Brain death is the irreversible end of all brain activity including involuntary activity necessary to sustain life. Since the first organ transplantation from a brain-dead donor in 1979, organ transplantation has been developing continuously in Korea. The Organ Transplantation Act was enacted in February 2000, making brain-dead organ donation legal in Korea, and the Korean Network for Organ Sharing (KONOS) was simultaneously launched, permitting the organized procurement and distribution of organs. Once brain death is declared, aggressive fluid management, use of vasopressors, and mechanical ventilation should be maintained between brain death and organ donation to keep all other vital organs completely functional, providing optimal opportunities for organ donation.
Brain ; Brain Death ; Humans ; Korea* ; Organ Transplantation ; Respiration, Artificial ; Tissue and Organ Procurement ; Tissue Donors* ; Transplantation ; Transplants

No abstract available.
Brain Death* ; Brain* ; Humans ; Organ Transplantation* ; Tissue Donors* ; Transplants*

Brain Death ; China ; Death ; Humans ; Organ Transplantation ; Tissue and Organ Procurement

BACKGROUND: Face transplantation has naturally evolved from reconstructive procedures. However, few institutions perform face transplantations, because it is time-consuming and it is necessary to justify non-vital organ transplantation. We investigated the process of organ donation from brain-dead patients and the possibility of incorporating face transplantation into the donation process. METHODS: A retrospective review was performed of 1,074 brain-dead patients from January 2015 to December 2016 in Korea. We analyzed the time intervals from admission to brain death decisions (first, second, and final), the causes of brain death, and the state of the transplanted organs. RESULTS: The patient base (n=1,074) was composed of 747 males and 327 females. The average period between admission to the first brain death decision was 8.5 days (±15.3). The average time intervals between the first brain death decision and medical confirmation using electroencephalography and between the first brain death decision and the final determination of brain death were 16 hours 58 minutes (±14 hours 50 minutes) and 22 hours 57 minutes (±16 hours 16 minutes), respectively. The most common cause of brain death was cerebral hemorrhage/stroke (42.3%), followed by hypoxia (30.1%), and head trauma (25.2%). CONCLUSIONS: When face transplantation is performed, the transplantation team has 22 hours 57 minutes on average to prepare after the first brain death decision. The cause of brain death was head trauma in approximately one-fourth of cases. Although head trauma does not always imply facial trauma, surgeons should be aware that the facial tissue may be compromised in such cases.
Anoxia ; Brain Death ; Brain ; Craniocerebral Trauma ; Electroencephalography ; Facial Transplantation ; Female ; Humans ; Korea ; Male ; Organ Transplantation ; Retrospective Studies ; Surgeons ; Tissue and Organ Procurement ; Tissue Donors ; Transplantation ; Transplants

We have tracked the response of host and transplanted neural progenitors or stem cells to hypoxic-ischemic (HI) brain injury, and explored the therapeutic potential of neural stem cells (NSCs) injected into mice brains subjected to focal HI injury. Such cells may integrace appropriately into the degenerating central nervous system (CNS), and showed robust engraftment and foreign gene expression within the region of HI inury. They appeared to have migrated preferentially to the site of ischemia, experienced limited proliferation, and differentiated into neural cells lost to injury, trying to repopulate the damaged brain area. The transplantation of exogenous NSCs may, in fact, augment a natural self-repair process in which the damaged CNS "attempts" to mobilize its own pool of stem cells. Providing additional NSCs and trophic factors may optimize this response. Therefore, NSCs may provide a novel approach to reconstituting brains damaged by HI brain injury. Preliminary data in animal models of stroke lends support to these hypotheses.
Animal ; Brain/pathology ; Brain Diseases/therapy* ; Brain Diseases/pathology ; Brain Ischemia/therapy* ; Brain Ischemia/pathology ; Gene Therapy* ; Human ; Nerve Tissue/cytology* ; Stem Cells/transplantation* ; Tissue Therapy*

