Publications by authors named "DeokBog Moon"
Article Synopsis
- This study compares adult living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) outcomes in patients with acute liver failure over a 14-year period.
- The findings show no significant differences in in-hospital mortality, long-term survival, or graft survival rates between the two methods, although LDLT patients had shorter intensive care unit stays.
- The research concludes that LDLT is a viable alternative for patients awaiting liver transplants, particularly when deceased donor organs are not accessible.
We evaluated the liver transplantation (LT) criteria in acute-on-chronic liver failure (ACLF), incorporating an urgent living-donor LT (LDLT) program. Critically ill patients with a Chronic Liver Failure Consortium (CLIF-C) ACLF score (CLIF-C_ACLF_score) ≥65, previously considered unsuitable for LT, were included to explore the excess mortality threshold of the CLIF-C_ACLF_score (CLIF-C_ACLF_score_threshold). We followed 854 consecutive patients with ACLF (276 ACLF grade 2 and 215 ACLF grade 3) over 10 years among 4432 LT recipients between 2008 and 2019.
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- This study evaluated the influence of ABO blood types on the recurrence of hepatocellular carcinoma (HCC) in patients who underwent living donor liver transplantation (LDLT).
- Researchers analyzed 856 patients from 2006 to 2016 and found that the ABO blood group did not significantly affect disease-free survival (DFS) or overall survival (OS) after LDLT.
- Key factors impacting survival were identified as tumor size and microvascular invasion, while the study concluded that ABO blood type is not a predictive factor for the outcomes in these patients.
Article Synopsis
- Living donor liver transplantation (LDLT) has become a preferred option over deceased donor transplantation, especially in countries like South Korea with low organ donation rates.
- The Asan Medical Center (AMC) has conducted over 6000 LDLT procedures, developing advanced surgical techniques and achieving high patient survival rates.
- This large study reveals that tailored surgical approaches and multidisciplinary care significantly enhance the long-term success and safety of LDLT for both adults and children.
Backgrounds/aims: This study aimed to compare the outcomes of liver resection (LR) and transarterial chemoembolization (TACE) in patients with multinodular hepatocellular carcinoma (HCC) within the Milan criteria who were not eligible for liver transplantation.
Methods: We retrospectively analyzed 483 patients with multinodular HCC within the Milan criteria, who underwent either LR or TACE as an initial therapy between 2013 and 2022. The overall survival (OS) in the entire population and recurrence-free survival (RFS) in patients who underwent LR and TACE and achieved a complete response were analyzed.
Article Synopsis
- A study in South Korea examined the safety and effectiveness of liver transplants from living donors who lost at least 10% of their body weight to reduce liver fat (steatosis) before donating their right lobe.
- Out of 1,040 donors, 150 were in the weight loss group and showed significant improvements in body weight and BMI, with similar postoperative outcomes and complication rates compared to a control group.
- The findings suggest that weight loss can effectively enhance liver health in donors, leading to comparable surgical success in both recipients of improved grafts and standard grafts.
Article Synopsis
- - This study assessed the impact of low graft-to-recipient weight ratio (GRWR) on the recurrence of hepatocellular carcinoma (HCC) after living donor liver transplantation (LDLT), involving 856 patients at Asan Medical Center from 2006 to 2016.
- - Results showed no significant differences in disease-free survival (DFS) or overall survival (OS) rates across different GRWR categories, indicating that GRWR does not appear to affect outcomes for HCC patients post-transplant.
- - The findings suggest that a GRWR of less than 0.8% does not have a significant prognostic effect on oncological results, highlighting the need for further research through high-volume multi-center studies for validation.
Regorafenib has anti-tumor activity in patients with unresectable hepatocellular carcinoma (uHCC) with potential immunomodulatory effects, suggesting that its combination with immune checkpoint inhibitor may have clinically meaningful benefits in patients with uHCC. The multicenter, single-arm, phase 2 RENOBATE trial tested regorafenib-nivolumab as front-line treatment for uHCC. Forty-two patients received nivolumab 480 mg every 4 weeks and regorafenib 80 mg daily (3-weeks-on/1-week-off schedule).
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- Liver transplant recipients are at a heightened risk for tuberculosis (TB), which can lead to increased mortality.
- A study screened 857 liver transplant candidates for latent tuberculosis infection (LTBI), identifying 199 (23.2%) positive cases, with 171 initiating treatment.
- Those treated for LTBI had no cases of active TB during follow-up, while untreated individuals had a 3.6% TB development rate, highlighting the effectiveness and safety of LTBI treatment in liver transplant patients.
Article Synopsis
- The COVID-19 pandemic significantly affected global liver transplantation (LT) and living donor programs, prompting the study to examine how these programs adapted and succeeded during this period.
- The research focused on 1201 living donor liver transplants performed at Asan Medical Center between 2020 and 2022, highlighting key patient demographics and medical outcomes.
- Despite higher than usual in-hospital mortality at 2.2%, and various challenges, the program maintained high standards of care and successful outcomes thanks to established infection control protocols and tailored surgical strategies.
Article Synopsis
- Hepatic artery thrombosis (HAT) occurs in 2.5%-8% of living-donor liver transplant patients, leading to potential graft loss, and the study focuses on understanding risk factors and reconstruction techniques for grafts with multiple hepatic arteries.
