Journal Detail Information

1

Cite

Share

Clinical Strategies to Develop Transplantation Tolerance.

Jong Soo LEE ; Byungsuk KWON ; Hong Rae CHO

Hanyang Medical Reviews.2006;26(3):70-76.

The development of immunosuprressants has had a significant influence on inhibition of acute allograft rejection. However, long-term graft survival has not been achieved by immunosuppressants, probably because of their nonspecific suppression of T cell activity and nonimmune side effects. The ideal way to overcome the limitations of current immunosuppressants is to induce allograft-specific immune tolerance. Transplant immunologists are exerting their efforts in achieving transplantation tolerance using four different approaches; costimulatory blockade, mixed hematopoietic chimerism, T cell depletion, and regulation by regulatory T cells. It is expected that transplantation tolerance will soon be established as a standard immunosuppressive regimen with little side effects in preventing and reversing allograft rejection.
Allografts ; Chimerism ; Graft Survival ; Immune Tolerance ; Immunosuppressive Agents ; T-Lymphocytes, Regulatory ; Transplantation Tolerance*

2

Cite

Share

Pancreas Islet Cell Transplantation: Present and Future.

Song Cheol KIM

Hanyang Medical Reviews.2006;26(3):62-69.

Pancreas islet cell transplantation has been regarded as an ideal method to treat the type I diabetes mellitus. However, it could not be the method of choice because of poor graft survival rate after transplantation. Recently, the outcome of pancreas islet cell transplantation has been improving, especially since the Edmonton group has succeeded in controlling the glucose metabolism in 7 consecutive type I diabetes mellitus patients. Returning to diabetic status in a substantial portion of transplanted patients, however, has revealed that lots of hurdles, such as primary non-function of the islet from non-specific inflammation, immunologic destruction of islets from either allogenic or autoimmune process, and shortage of donor source, remained to be solved in the near future, if pancreas islet cell transplantation is to be a practical clinical treatment modality for diabetic patients. We herein discuss on the current status and future of pancreas islet cell transplantation.
Diabetes Mellitus ; Glucose ; Graft Survival ; Humans ; Inflammation ; Islets of Langerhans* ; Metabolism ; Pancreas* ; Tissue Donors ; Transplantation

3

Cite

Share

Pancreas Transplantation.

Jongwon HA

Hanyang Medical Reviews.2006;26(3):54-61.

Pancreas transplantation is the best option for the cure of insulin dependent diabetes. Simultaneous pancreas kidney transplantation (SPK), pancreas transplantation alone (PTA), or pancreas transplantation after kidney transplantation (PAK) is performed according to the renal failure status. The best survival result comes from SPK. Donor selection is much more important than the type of transplantation since the purpose of transplantation is mainly to improve quality of life and poor quality pancreas may result in severe life threatening complications. In the majority of pancreas transplantations, systemic venous drainage is performed and this does not seem to increase the risk of atherosclerosis. Bladder drainage of exocrine secretion may result in several side effects and is not frequently performed in SPK recently. With the development of good immunosuppression regimen, the patient and graft survival rates have improved. Pancreas transplantation should be considered for the insulin dependent diabetes patients who meet the inclusion criteria.
Atherosclerosis ; Donor Selection ; Drainage ; Graft Survival ; Humans ; Immunosuppression ; Insulin ; Kidney Transplantation ; Pancreas Transplantation* ; Pancreas* ; Quality of Life ; Renal Insufficiency ; Urinary Bladder

4

Cite

Share

Innate Immunity and Organ Transplantation.

Chul Woo YANG

Hanyang Medical Reviews.2006;26(3):48-53.

The immune response of transplanted grafts has been considered to be within the realm of the adaptive immune system. Recently, with the discovery of the Toll-like receptors (TLRs), the role of innate immune responses in the control of adaptive immunity has become a new area of interest. Emerging evidence suggests that in addition to responding to pathogen-associated molecular patterns of microorganisms, TLRs can be activated by endogenous ligands, expressed by mammalian cells. These 'danger signals' may participate in ischemia-reperfusion related organ damage and the toxicity of immunosuppressant subsequently influence the function and survival of transplanted grafts. Furthermore, it has been suggested that adaptive immune responses can enhance the acute inflammatory responses controlled by innate immunity in organ transplantation. This review addresses the potential role of innate immunity in organ transplantation.
Adaptive Immunity ; Immune System ; Immunity, Innate* ; Ligands ; Organ Transplantation* ; Toll-Like Receptors ; Transplantation ; Transplants*

5

Cite

Share

Pathology of Renal Transplantation.

Moon Hyang PARK

Hanyang Medical Reviews.2006;26(3):32-47.

Even with improved immunosuppressive therapies, graft rejection remains the major cause of failure. Renal biopsy is the most sensitive tool and gold standard for the diagnosis of rejection and other causes of graft dysfunction. Because of the large number of conditions that can affect the allograft, sometimes in combination, renal transplantation pathology is one of the most challenging areas for the renal pathologist. The major causes of allograft dysfunction include rejection, postoperative acute tubular necrosis, perfusion injury, drug toxicity, obstruction, major vascular occlusion, infection, allergic interstitial nephritis, recurrent or de novo glomerular disease, and post-transplant lymphoproliferative disease. The criteria for grading rejection by the Banff 97 schema and the new concept of acute antibody-mediated rejection are introduced.
Allografts ; Biopsy ; Diagnosis ; Drug-Related Side Effects and Adverse Reactions ; Graft Rejection ; Kidney Transplantation* ; Necrosis ; Nephritis, Interstitial ; Pathology* ; Perfusion ; Transplants

6

Cite

Share

Kidney Retransplantation.

