Effect of Caring for Potential Brain Death Organ Donors during the Organ Donation Process upon Physician Attitudes / 대한이식학회지

BACKGROUND: The purpose of this study was to identify the attitude of physicians stemming from their experiences of caring for potential brain death donors during the organ donation process. METHODS: Grounded theory methodology was used for this study. In depth interviews were conducted with six physicians who had experience of management of potential brain death donors. Data collection was done from January to October 2011. Theoretical sampling was used until the data reached saturation. RESULTS: As a result of the analysis, dilemma of organ donation solicitation was identified as the core category. Twelve subcategories were identified and they were integrated to the core category. Obtaining organ donation counseling skills was identified as the consequence. CONCLUSIONS: The results of the study will provide a frame for understanding the attitudes stemming from their experience of caring for potential brain death donor and helping the development of effective intervention strategies for increasing organ donation.

Severity of End-stage Liver Disease in Liver Transplant Candidate; Comparison of KONOS Status with MELD Score / 대한이식학회지

BACKGROUND: We have allocated liver according to the Korean Network Organ Sharing (KONOS) status. However, it was necessary to change the system to a more adequate and objective system. We analyzed the correlation between KONOS status and MELD score under the current status of organ allocation. METHODS: We reviewed medical records of 70 liver recipients as KONOS status 2A and 2B between September 2005 and December 2010. We analyzed their KONOS status, MELD score, clinical characteristics, waiting time, Child-Turcotte-Pugh (CTP) score and clinical symptoms accorded to KONOS status 2A. RESULTS: Mean MELD and CTP score of the 2A group was significantly higher than the 2B group (P<0.001). In the 2B group, the blood types of all recipients were identical to those of the donors. However, 2A group included 7 cases (23.3%) of non-identical blood types. The MELD score of all recipients were correlated with CTP score (R=0.798, P<0.001). However, there was an overlapping area between the 2B group and the 2A group that was registered by the condition of intractable ascites. Those who had hepatorenal syndrome and hepatic encephalopathy showed high MELD score over 20. However, 36.4% of the patients who had only intractable ascites showed a MELD score of less than 20. CONCLUSIONS: CTP score was highly correlated with MELD score. However, KONOS status showed some overlapping area of the MELD score between 2A and 2B groups. We should make an effort to improve KONOS allocation system to meet the Korean situation.