Smart care, smart choice Living donor transplantation

Organ transplantation is an operation moving an organ from one body to another, for the purpose of replacing the recipient's damaged or absent organs due to disease or injury. Organ transplant is classified into deceased donor transplantation and living donor transplantation. The kidneys, liver, pancreas, small intestines and bone-marrow can be transplanted and living donor transplantation is performed mostly for the kidneys and liver. As a person has two kidneys, one of them can be removed and only 30% of a liver will grow back to its original size in just three months, so part of a liver can be removed.

Organ transplantation is often called the “centerpiece of modern medicine,” a “composite art,” or the “final piece in the puzzle of surgery.” A successful transplantation requires equal development of all departments such as infectious diseases, gastroenterology, cardiology, surgery, radiology, laboratory medicine, pathology and food and nutrition. In this regards, a country with excellent organ transplantation technique is considered as having high medical technology. Korea has the world’s best techniques in organ transplantation, especially living donor transplantation.

According to organ transplantation data compiled by the WHO in 2008, Korea performed 13.64 living liver transplants per 1 million people, the highest among 96 countries in the world and twice the number of Singapore’s 7.33 cases. Singapore ranked 2nd.
Other data published by the Korean government (Korea Center for Disease Control & Prevention) shows that 824 people donated their livers in 2010, which accounts for 26% out of 3,116 donors in the world. In addition, 77% of liver transplants were from living donors among the total liver transplants, while the world’s average was 15%. Korea also recorded 62% in terms of kidney transplants from living donors, higher than the world’s average of 44%.
In Korea, more than half of the livers (58.6%) were donated by children for their parents. This is a result of Korean culture which values filial piety and respects for parents.
Thanks to such a culture, Korea’s living liver transplant technique which started in 1988 developed substantially though a short history. According to the 2008 yearbook of the Korean Network for Organ Sharing, a 5-year survival rate for living kidney transplants stood at 93.8% and living liver transplants at 77.9%, higher than 80.2% and 68.6% of the U.S. rate, respectively. Currently, around 20 hospitals perform liver transplants and 60 hospitals perform kidney transplants in Korea.

Liver transplant was first attempted in the U.S., Australia and Brazil and flourished in Japan. Today, Korea boasts the best performance in the world. Organ transplants from living donors require highly advanced medical techniques in order to save the lives of both donors and recipients. Korean doctors have built their skills based on excellent dexterity, a passion for study and concentration in a short period of time. In 2005, an organ transplant team from Johns Hopkins Hospital visited Korea for 3-week trainings in living liver transplant. Professor Robert Montgomery from Johns Hopkins Hospital who discovered the surgical technique that resolved the rejection of an organ transplanted from a donor with a different blood type, highly praised Korea’s technique. He said that “Korea has the best living liver transplant technique.” Transplantation takes 12 hours on average in other countries, but it takes only 6-7 hours in Korea.

Fatima Al Ali (female, aged 35) who suffered from juvenile diabetes since she was 6 had to receive a kidney transplant because her kidney function had significantly deteriorated due to frequent hemodialysis and transfusion. Fortunately, the UAE operated a medical system that transfers patients who cannot be treated in the home country to countries overseas for treatment. The UAE government requested a kidney transplant for Fatima at a hospital in the U.S. However, the hospital said “no” because she was a high-risk patient who was likely to reject the transplant given her medical history.
The UAE government also requested the procedure at the ASAN Medical Center in Seoul because of the hospital’s excellent technique in reducing the risk of transplant rejection. The ASAN Medical Center accepted the request and Fatima came to Korea in January 17, 2011 with her brother Khaled Al Ali (male, aged 24). Fatima received various pre-op treatments to reduce the possibility of rejection and underwent surgery on February 1. She recovered quickly from the surgery. She could have normal meals and walk in just one week. She returned to her home two weeks later.
She said that “when I heard that the American hospital could not give me the transplant, I was really disappointed. But, I was not concerned because I was told that the ASAN Medical Center has the best technique in the world. When I return home, I will definitely recommend Korea’s medical techniques.”

ASAN Medical Center in Korea performed the greatest number of living kidney transplants in the world in 2011. In 2011 alone, the hospital performed 202 kidney transplants from living donors. It is the only hospital which operates more than 200 kidney transplants a year for four consecutively years in Asia. The hospital successfully performs surgeries which require a high-level technique and has an intensive patient management system. Coordinators from Japan, China, Uzbekistan and Syria are present at the hospital.

Michael Milne (male, aged 47), an English teacher in a provincial town in Korea was first brought to the emergency room at Pusan National University Yangsan Hospital in September 2011. After that, he received a through medical checkup in December due to repeated symptoms such as difficulty breathing, abdominal inflation, coughing and edema. He was diagnosed with hepatocirrhosis. In his case, the disease progressed faster than normal. He had to get a liver transplant as soon as possible. Otherwise, he could have liver failure and hepatic coma.
His brother Randall (male, aged 43), public official at the Ministry for the Environment in New Zealand rushed to Korea as soon as he heard the news. Randall wanted to offer new life to his brother and decided to offer his liver. Randall was found to have a fatty liver through examination, so he exercised to lose weight before surgery.
Pre-op examination also found that Michael’s blood type was Rh –O while Randall’s blood type was Rh+ O. It was worrisome because different Rh values may destroy red blood cells, but it was confirmed through a thorough test that such a response would not occur.
Finally, they underwent surgery in Korea on December 7, 2011. After a 20-hour long surgery, 70% of Randall’s liver was transplanted to Michael. The surgery was successful. Randall was discharged in just two weeks and returned to home. He said that “I am so happy that my brother regained his health and we can spend New Year’s holiday together in New Zealand with other family members. I expected the worst and decided to stay with him until his last moment. I appreciate the medical staff’s excellent technique. And I also thank the nurses for their hospitality. I could feel their kindness even though we speak different language.”

Since its foundation in May, 2010, the hospital conducted 40 liver transplants for a year and half. With a 96% success rate, the hospital has not experienced a single hepatic artery and biliary stricture, which are common responses among liver transplant patients. Recipients did not have complications as well. As a JCI accredited hospital, it offers a detailed explanation about the success rate, the death rate and the cause of death to international patients who are not familiar with living donor transplantations and checking patients’ health thoroughly.

In Korea, every mountain with fresh air and beautiful scenery has a temple. Recently, temples which focused on religious activities began running temple stay programs for the general public and tourists from aboard. Visitors stay at a temple for 2 or 4 days, eating meals with monks and participating in meditation. Temple stay which allows people to look after themselves becomes popular as the program purifies one’s fatigued body and soul regardless of the participants’ religion.
Korea’s largest temple, Tongdosa Temple. The temple is one of the most famous temples for temple stays and other temples such as Gilsangsa temple in Seoul, Woljeongsa Temple in Gangwon and Donghwasa Temple in Daegu have such programs as well. For more information,

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