Clinical Analysis of 10 Years Brain Death Donors in Single Center after Korean Network for Organ Sharing / 대한이식학회지

BACKGROUND: Brain-death donation became legal in Korea after "The law of organ transplantation" was established at 2000. Therefore, in this study, we report on the clinical analysis of brain-death donors at Ajou University Hospital since the Korean Network for Organ Sharing (KONOS) was launched in the year 2000. METHODS: We reviewed 90 brain-death donors who were managed at Ajou University Hospital from 2000 to 2009 and we retrospectively analyzed the clinical characteristics. RESULTS: The number of brain-death donors was 29 from 2000 to 2005 and 61 from 2006 to 2009, and this showed an increasing tendency. Forty-three brain-death donors (47.8%) were detected at our hospital and 47 donors (52.2%) were from referring hospitals. The percent of brain-death donors at our hospital was 31.0% from 2000 to 2005 and 55.7% from 2006 to 2009 (P=0.042). The mean age of the brain-death donors was 36.3 years (range: 8 months~70 years) and the fifth decade was the most common (25.6%). The gender ratio showed significant difference (P=0.001); there were 60 male donors (66.7%) and there were 30 females (33.3%). The most common cause of brain-death was cerebrovascular disease/stroke (48 donors, 53.3%) followed by traffic accident (15 donors, 16.7%). The most common blood type was Rh+ O (35.6%). The mean number of harvested organs was 3.9 and one donor (1.1%) had the largest number of harvested organs (9) (liver, 2 kidneys, pancreas, heart, lung, 2 corneas, tissue). The mean time to procurement was 3.6 days (range: 2~24 days). CONCLUSIONS: We recommend active discovery and evaluation of brain-death donors in all the hospitals including the hospital organ procurement organization (HOPO).

Penetrating Keratoplasty before and after Establishment of Korean Network for Organ Sharing

PURPOSE: This study was performed to evaluate the status of corneal transplantation in Korea over the last 6 years. METHODS: We evaluated the current status of domestic corneal transplantation using the data obtained from Korean Network for Organ Sharing (KONOS). We evaluated imported corneal transplantation by the number of corneal transplantations, the country of origin of imported cornea, the preserved state of corneas, the time from the death to transplantation and the result of corneal transplantation. The imported corneal transplantation data was obtained from the institution registered in KONOS and the institution recognized by the authers. RESULTS: The number of domestic cornea donations has not increased since 2000, but the number of transplantations using imported corneas has increased year by year. The quality of imported corneas was good. There was no difference in operation results when domestic corneas were used compared to the use of imported corneas from the USA, Australia or Sri Lanka. CONCLUSIONS: The increased use of imported corneas results of a deficiency in the number of domestic cornea donations. Social motivation should be used to increase domestic donations of corneas.

Penetrating Keratoplasty before and after Establishment of Korean Network for Organ Sharing

PURPOSE: This study was performed to evaluate the status of corneal transplantation in Korea over the last 6 years. METHODS: We evaluated the current status of domestic corneal transplantation using the data obtained from Korean Network for Organ Sharing (KONOS). We evaluated imported corneal transplantation by the number of corneal transplantations, the country of origin of imported cornea, the preserved state of corneas, the time from the death to transplantation and the result of corneal transplantation. The imported corneal transplantation data was obtained from the institution registered in KONOS and the institution recognized by the authers. RESULTS: The number of domestic cornea donations has not increased since 2000, but the number of transplantations using imported corneas has increased year by year. The quality of imported corneas was good. There was no difference in operation results when domestic corneas were used compared to the use of imported corneas from the USA, Australia or Sri Lanka. CONCLUSIONS: The increased use of imported corneas results of a deficiency in the number of domestic cornea donations. Social motivation should be used to increase domestic donations of corneas.

Cadaveric Renal Transplantation, before and after KONOS System (Single Center Report) / 대한이식학회지

INTRODUCTION: Comparing with living donor renal transplantation, cadaveric renal transplantation is usually performed as an emergency procedure and has prolonged preservation time and increased incidence of delayed graft function. Korean Network for Organ Sharing (KONOS) was launched from February 2000 to manage the organ transplantation in Korea and expected to increase donor organs supply and an effective organ allocation. PURPOSE: In order to compare the result of cadaveric renal transplantation before and after KONOS system, 108 cadaveric renal transplants performed in Dongsan hospital until October 2003 were reviewed and analyzed. METHODS: Donors and recipients were divided into two groups (group 1; transplantation performed before KONOS, group 2; transplantation after KONOS) and their characteristics and results were analyzed retrospectively. RESULTS: Among donor factors, number of multi-organ procurement increased (23.1% vs 78.6%), and use of inotrophic agent decreased (63% vs 46%) significantly after KONOS, however cold preservation time was not changed even after KONOS system. Procured organs per one donor in our hospital was increased from 2.25 to 2.65. Increased recipient age (from 30.1 to 41.9 years old), more chance to diabetic patient and decreasing number of HLA mismatching (4.6 to 3.9) were considered as a result of KONOS allocation system. However, early results including incidence of acute rejection episode and delayed graft function, and serum creatinine level at the end of one year were no statistic differences. The number of early graft loss were decreased up to 2 years after transplantation. CONCLUSION: Renal transplantation from cadaveric donor after KONOS resulted in lower early graft loss but increased waiting time due to organ shortage is a serious problem to be solved in the future.

Development of Organ Transplantation Information System Associated with Hospital Order Communicating System (OCS) and Korean Networking for Organ Sharing (KONOS) / 대한이식학회지

A well designed transplant software program with its database is a valuable tool in the management of transplant patients and transplant associated works. PURPOSE: The purpose of this study is to make the organ transplantation information system associated with Hospital Order Communicating System (OCS) and Korean Networking for Organ Sharing (KONOS) METHODS: We used the Hospital Order Communicating System in Asan Medical Center as a data capture source. Web EDI system was going to be used to connect the Korean Networking for Organ Sharing. RESULTS: Electronic link to Order Communicating System in our hospital can eliminate the necessity of double entry of data and eliminates the manual entry errors while increasing the efficacy of service. Multicentric accessibility to this new software system makes the data entry be easy. This program can capture the necessary data including text, numeric, scanned data at all stages of treatments, from the pretransplant to posttransplant follow-up using data transmission with Order Communicating System. The built-in tools for data analysis and other services can assist the coordinators in performing their daily tasks. Complying with timely reporting demanded by KONOS overburdened the transplant center staff and coordinators. We are already prepared to connect to KONOS reporting system using EDI system, and we are waiting for response of KONOS. CONCLUSION: Even though it was not simple to make the well designed transplant software because it involves several concerns, we were able to make the organ transplant information system linked to OCS successfully. We hope this system can be connected to KONOS in the near future.