transplantation (Ann Liver Transplant), the official publication of the Korean Liver Transplantation Society, is an international, peer-reviewed open access journal. The journal pursues its advancement through original articles, reviews, case reports, editorials, and letter to editor. The journal is concerned with clinicians and scientists in liver transplantation and also with those in other fields who are interested in liver transplantation. The aim of the journal is to make contribution to saving lives of patients undergoing liver transplantation through active communication and exchange of study information on liver transplantation and provision of education and training on the diseases. The Ann Liver Transplant serves as a platform for debate and reassessment, a trigger of innovation, and a major pedestal for promoting understanding, improving outcomes, and advancing knowledge and technique in liver transplantation.

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