Lee S G, Moon D B, Hwang S, Ahn C S, Kim K H, Song G W, Jung D H, Ha T Y, Park G C, Jung B H
Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Transplant Proc. 2015 Apr;47(3):705-8. doi: 10.1016/j.transproceed.2015.02.015.
This study reviewed the past and present status of liver transplantation (LT) and outlooks for the future of LT in Korea.
The first LT in Korea was successfully performed using a deceased donor graft in 1988. Pediatric and adult living donor liver transplantations (LDLTs) were initiated in 1994 and 1997, respectively. From 1988 to 2013, 10,581 LTs were performed at 40 centers, whereas LDLT accounted for 76.5% of all LTs.
In the early 1990s, the deceased organ donation rate was less than 1.5 per million population (PMP) per year, but it increased to 5 PMP beginning in 2008. Despite the increasing number of deceased donor liver transplantations (DDLTs), high prevalence of hepatitis B virus (HBV)-induced cirrhosis and hepatocellular carcinoma (HCC) has provoked persistent performance of adult LDLT with technical advancement including middle hepatic vein (MHV) reconstruction of right lobe graft and dual graft LDLT with 1 nationwide donor mortality.
The number of LTs in Korea in 2010 was 23.2 PMP (1042 LTs/45 million population), lower than 23.5 PMP of Spain, but higher than 20 PMP of the United States. However, future LT numbers may decrease because of lowering the HBV carrier rate (neonatal HBV universal vaccination began in 1992), new potent anti-HBV agents, and lowest birth rate (1.22 children per family) with a decrease of potential live donors.
本研究回顾了韩国肝脏移植（LT）的过去和现状，并展望了其未来前景。
1988年，韩国首例LT使用尸体供肝成功完成。小儿和成人活体肝移植（LDLT）分别于1994年和1997年开始。1988年至2013年，40个中心共进行了10581例LT，其中LDLT占所有LT的76.5%。
20世纪90年代初，尸体器官捐献率每年低于每百万人口（PMP）1.5例，但从2008年开始升至5 PMP。尽管尸体供肝肝移植（DDLT）数量不断增加，但乙型肝炎病毒（HBV）所致肝硬化和肝细胞癌（HCC）的高患病率促使成人LDLT持续开展，技术不断进步，包括右叶移植物的肝中静脉（MHV）重建和双移植物LDLT，全国范围内供体死亡率为1。
2010年韩国的LT数量为23.2 PMP（1042例LT/4500万人口），低于西班牙的23.5 PMP，但高于美国的20 PMP。然而，由于HBV携带者率降低（1992年开始实施新生儿普遍接种HBV疫苗）、新型强效抗HBV药物以及最低出生率（每户1.22个孩子）导致潜在活体供体减少，未来LT数量可能会下降。