- The research analyzed 1601 patients who received right lobe grafts, finding that pretransplant hepatectomy, female donor, smaller graft-to-recipient weight ratio, and extra-anatomical reconstruction increased HAT risk, while having two hepatic arteries did not.
- Survival rates were similar between patients with one and two hepatic arteries, suggesting that reconstructing both arteries when possible might be a beneficial approach in transplant surgeries.
Article Synopsis
- - The study investigated the impact of donor sex and donor-recipient sex disparity on recurrent hepatocellular carcinoma (HCC) after living donor liver transplantation (LDLT) using 772 patients from a high-volume center.
- - Researchers categorized patients by donor-recipient sex pairs and found no significant differences in disease-free survival (DFS) and overall survival (OS) among the groups.
- - The conclusion indicated that neither donor sex nor the disparity between donor and recipient sex had a significant effect on HCC recurrence post-transplantation.
Article Synopsis
- The study evaluates the safety and effectiveness of mini-incision techniques for living donor liver transplants compared to traditional open surgery.
- It involved 448 donors, dividing them into two groups based on incision type: mini-incision (187 donors) and conventional (261 donors).
- Results suggest mini-incision has similar complication rates and donor safety, making it a viable alternative to open surgery.
Article Synopsis
- The study focused on a surgical technique called renoportal anastomosis (RPA) for living donor liver transplants in patients with complete portal vein blockage, aiming to evaluate its long-term effectiveness.
- In a retrospective study of 15 patients from 2005 to 2019, the researchers noted an improvement in RPA procedures over time, with a significant decrease in complications after standardizing the technique.
- Results showed that by the end of the study, most patients had normal liver function and successful vascular connections, indicating the RPA technique is a safe option for portal flow reconstruction.
Background And Aims: The effectiveness of gemcitabine-based adjuvant chemotherapy is unclear in cholangiocarcinoma. We investigated the role of adjuvant gemcitabine plus cisplatin (GemCis) in a homogeneous group of high-risk patients with resected, lymph node-positive extrahepatic cholangiocarcinoma.
Approach And Results: Adenocarcinoma of perihilar or distal bile duct with regional lymph node metastasis who underwent curative-intent surgery (R0/R1) was eligible.
Background: This study aimed to investigate prognostic factors of recurrence and survival associated with hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT).
Patients And Methods: This retrospective study included 161 patients with HCC with PVTT who underwent hepatectomy between January 2003 and January 2014 at the Asan Medical Center. Regression analyses were conducted to identify favorable predictive factors for overall survival (OS) and recurrence-free survival (RFS).
Background: Mycophenolate mofetil exhibits pharmacologic mechanisms different from calcineurin inhibitors. Therefore, the dose of calcineurin inhibitors can be reduced along with side effects for effective immunosuppression. We aimed to evaluate the efficacy and safety of tacrolimus and corticosteroid in combination with or without mycophenolate mofetil in living donor liver transplantation (LDLT) recipients infected with hepatitis B virus (HBV).
View Article and Find Full Text PDFIntroduction: Lenvatinib is approved for the treatment of patients with metastatic or recurrent hepatocellular carcinoma (HCC); however, clinical outcomes of lenvatinib therapy in patients with post-liver transplantation (LT) HCC recurrence remain unclear. We investigated the efficacy and safety of lenvatinib in patients with post-LT HCC recurrence.
Methods: This multinational, multicenter, retrospective study included 45 patients with recurrent HCC after LT who received lenvatinib at six institutions in three countries (Korea, Italy, and Hong Kong) from June 2017 to October 2021.
Delayed gastric emptying (DGE) is a common complication of liver transplantation. This study aimed to clarify the efficacy and safety of the application of an adhesion barrier for preventing DGE in living-donor liver transplantation. This retrospective study included 453 patients who underwent living-donor liver transplantation using a right lobe graft between January 2018 and August 2019, and the incidence of postoperative DGE and complications was compared between patients in whom adhesion barrier was used (n=179 patients) and those in whom adhesion barrier was not used (n=274 patients).
View Article and Find Full Text PDFPurpose: To investigate the effectiveness of plug-assisted retrograde transvenous obliteration (PARTO) for portal steal from complicated portosystemic shunts (PSSs) in living-donor liver transplantation (LDLT).
Materials And Methods: This retrospective study included consecutive patients who underwent LDLT and intraoperative or postoperative PARTO for complicated PSS between January 2020 and December 2021. PARTO was performed when hepatofugal portal flow steal was identified during intraoperative cineportography, and afferent vein embolization was difficult because of multiple afferent veins or incomplete afferent vein embolization.
Backgrounds: The anatomy of the left hepatic vein (LHV) is variable; thus, it should be considered for graft hepatic vein (GHV) venoplasty for left lateral section (LLS) and left liver grafts. This study assessed the incidence of superficial LHV (sLHV) branches according to LHV anatomy and its usability for GHV venoplasty in pediatric liver transplantation (LT).
Methods: This study consisted of three parts: (1) anatomical classification of LHV variations and the incidence of sLHV branches; (2) morphometric simulative analysis of GHV reconstruction and (3) clinical application based on LHV anatomy.
Complete pathological response (CPR) is achieved with various pretransplant locoregional treatments for hepatocellular carcinoma (HCC). This study aimed to investigate pretransplant expression of HCC tumor markers in liver transplantation (LT) recipients showing CPR. For the CPR group, 166 patients were selected from a single-institution LT database.
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