In Sung MOON ; Sun Cheol PARK

Hanyang Medical Reviews.2006;26(3):27-31.

Renal transplantation is the optimal treatment for end stage renal disease and it has significantly improved the quality and length of life of transplant recipients. It has led to an increasing number of transplant recipients with failed primary allografts due to rejection or other causes and the recipients must decide whether to return to dialysis or seek retransplantation. Although recently, the frequency of retransplantation has begun to increase gradually and retransplantation have presumed to be a favorable option in some articles, there are limitations (little data) to support this. The results of retransplantation is dependent on recipients, such as patients with recurrent renal disease, recipient comorbidities, previous transplant graft outcome, and the expected wait time to retransplant operation. The use of potent and appropriate immunosuppression and surgical technique for retransplantation could help to improve results.
Allografts ; Comorbidity ; Dialysis ; Humans ; Immunosuppression ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney* ; Longevity ; Transplantation ; Transplants

7

Cite

Share

Recent Advancement of Living Donor Renal Transplantation.

Hyung Joon AHN ; Beom Seok KIM ; Yu Seun KIM

Hanyang Medical Reviews.2006;26(3):18-26.

The field of renal transplantation has undergone continual evolution to become the standard treatment for patients with end-stage renal diseases. The attempts to improve organ shortage, studies for clinical and basic science, empirical trial of new immunosuppressive drugs and technical challenges are very important for the development of renal transplantation medicine and improved patient outcome. This review will focus on the recent advancement and current hot issues of living donor renal transplantation worldwide.
Humans ; Kidney Transplantation* ; Living Donors*

8

Cite

Share

Pediatric Liver Transplantation.

Suk Koo LEE ; Choon Hyuck KWON

Hanyang Medical Reviews.2006;26(3):9-17.

Since the past several decades, remarkable improvements in the management of pediatric liver transplantation was achieved and pediatric transplant surgeons have transformed a once hopeless end-stage liver disease in children into a treatable disease with limited mortality. Biliary atresia, the most common indication of liver transplantation, needs judicious selection of patients and timing of transplantation in order to achieve best results. In fulminant hepatic failure, laboratory data and neurological signs help decide the need for transplantation and determine the prognosis. Various types of transplantation methods are possible, but the living donor liver transplantation using the left lateral section is currently the most widely used. Therapeutic interventions, such as percutaneous transhepatic biliary drainage or balloon angioplasty can be used to manage post-transplant complications with minimal morbidity. Vigilant prophylaxis against viral infections with careful use of balanced immunosuppressive medications can prevent deleterious diseases such as cytomegalovirus infection or post-transplant lymphoproliferative disease. Despite the improved results, more study needs to be done to elucidate the long-term outcome of these young liver recipients.
Angioplasty, Balloon ; Biliary Atresia ; Child ; Cytomegalovirus Infections ; Drainage ; Humans ; Liver Diseases ; Liver Failure, Acute ; Liver Transplantation* ; Liver* ; Living Donors ; Mortality ; Prognosis

9

Cite

Share

Current Issues in Living Donor Liver Transplantation.

Jae Won JOH

Hanyang Medical Reviews.2006;26(3):4-8.

Living donor liver transplantation (LDLT) was first successfully done in pediatric patients and now its application has been expanded to adult patients. Especially in Asian countries, LDLT has become the mainstay of liver transplantation because of a severe shortage of cadaveric organs. The overall survival rate of recipients is almost same as in cadaveric whole organ transplantation. Advantages of LDLT include reduction in waiting time, flexible operation time, good quality of donor organ, and minimal cold ischemic time, etc. But it needs a thorough understanding of anatomy and it is technically more demanding. Recipient morbidity is increased, especially in biliary complications, and donor morbidity and mortality issues should be considered. Many surgical problems have been solved in the field of LDLT. Still the issues of small for size syndrome and biliary complication should be solved in the near future.
Adult ; Asian Continental Ancestry Group ; Cadaver ; Cold Ischemia ; Humans ; Liver Transplantation* ; Liver* ; Living Donors* ; Mortality ; Organ Transplantation ; Survival Rate ; Tissue Donors ; Transplants

10

Cite

Share

Biologic Agent for Rheumatoid Arthritis.

Sung Hoon PARK ; Seong Kyu KIM ; Jung Yoon CHOE

Hanyang Medical Reviews.2012;32(2):68-76. doi:10.7599/hmr.2012.32.2.68

Decades of accumulated knowledge and improved comprehension of various perspectives on rheumatoid arthritis (RA) pathophysiology has led to the development of new biologic agents that inhibit a specific component of the RA inflammatory process. Especially during the last two decades, several epochal agents which target tumor necrosis factor-alpha, interleukin-1, interleukin-6, CD20-expressing B cell, and cytotoxic T lymphocyte antigen-4 were used in the management of RA and other autoimmune diseases with highly comparable efficacy and safety. Moreover, dozens of innovative agents queue up for clinical trials day by day. Herein, we review the current scenario of RA management in terms of pathogenesis and targeted molecular pathways, and some important controversies in this field as well. Based on the complications that these kinds of diseases pose, it is highly reasonable to hope that further improved therapies and more tailored drugs for RA will be introduced in the near future.
Arthritis, Rheumatoid ; Autoimmune Diseases ; Comprehension ; Interleukin-1 ; Interleukin-6 ; Lymphocytes ; Tumor Necrosis Factor-alpha

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share