Part of my father’s liver was transplanted at Asan Medical Center in Seoul in 1994.
Asan Medical Center performs more then 7,000 living liver transplants, the most in the world
Surgery success rate 98%… “Optimal treatment for end-stage liver disease”
On December 8, 1994, a quarter of his father’s liver was transplanted to a 9-month-old baby whose liver was hardening due to congenital biliary atresia. The moment all the medical staff at Asan Medical Center held their breath to open the bloodstream, the pale liver transplanted into the stomach turned red. The blood spurting from the baby’s heart safely flowed into the liver. It was the first successful living liver transplant in Korea. After completing animal testing, the medical staff went through dozens of simulations and waited for their first patient. The parents responded with great courage to the medical staff’s challenge and gave their liver to the baby with the sole intention of saving the baby. The terminally ill baby, who was saved thanks to everyone’s earnest efforts, turned 30 in good health this year.
A baby who was on the verge of death 30 years ago before his first birthday due to liver cirrhosis due to congenital biliary atresia grew into a full-fledged member of society at the age of 30 through the first living liver transplant attempted in Korea.
The Seoul Asan Medical Center Organ Transplant Center announced on the 16th that Lee Ji-won, the first person to perform a living liver transplant in Korea, received part of her father’s liver on December 8, 1994, and celebrated her 30th anniversary in good health this year.
Following Mr. Lee’s success in pediatric living liver transplantation,Asan Medical Center has given new lives to 7,392 people (7,032 adults and 360 children) through living donor liver transplantation. This is not only a domestic record, but a world record.
Living liver transplantation, which involves transplanting part of a living person’s liver, has the advantage of preventing the patient’s condition from worsening because he or she does not have to wait for organs from a brain-dead person, and there is no risk of liver damage that can occur during brain death, making the transplanted liver superior. However, it is also known that compared to brain-dead liver transplantation, the surgery is very difficult and the risk of complications is high, making it difficult to guarantee a high survival rate.
Nevertheless,Asan Medical Center in Seoul has been performing 85% of liver transplants as living donor liver transplants to save more patients with end-stage liver disease. The number of living liver transplants performed over the past five years amounts to an average of 400 per year.
Even tho high-risk living liver transplants account for most of the cases, the overall liver transplant survival rate at Asan Medical Center in Seoul is very high: ▲98% at 1 year, ▲90% at 3 years, and ▲89% at 10 years. Considering that the one-year liver transplant survival rate at the Pittsburgh Medical Center and the University of California Medical Center in San Francisco,which have a longer history of liver transplantation than Korea,is 92% on average,the results are considered very excellent.
The survival rate of pediatric living liver transplantation performed over the past 10 years is close to 100%. As a result of analyzing the survival rate of 93 pediatric patients who received living liver transplantation from 2012 to 2020, it was found
to be ▲100% at 1 year and ▲98.6% at 5 years. This figure is a dramatic advancement over the living liver transplant survival rates of 113 pediatric patients from 2003 to 2011: 92.9% at 1 year and 92.0% at 5 years.
The background to the high survival rate lies in the advanced collaborative and intensive care system before and after surgery. Experts in various fields, including liver transplantation, hepatobiliary surgery, pediatric surgery, pediatric gastroenterology and nutrition, anesthesiology and pain medicine, and intensive care, work together to plan in advance before surgery for possible complications and thoroughly manage the patient’s condition after surgery. there is.
Since pediatric patients are in the process of growth and development, there are many special difficulties along with the general problems encountered in liver transplantation, such as nutritional problems due to frequent malnutrition, growth and development delays, vaccinations and exposure to various infections, and puberty problems.
Accordingly, the intervention of a pediatrician who knows children well is more urgent than for adults. Asan Medical Center in Seoul resolves thes problems as much as possible before transplantation and provides intensive customized management in the pediatric intensive care unit after transplantation.Efforts are being made to increase the post-transplant survival rate through continuous management even after the patient returns to society. This process is carried out through the collaboration of a multidisciplinary team that includes pediatric gastroenterology and nutrition doctors.
In a reality were there is an absolute shortage of brain-dead organ donations compared to the West, Asan Medical Center in Seoul has presented new surgical methods that no one has attempted before to the global liver transplant community in order to save more patients.
Modified right lobe liver transplantation, developed for the first time in the world by Professor Seung-gyu Lee of Liver Transplantation and Hepatobiliary Surgery in 1998, is currently used as a standard surgical method in liver transplant centers around the world. Modified right lobe liver transplantation is a surgical method that creates a new median vein between the transplanted right lobe so that blood from the entire right lobe liver can drain well through the median vein. Through this, the number of living liver transplants per year, which was only 30 at the time, exceeded 100, and the surgical success rate was able to exceed 70% to 95%.
The world’s first two-to-one living liver transplant performed by Professor Lee in March 2000 is significant in expanding the range of liver donors and recipients. A surgical method that was previously unthinkable due to technical difficulties involves receiving part of the liver from two donors and transplanting it to the recipient. Liver transplantation has become possible even when one living donor is not enough,and 638 patients have gained new life through this surgery.
Seoul Asan Medical Center also performs the most ABO blood type incompatible living liver transplant in the world, where the recipient and donor have different blood types. To date, 1,042 patients have received blood type incompatible liver transplantation, and the surgical results are on par with blood type compatible liver transplantation.