Since the first deceased donor kidney transplantation in 1979, continuous efforts have been made to increase deceased organ donation in Korea. However, a critical shortage of human organs for transplant is still a serious problem and is partly caused by the absence of a system to actively identify and properly manage deceased donors in Korea. Considering this, Korea needs to create a new national system for deceased donor identification, management, and organ procurement. There are three kinds of organ procurement systems in the world: The "Spanish model", the "United States model", and the "other European model". We reviewed each system and suggested the optimal organ procurement system for Korea. We also proposed requirements for operating an organ procurement organization and increasing deceased organ donation. Further improvements in the organ procurement system will contribute to improve the current organ shortage.
Brain Death ; Humans ; Kidney Transplantation ; Korea ; Spain ; Tissue and Organ Procurement ; Tissue Donors ; Transplants ; United States

The disparity between the number of patients awaiting kidney transplantation (KT) on the list and the number of actual number of KT from deceased organ donation has become wider despite the recent increase in the number of donations. Moreover, the proportion of donors aged 60 or more has rapidly increased. KT from expanded criteria donor (ECD) has been not only been necessary, but also inevitable with respect to maximizing the use of this scarce organ resource. However, we still use the “marginal donor criteria” implemented in 2000 when KONOS (Korean Network for Organ Sharing) was established. In the Korean transplantation environment, this “marginal donor criteria” does not have the power to predict graft outcome, and fails to discern grafts with inferior transplant outcomes from successful transplants. As a result, it does not meet the role of the criteria in Korea. Therefore, we should develop our own criteria based on our deceased donor kidney transplantation experience. Here, we review the current status of ECD KT in Korea in context with the progression of the ECD criteria system in UNOS (United Network for Organ Sharing) and present some considerations for the Korean donor criteria system.
Allografts ; Brain Death ; Humans ; Kidney Transplantation* ; Kidney* ; Korea* ; Tissue and Organ Procurement ; Tissue Donors* ; Transplants

International norms of organ transplantation mainly depends on the organ donation after the death of citizens. Numbers of studies on the quality of donated livers were conducted to reduce the early postoperative primary dysfunctions and relevant complications. The donations is based on donation after brain death (DBD) and donation after cardiac death (DCD). Hence, the differences in the quality of liver from DBD and DCD are the focus.
Brain Death ; Humans ; Liver ; physiology ; Liver Transplantation ; Tissue Donors ; Tissue and Organ Procurement

It has been extensively confirmed that fetal ventral mesencephalic cell (VMC) transplantation can ameliorate the symptoms of Parkinson's disease (PD). But there are still several problems to be resolved before the extensive clinical application of this technology. The major limitations are the poor survival of grafted dopamine (DA) neurons and restricted dopaminergic reinnervation of host striatum. Some attempts have been made to solve these problems including use of some trophic factor and co-transplantation with neural/paraneural origins. The purpose of this review is to overview advances of the means improving the survival of grafts and their current limitations.
Animals ; Brain Tissue Transplantation ; methods ; Fetal Stem Cells ; transplantation ; Fetal Tissue Transplantation ; methods ; Graft Survival ; Humans ; Mesencephalon ; embryology ; transplantation ; Parkinson Disease ; therapy

PURPOSE: The demand for suitable organs in the world greatly outweighs the supply of transplantable organs. Perceptions and attitudes of the attending physician to brain death are pivotal for the organ donation process in brain dead donors. The purpose of this study is to evaluate the perceptions and attitudes of the attending physician on brain death and organ donation in order to promote the organ donation from brain dead donors in Korea. METHODS: Questionnaires were collected from 194 (17.9%) among 1,018 physicians and were analyzed by descriptive statistics. RESULTS: 97.5% (189/194) of respondents have positive attitudes toward organ donation. Although 97.9% (190/194) have experienced donor management, the referral rate was no more than half (96/194, 49.5%). The main barriers against organ donation were lack of knowledge on organ donation and transplantation (60/129, 46.5%), cultural background (27/120, 20.9%) and complexity in the organ donation process (12/129, 9.3%). CONCLUSION: Promotion of organ procurement organization and well trained-education programs are crucial to help attending physicians to understand the organ donation process, and eventually to increase the rate of organ donations in brain dead donors.
Brain Death* ; Brain* ; Humans ; Korea ; Surveys and Questionnaires ; Referral and Consultation ; Surveys and Questionnaires ; Tissue and Organ Procurement* ; Tissue Donors* ; Transplantation