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Backgrounds/Aims This study intended to evaluate patient safety and efficiency of facility utilization following simplified ultra-rapid intravenous infusion of hepatitis B immunoglobulin (HBIG) in recipients of hepatitis B virus-associated adult liver transplantation (LT), who visited our outpatient clinic. Methods Our simplified ultra-rapid infusion protocol was to directly infuse 50 ml volume of 10,000 IU HBIG for 20-25 minutes on an ambulatory basis. The incidence of adverse side-effects and the efficiency of facility utilization were assessed retrospectively. Results A total of 1,513 patients received 12,472 sessions of HBIG infusion according to simplified ultra-rapid infusion method. Of these, 1,172 patients were converted from conventional ultra-rapid infusion method, and received 8,352 sessions of HBIG infusion for 18 months (mean 7.1 times; 4.8 times per year). The remaining 341 de novo patients received 4,120 sessions of HBIG infusion for 18 months (mean 12.1 times; 8.1 times per year). None of these patients experienced any adverse side-effects following the simplified ultra-rapid infusion. The maximal capacity of HBIG infusion sessions at the injection facility of our outpatient clinic was increased from 65-70 sessions to 80 sessions, after introduction of simplified ultra-rapid infusion method. Mean trough anti-HBs titer was lower, and mean interval of HBIG infusion was longer in the combination therapy group compared with HBIG monotherapy group. Conclusions Our high-volume study indicates that in nearly all LT recipients, rapid infusion of highly purified HBIG within 30 minutes was well-tolerated. This suggests that it would be reasonable to perform simplified ultra-rapid infusion protocol widely for patient convenience.

Background: Simultaneous liver and kidney transplantation (SLKT) has been established as the treatment of choice for patients with concurrent end-stage liver and end-stage kidney diseases. The objective of this study was to analyze the nationwide inci dence of SLKT in Korea and the outcomes of SLKT in a high-volume transplant center. Methods: Databases of the Korean Network for Organ Sharing (KONOS) and Asan Medical Center from 2000 to 2019 were retro spectively reviewed to determine the incidence of SLKT. Results: During 20 years from 2000 to 2019, deceased donor SLKT was performed for 38 cases in the KONOS database. The proportion of deceased donor SLKT was 0.6% (20 of 3,333) before adoption of model for end-stage liver disease (MELD) score, which was significantly increased to 1.2% (18 of 1,524) after the adoption of MELD score (P=0.034). In our institution, there were 11 cases of SLKT (two cases with deceased donors and nine cases with living donors). SLKT accounted for 0.2% (11 of 6,468) of total liver transplantation volume. During follow-up, five patients died due to hepatocellular carcinoma recurrence (n=2), infection (n=2), or unknown cause (n=1). The 1-year and 10-year overall patient survival rates were 90.9% and 81.8%, respectively. Conclusions: Results of this study revealed that the incidence of deceased donor SLKT was very low. An increase of such inci dence is not anticipated unless the number of deceased donors is markedly increased. Currently, sequential living donor liver transplantation and kidney transplantation with deceased or living donors are mainstays of transplantation rather than SLKT in our institution.

Background: The waitlist period for kidney transplantation (KT) has been increasing due to intractable shortage of brain-dead donors in Korea. To solve this organ shortage issue, KT cases with expanded criteria brain-dead donor (ECD) organs have been increasing. This study intended to analyze the willingness of waitlist patients to undergo KT with ECD in a single institution in or der to use as the basic data for selecting and managing patients waiting for deceased donor KT (DDKT). Methods: We carried out a survey with 1,069 patients who were enrolled at the waitlist for DDKT from 2015 to 2019 at a single in stitution. They were asked whether they were willing to undergo KT with ECD of type 1 and 2. The answers were analyzed through descriptive statistics. ECD type 1: age over 60 years, but serum creatinine is normal (

Background The obstetrician's role in vitalizing cord blood (CB) banking is important in both informing donors and beginning CB processing. The aim of the study was to investigate obstetricians' understanding of CB and their roles in informing donors and collection management. Study Design and Methods Questionnaires examining the management and awareness of CB were distributed to collection centers, and we analyzed 57 respondents who had collection experience. Results All respondents were experienced, and 82.5% had CB collection experience of at least 4 years. If patients asked for information, one-third provided information about CB themselves, and two-thirds provided CB banks' (CBBs') contact information. Less than half of the respondents knew the legal regulations and had a collection manual. Regarding the awareness of transportation and storage of CB, 58% rated their knowledge as minimal, and respondents who knew the legal regulations rated their knowledge at a higher level. One-fifth of the participants felt that CB collection distracted the labor process, and 16% were concerned about delayed bleeding control. The probability of autologous CB transplantation was overestimated, and the matching probability in public CBBs was underestimated. Approximately 82.7% of the respondents correctly rated the therapeutic use of CB, and 54% rated their knowledge level about CB usefulness as average. Conclusion Obstetricians' understanding of CB was lower than expected, considering that they are associated with CB collection centers. Obstetricians who provide information and recognize regulations seem to collect CB in compliance with the regulations better. These results will be helpful in CB collection management and education planning for obstetricians.

In Korea, living donor transplantation is increasing steadily as a life-saving alternative. It is essential to provide living donors the mental and physical care they need throughout their lives including postoperative period. Therefore, this study explored postoperative pain among living liver donors.We used a convenience sampling at a university-affiliated hospital from March 1 to August 30, 2009 including 102 subjects. Face-to-face interviews with questionnaires and medical records were used to assess postoperative pain levels, state and trait anxiety as well as satisfaction. Data were analyzed using SPSS 14.0 (SPSS Inc., Chicago, Ill, USA).Average age of donors was 28.9±7.7 years (ranged 16 to 53) with 70.6% male. Most donors (80.4%, n=82) were immediate family members. Ninety-one (89.2%) participants made the decision by themselves. To control postoperative pain, all participants had patient-controlled anesthesia with several types of analgesics as prescribed by physician's preference. The mean values of state anxiety, trait anxiety, and satisfaction in this study were 2.1±1.89, 36.7±7.25 and, 8.9±1.79, respectively. Multivariate analysis showed that trait anxiety and number of analgesics use were significantly associated with postoperative pain. Overall, approximately 29.7% of total variability in postoperative pain could be explained by the nine variables in this model (R2=0.297, F9,102=4.28, (P.001). There was no multicollinearity checked by tolerance, variation inflation factor, or condition index.This study of postoperative pain among living liver donors may contribute to developing the safest, most effective strategy to relieve postoperative pain after living liver donation.

Purpose: Liver transplantation (LT) is the best treatment for patients with end-stage liver disease and most patients with LT return to their normal life. However, pregnancy and childbirth for women with LT are less common, mainly because it is considered to be dangerous for their health. The purpose of this study was to describe how Korean women after LT experience their pregnancy and childbirth. Methods: This study was designed to explore the expe- riences of pregnancy and childbirth of women with LT. Data were collected by individual in-depth interviews with four women who were pregnant and gave birth following LT in 2009. All interviews were audio-taped and tran- scribed verbatim. The transcribed data were analyzed using qualitative content analysis. Results: Four themes emerged as a result of analysis: recovery of lost feminity and marriage; fulfilling roles through pregnancy; life-risk- ing pregnancy; and perfect family achieved by childbirth. These themes describe in detail about challenges and concerns the women with LT faced for their pregnancy and childbirth as well as many emotionally touching experiences. Conclusion: The results of this study would support health professionals to be better prepared to help women with LT for pregnancy and childbirth by providing in-depth and insightful information.