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Alteration of MRP2 expression and the graft outcome after liver transplantation
Nam-Joon Yi,Joohyun Kim,YoungRok Choi,Heyoung Kim,Kyoung Bun Lee,Ja-June Jang,Jae Young Lee,Jeong Min Lee,Joon Koo Han,Kwang-Woong Lee,Kyung-Suk Suh 대한외과학회 2018 Annals of Surgical Treatment and Research(ASRT) Vol.95 No.5
Purpose: Multidrug resistance-associated protein (MRP) 2 is a glutathione conjugate in the canalicular membrane of hepatocytes. Early graft damage after liver transplantation (LT) can result in alteration of MRP2 expression. The purpose of this study was to evaluate the relationship between the pattern of MRP2 alteration and graft outcome. Methods: Forty-one paraffin-embedded liver graft tissues obtained by protocol biopsy within 2 months after LT; these were stained using monoclonal antibodies of MRP2. We selected 15 live donor biopsy samples as a control, that showed homogenous canalicular staining for MRP2. The pattern of canalicular MRP2 staining of graft was classified into 3 types: homogenous (type C0), focal (type C1), and no (type C2,) staining of the canaliculi. Results: In total, 17.1% graft tissues were type C0, 36.6% were type C1, and 46.3% were type C2. The median operation time was longer in patients with type C2 (562.6 minutes) than in patients with type C0 (393.8 minutes) (P = 0.038). The rates of posttransplant complications were higher in patients with type C2 (100%) than in patients with type C0 (42.9%) and C1 (73.3%) (P < 0.001). Conclusion: MRP2 expression pattern was altered in 82.9% after LT. The pattern of MRP2 alteration was associated with longer operation time and higher rates of post-LT complications.
When to consider liver transplantation
( Nam Joon Yi ) 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3(S)
Liver transportation has been the treatment of choice for a end stage liver disease and the early stage of hepatocellular carcinoma. Recently, there has been a gradual expansion of indications for liver transplantation due to the excellent survival rate after liver transportation. However, due to the organ shortage in Asia, including Korea, compared to the Western countries, there has been no guideline about how to preparation and when to consideration for liver transplantation for individual patients with terminal liver diseases. Herein, this article reviews the present status of liver transplantation and how to preparation of liver transplantation in Korea.
( Nam-joon Yi ),( Kwang-woong Lee ),( Kyung-suk Suh ),( Suk Kyun Hong ),( Kyung Chul Yoon ),( Dongkyu Oh ),( Berik Rovgaliyev ),( Joon Koo Han ),( Min Uk Kim ),( Jeong Min Lee ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Biliary complication (BC) is prevalent in pediatric liver transplantation (PLT), with reported rates from 12% to 50%. This study analyzed which factors of perioperative variables caused BCs and how BCs affected graft and patient survival in PLT. Methods: A retrospective analysis reviewed 237 consecutive pediatric recipients from 1988 to 2015 in a Korean high-volume living donor LT (LDLT) center. The median follow-up was 80.3 (range, 28.7-153.9) months. Results: Of these 237 patients, 23 (9.7%) patients developed BCs. The overall 1-, 5-, and 10-year patient and graft survival rates were 89.8%, 87.8%, and 86.9% and 88.2%, 86.7%, and 85.8%. The 1-, 5-, and 10-year BC-free survival rates were 91.8%, 89.8%, and 89.0%. There was no significant difference of both patient and graft survival rate between the patients with and without BCs (P >0.05). In multivariate analysis, type of liver transplant (LDLT 12.8% vs. whole LT 5.0% vs. split LT 2.4%), portal vein complication (21.7% vs. 6.5%), and hepatic vein complication (26.0% vs. 8.9%) were revealed as significant contributor to BCs (P<0.05). Conclusions: Despite of BCs, graft and patient survival rates were not significantly affected. Although the rate of BC was acceptable, LDLT was one of the risk factors of BCs in PLT, and meticulous technique to avoid vascular complication could also improve the outcome of biliary reconstruction.