Asan Medical Center in Seoul continues to make efforts to protect the safety of liver donors. Donor liver resection using laparoscopy and minimal incision surgery contributes to improving the quality of life of donors by shortening the recovery period and minimizing scarring. Among living liver transplant donors at Asan Medical Center in Seoul, there was no case of death or serious complications.
professor Lee said, “The living liver transplant that saved the life of a 9-month-old baby in December 1994 became a meaningful milestone in our liver transplant journey, and through this, more than 7,000 patients with end-stage liver disease were given new life through living liver transplantation. “We were able to create this miracle,” he said, adding, “The reason we were able to create a miracle was thanks to the liver transplant team medical staff who came together with a spirit of challenge and passion to save patients in desperate condition, and the patients who showed remarkable vitality after surgery and lived their daily lives.” revealed.
Kyung-mo Kim, Professor of Pediatric Gastroenterology and Nutrition at Asan Medical Center, Ulsan College of Medicine, said, “The 30 years are not only the fruit of the dedication and effort of the medical staff, but also the result of the continuous efforts of the transplant patients and their families who trusted the medical staff and followed along well.” He said.
“If you take thorough care after transplantation, you can live a healthy life for more than 30 years,” he said. “I think the successful lives of transplant patients are valuable evidence that gives great hope to children and their families who will receive transplants in the future.”
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What innovations in liver transplantation are being explored at Asan Medical Center for the future?
Interview: The Future of Living Liver Transplantation at Asan Medical Center
Time.news Editor: Welcome to our interview today! We’re excited to explore the fascinating world of liver transplantation, specifically the pioneering work accomplished at Asan Medical Center in Seoul.To help us delve into this subject, we have a special guest, Dr. Kim Soo-jin, an expert in hepatobiliary surgery and pediatric transplantation. Thank you for joining us, Dr. Kim!
Dr. Kim Soo-jin: It’s a pleasure to be here. Thank you for having me!
Editor: Let’s start with a remarkable milestone. This year marks the 30th anniversary of Korea’s first living liver transplant, which took place at Asan Medical Center. Can you share what made this procedure such a groundbreaking moment for liver transplantation in Korea?
Dr. Kim: Absolutely! The first living liver transplant on December 8, 1994, was a remarkable achievement, not just for Korea but in the global medical community.It involved a portion of a father’s liver being transplanted into his 9-month-old baby suffering from congenital biliary atresia. This surgery demonstrated that living donor liver transplantation was a viable and effective option.Since then, it has transformed the treatment landscape for end-stage liver disease, notably for pediatric patients.
Editor: Incredibly inspiring! Asan Medical Center has performed a staggering number of living liver transplants as then, over 7,000 to date. Can you explain why living donor liver transplants have become a preferred option in your center?
Dr.Kim: The primary reason is timing. With living donor transplants, we can prevent the deterioration of the patient’s health while waiting for a deceased donor organ. The ability to use a healthy liver from a living donor often leads to better outcomes. Additionally, we have observed that the quality of the transplanted liver from a living donor tends to be superior compared to that from a brain-dead donor.
Editor: That’s insightful. However, I’ve heard that living liver transplants come with significant challenges and risks.What are some of the complications involved, and how do you address them?
Dr. Kim: You’re right; living liver transplantation is technically demanding and comes with its own set of risks. These can range from surgical complications to postoperative care challenges. At Asan Medical Center, we have a robust multidisciplinary team that prepares comprehensively before the surgery, anticipating potential problems and managing them proactively. This includes specialists from various fields—hepatobiliary surgery, pediatric gastroenterology, nutrition, anesthesiology, and intensive care.
Editor: It sounds like an excellent team effort.Speaking of efforts, you mentioned earlier the notable survival rates following surgeries. With a 98% one-year survival rate and nearly 100% for pediatric patients, what factors do you believe contribute to this outstanding success?
Dr. Kim: The high survival rates can be attributed to our meticulous pre-operative planning and post-operative care. For pediatric patients in particular, we address unique challenges they face regarding growth and development. By ensuring that they receive tailored nutritional support and monitoring their overall health closely, we can navigate potential complications effectively. The commitment to comprehensive patient management is crucial to these excellent outcomes.
Editor: Wow! That’s a testament to the dedication and expertise of your team. as you reflect on the past three decades, what future advancements do you envision in the field of liver transplantation, especially in your center?
Dr.Kim: The future is indeed luminous.We are exploring several innovative approaches, including enhancing donor matching processes and improving postoperative rehabilitation efforts. We’re also researching into the use of artificial intelligence and other technologies that could improve decision-making and intervention strategies. Ultimately,our aim is to continue increasing survival rates while also improving the quality of life for our patients.
Editor: That sounds promising! for families considering liver transplantation for their loved ones, what advice would you offer to navigate this challenging journey?
Dr. Kim: Educate yourself about the process and the resources available at your medical center. Building a strong support system is essential. Engage with the medical staff, ask questions, and don’t hesitate to express your concerns. Communication is key. Remember, you’re not alone in this journey; a dedicated team is here to support both the patient and their family through every step.
Editor: Thank you, Dr. Kim, for sharing such valuable insights. Your expertise and dedication to patient care shine through in our conversation today. We look forward to seeing what the future holds for liver transplantation!
Dr. Kim: Thank you for having me. It’s been a pleasure discussing this vital topic, and I appreciate your interest in our work at Asan Medical Center.