In 19 years ago, the world’s first Dual-Graft Living Donor Liver Transplantation surgery method was developed with the dedication of a South Korean surgeon to save a patient with a terminal liver disease. With the surgery, a man in his 60s from Chile was given a new life as a gift. Seoul Asan Medical Center liver transplant team has successfully completed a Dual-graft living donor liver transplantation, in which a donor of two daughters’ livers were donated to Alberto(male,62), who had made a living as a civil engineer in Chile. Alberto visited the hospital in September 2018 with severe fatigue and jaundice, and was diagnosed with terminal cirrhosis and liver cancer. At that time, he was completely instructed to complete his life in a nursing hospital with complete occlusion of the hepatic portal vein and liver cancer invading the biliary tract.
However, he was able to choose to travel to Korea by the proposal of an Ecuadorian transplant surgeon in Chile. Raul Oleas, an Ecuadorian liver transplant surgeon who received two training sessions at Seoul Asan Medical Center, recommended to Alberto’s family to receive a Dual-graft living donor liver transplantation from the Seoul Asan Medical Center’s liver transplant team which has 97% success rate for liver transplants in patients with more than 6,000 cases of liver transplant experience. Last March, the Seoul Asan Medical Center’s liver transplant team received an urgent e-mail from Raul Oreas, a specialist in transplant surgery. “Professor Seung-gyu Lee! I have a patient in Chile who needs a dual-graft living donor liver transplantation right now with terminal hepatic and progressive liver cancer. The portal vein is closed and cancer has invaded the entire wall, causing jaundice and revenge.
Please check that surgery is possible in Korea.” Transplantation of a liver from one living person was not possible due to the small size of the liver, which can be donated to a patient weighing 182 cm and weighing 92 kg, and liver transplantation from the brain-dead patient also who could not be assured of the results due to technical problems caused by the widespread invasion of gallbladder cancer and contextual. The only way Alberto could get back into shape was with a Dual-graft living donor liver transplantation, which was provided with part of the liver from each of the two living people. The only problem is, even if two liver donors were secured, Seoul Asan Medical Center was the only hospital that could perform a Dual-graft living donor liver transplantation. Currently, there are only a few centers in the world where there is a Dual-graft living donor liver transplantation, and more than 95% of Dual-graft living donor liver transplantation is performed at Asan Hospital in Seoul. Dual-graft living donor liver transplantation began in March 2000, when a 50-year-old father, who was sentenced to a year and a half by the end of cirrhosis of the liver, received surgery for the first time at Seoul Asan Hospital. It is the first method in the world developed by Professor Seung-Kyu Lee of Seoul Asan Hospital, which can be applied when one person’s liver donation is not enough or if the remaining liver can carry a little risk to the donor’s life. The Asan Hospital Transplant Team, which had been contacted in advance, carefully reviewed Alberto’s medical records and video data in mid-March and conveyed the opinion that Dual-graft living donor liver transplantation is possible. Alberto and his family decided to go to Korea without any hesitation after checking the results of the Seoul Asan Hospital transplant team. They first visited Korea on March 25 this year. Alberto had severe jaundice due to hepatic insufficiency when he was admitted to Seoul Asan Medical Center for liver transplant and liver surgery. He also had a large amount of revenge, coagulation dysfunction and hepatic coma. Everyone went to the donor suitability test in a hurry. The best match for blood type and histocompatibility was identified as the first daughter (Barbara Christina, 34) and the youngest daughter (Anita Isidora, 23). On April 8, the Asan Medical Center transplant donation team successfully donated two daughters’ livers and successfully completed Alberto’s Dual-graft living donor liver transplantation. The surgery for the first daughter’s liver left-lobe donation was performed using the minimal incision technique to resect small incisions less than 10cm in the abdomen, while the surgery for the youngest daughter’s right-lobe donation was performed using laparoscopy to successfully reduce the possibility of scarring and complications.
It was not easy to remove the entire wall of the cancer-infested wall and the closed portal vein and connect the liver of the two daughters. After long periods of surgery, he had to stay in the intensive care unit for a long time, and Alberto’s liver function from his two daughters did not recover as quickly as expected. The liver volume of the two daughters was smaller than the size of the beneficiary at the time of the operation, and the liver could not function properly even after transplantation. However, due to proper treatment by medical staff at Seoul Asan Medical Center, he was able to overcome the crisis well, and moved to a general hospital room from July to continue its recovery.The Seoul Asan Medical Center’s liver transplant team also offered Alberto, who is enduring a long-term recovery process after the surgery, and his family, who are struggling to make the most of their midday recovery, a small consideration to support their usual comfortable guest houses and cars when they go out. Alberto, who is about to return home, says, “I am grateful and sorry for my two daughters who donated some of their livers without hesitation and my wife who suffered from long-term care.” The transplant team that helped bring me back to normal happiness All the staff and nurses will be remembered with gratitude and excitement for me and my family for the rest of my life.” Alberto’s youngest daughter, Anita Isidora, had tears as she recalled the situation at the time, saying, “It was unbelievable to see the outstanding performance of the Seoul Asan Medical Center’s liver transplant team on the Web site, developed the first Dual-graft living donor liver transplantation, and hoped to save her father upon hearing that experts from around the world come and receive training.” Ki-hoon Kim, professor of liver transplantation and liver surgery at Seoul Asan Hospital, said, “When the patient was first referred, there were a lot of revenge due to liver cirrhosis as well as terminal cirrhosis, advanced liver cancer, portal obstruction and biliary obstruction. But our experience with our liver transplantation confirms good results, and all of our teams of anesthesiologists, critical care and nursing teams, ward nursing teams, and infectious medicine teams have all worked together to treat patients.” Seung-kyu Lee, Chairman of the Liver Transplantation Department, Seoul Asan Hospital, said, “The world recognized the level of Korean Dual-graft living donor liver transplantation by visiting South Korea without going close to the United States from Chile on the other side of the world. “The liver transplantation technology at Seoul Asan Hospital will lead the development of the global transplantation system and make efforts to serve as a fourth revolutionary hospital medical institution that patients with terminal liver diseases can trust and find around the world.”