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Gil-Chun Park,Shin Hwang,Dong-Hwan Jung,Gi-Won Song,Chul-Soo Ahn,Ki-Hun Kim,Deok-Bog Moon,Tae-Yong Ha,Young-In Yoon,Hui-Dong Cho,Jae-Hyun Kwon,Yong-Kyu Chung,Sang-Hyun Kang,I-Ji Jung,Jin Uk Choi,Sung- 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.98 No.2
Purpose: Hepatorenal syndrome (HRS) is a fatal complication in patients with end-stage liver disease awaiting liver transplantation (LT). HRS often develops in patients with high model for end-stage liver disease (MELD) score. This study investigated the outcomes of peritransplant management of HRS in a high-volume LT center in Korea for 2 years. Methods: A total of 157 recipients that deceased donor liver transplantation (DDLT) from January 2017 to December 2018 were included. In-hospital mortality (IHM) was analyzed in relation to pre- and posttransplant application of renal replacement therapy (RRT). Results: Primary diagnoses for DDLT were alcoholic liver disease (n = 61), HBV-associated liver cirrhosis (n = 48), retransplantation for chronic graft failure (n = 24), and others (n = 24). Mean MELD score was 34.6 ± 6.2 with 72 patients at Korean Network for Organ Sharing MELD status 2 (45.9%), 43 at status 3 (27.4%), 36 at status 4 (22.9%), and 6 at status 5 (3.8%). Pretransplant RRT was performed in 16 patients (10.2%) that did not show IHM. Posttransplant RRT was performed in 69 patients (44.0%), for whom IHM incidence was 15.9%. In 53 patients that had undergone de novo posttransplant RRT, IHM incidence increased to 20.8%. IHM in the 88 patients not requiring RRT was 2.3%. Conclusion: The majority of adult DDLT recipients in Korean MELD score-based allocation system have very high MELD scores, which is often associated with HRS. Pretransplant RRT appears to improve posttransplant survival outcomes. We thereby recommend that, if indicated, pretransplant RRT be performed while awaiting DDLT.
Sang-Hyun Kang,Shin Hwang,Tae Yong Ha,Gi Won Song,Dong-Hwan Jung,Chul-Soo Ahn,Deok-Bog Moon,Ki-Hun Kim,Gil-Chun Park,Young-In Yoon,Yo Han Park,Hui-Dong Cho,권재현,Yong-Kyu Chung,Jin-Uk Choi,Sung Gyu Lee 대한이식학회 2019 Korean Journal of Transplantation Vol.33 No.4
Background: The mammalian target of the rapamycin inhibitor has dual inhibitory effects on cell growth and angiogenesis. This study aimed to analyze the usage of everolimus on actual immunosuppression (IS) regimens through a cross-sectional study in a high-volume liver transplantation (LT) center. Methods: Our institutional LT database was searched for adult patients who underwent primary LT surgery between January 2010 and December 2016. We identified 2,093 LT recipients with observation periods of 1 to 8 years. Results: We divided the 2,093 recipients into three groups according to the posttransplant follow-up period as follows: group A (12–36 months; n=680), group B (37–60 months; n=560), and group C (>60 months; n=853). The individual IS agents were tacrolimus in 1,807 patients (86.3%), cyclosporine in 169 patients (8.1%), mycophenolate mofetil (MMF) in 1,310 patients (62.6%), and everolimus in 115 patients (5.5%). The most common IS regimens were tacrolimus-MMF combination and tacrolimus monotherapy, regardless of the posttransplant period. Patients with pretransplant malignancies were administered everolimus more frequently than those without pretransplant malignancies (P<0.001). In 102 patients with hepatocellular carcinoma recurrence or de novo malignancies, IS regimens included everolimus-tacrolimus in 41 patients (40.2%), tacrolimus-MMF in 27 patients (26.4%), tacrolimus in 20 patients (19.6%), MMF in 10 patients (9.8%), cyclosporine in three patients (2.9%), and cyclosporine-MMF in one patient (1.0%). Conclusions: Administration of everolimus after LT has been gradually increasing with the expansion of indications in our institutional practice. Currently, the role of everolimus is minimal and not comparable to that of tacrolimus, but it has a unique position in the field of IS after LT.
Sung Il Kim,Won Jin Kang,Yeseul Choi,Hyunah Kim,Bueyong Park,Hyun Kyung Kim,Hyun-Ha Koo,Gil-Hah Kim 한국응용곤충학회 2018 한국응용곤충학회 학술대회논문집 Vol.2018 No.04
The two-spotted spider mite, Tetranychus urticae Koch (Acari: Tetranychidae), is one of the most important pest species devastating many horticultural and ornamental crops and fruit trees. In the present study, a field strain was collected in January 2001 and has been selected for sixteen years with acequinocyl. The resistance ratio calculated from the LC50 of eggs and adults was 191- and 4,237-fold, respectively. The laboratory-selected acequinocyl resistance (LSAR16) strain was screened with 11 acaricides for cross-resistance. The detoxifying enzyme activities and quantitative real-time PCR analysis were performed in the LSAR16 strain. Crossing experiments revealed that LSAR16 strain was inherited maternally, incompletely dominant and monogenic. Most importantly, we identified two new point-mutations at mitochondrial cytb from acequinocyl resistant T. urticae.