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Challenges for Liver Transplantation in Developing Country (Mongolia)
( Batsaikhan Bat-erdene ),( Sergelen Orgoi ),( Erdene Sandag ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Liver transplantation (LT) is a main treatment of end-stage liver disease. Specially developing country like Mongolia has high prevalence of HBV, and hepatocellular cancer. The inception and setting up of LT project in the developing country is associated with some difficulties, which includes financial costs of liver transplantation, lifelong follow-up, treatment and insurance problems of patient. Fortunately, Mongolia had found a huge chance to develop the big project, that started since 2011. Methods: Totally 31 patients had transplanted liver from living donor, and 1 patient from deceased donor. The cooperation of LT project between Mongolian First Central Hospital and ASAN Medical Center, nowadays project is going successfully. Results: There 27 cases of LT had done by mixed team, and 4 cases had done by Mongolian team separately. There 30 cases were living donor liver transplantation, only 1 case was deceased donor liver transplantation. There were not donor’s mortality in 31 cases. In our 31 cases 2 recipients deaths, one of them CMV, which could not diagnosed in Mongolia. We faced with some complications, which includes acute rejection, infection and IVC stenosis. Conclusions: Developing country like Mongolia faced with a lot difficulties to locate the expensive and difficult operation like LDLT. To do everything is a possible, the main thing is find the right way and good people for encourage the big project.
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Batsaikhan Bat-Erdene,Sergelen Orgoi,Erdene Sandag,Ulzii-Orshikh Namkhai,Bat-Ireedui Badarch,Batsaikhan Batsuuri 한국간담췌외과학회 2016 한국간담췌외과학회지 Vol.20 No.3
The sinusoidal obstructive syndrome (SOS) is a complication that usually follows hematopoietic stem cell transplantation. It is also known as veno-occlusive disease, which is a rare complication of living donor liver transplantation (LDLT). Herein, we reported a 34 year-old female patient presenting SOS after LDLT. Its underlying cause was presumed to be associated with liver abscess and subsequent inferior vena cava stenosis. SOS led to graft failure, thus requiring retransplantation with a deceased donor liver graft. The underlying causes of SOS are complex pathologic entity with multifactorial etiology. It is likely that its multifactorial etiology includes a decrease of hepatic venous outflow that is caused by graft liver infection and inferior vena cava stenosis.
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