1.Prognostic Value of Ambulatory Status at Transplant in Older Heart Transplant Recipients: Implications for Organ Allocation Policy
Junho HYUN ; Jong-Chan YOUN ; Jung Ae HONG ; Darae KIM ; Jae-Joong KIM ; Myoung Soo KIM ; Jaewon OH ; Jin-Jin KIM ; Mi-Hyang JUNG ; In-Cheol KIM ; Sang-Eun LEE ; Jin Joo PARK ; Min-Seok KIM ; Sung-Ho JUNG ; Hyun-Jai CHO ; Hae-Young LEE ; Seok-Min KANG ; Dong-Ju CHOI ; Jon A. KOBASHIGAWA ; Josef STEHLIK ; Jin-Oh CHOI
Journal of Korean Medical Science 2025;40(3):e14-
Background:
Shortage of organ donors in the Republic of Korea has become a major problem. To address this, it has been questioned whether heart transplant (HTx) allocation should be modified to reduce priority of older patients. We aimed to evaluate post-HTx outcomes according to recipient age and specific pre-HTx conditions using a nationwide prospective cohort.
Methods:
We analyzed clinical characteristics of 628 patients from the Korean Organ Transplant Registry who received HTx from January 2015 to December 2020. Enrolled recipients were divided into three groups according to age. We also included comorbidities including ambulatory status. Non-ambulatory status was defined as pre-HTx support with either extracorporeal membrane oxygenation, continuous renal replacement therapy, or mechanical ventilation.
Results:
Of the 628 patients, 195 were < 50 years, 322 were 50–64 years and 111 were ≥ 65years at transplant. Four hundred nine (65.1%) were ambulatory and 219 (34.9%) were nonambulatory. Older recipients tended to have more comorbidities, ischemic cardiomyopathy, and received older donors. Post-HTx survival was significantly lower in older recipients (P = 0.025) and recipients with non-ambulatory status (P < 0.001). However, in contrast to non-ambulatory recipients who showed significant survival differences according to the recipient’s age (P = 0.004), ambulatory recipients showed comparable outcomes (P = 0.465).
Conclusion
Our results do not support use of age alone as an allocation criterion. Transplant candidate age in combination with some comorbidities such as non-ambulatory status may identify patients at a sufficiently elevated risk at which suitability of HTx should be reconsidered.
2.Prognostic Value of Ambulatory Status at Transplant in Older Heart Transplant Recipients: Implications for Organ Allocation Policy
Junho HYUN ; Jong-Chan YOUN ; Jung Ae HONG ; Darae KIM ; Jae-Joong KIM ; Myoung Soo KIM ; Jaewon OH ; Jin-Jin KIM ; Mi-Hyang JUNG ; In-Cheol KIM ; Sang-Eun LEE ; Jin Joo PARK ; Min-Seok KIM ; Sung-Ho JUNG ; Hyun-Jai CHO ; Hae-Young LEE ; Seok-Min KANG ; Dong-Ju CHOI ; Jon A. KOBASHIGAWA ; Josef STEHLIK ; Jin-Oh CHOI
Journal of Korean Medical Science 2025;40(3):e14-
Background:
Shortage of organ donors in the Republic of Korea has become a major problem. To address this, it has been questioned whether heart transplant (HTx) allocation should be modified to reduce priority of older patients. We aimed to evaluate post-HTx outcomes according to recipient age and specific pre-HTx conditions using a nationwide prospective cohort.
Methods:
We analyzed clinical characteristics of 628 patients from the Korean Organ Transplant Registry who received HTx from January 2015 to December 2020. Enrolled recipients were divided into three groups according to age. We also included comorbidities including ambulatory status. Non-ambulatory status was defined as pre-HTx support with either extracorporeal membrane oxygenation, continuous renal replacement therapy, or mechanical ventilation.
Results:
Of the 628 patients, 195 were < 50 years, 322 were 50–64 years and 111 were ≥ 65years at transplant. Four hundred nine (65.1%) were ambulatory and 219 (34.9%) were nonambulatory. Older recipients tended to have more comorbidities, ischemic cardiomyopathy, and received older donors. Post-HTx survival was significantly lower in older recipients (P = 0.025) and recipients with non-ambulatory status (P < 0.001). However, in contrast to non-ambulatory recipients who showed significant survival differences according to the recipient’s age (P = 0.004), ambulatory recipients showed comparable outcomes (P = 0.465).
Conclusion
Our results do not support use of age alone as an allocation criterion. Transplant candidate age in combination with some comorbidities such as non-ambulatory status may identify patients at a sufficiently elevated risk at which suitability of HTx should be reconsidered.
3.Prognostic Value of Ambulatory Status at Transplant in Older Heart Transplant Recipients: Implications for Organ Allocation Policy
Junho HYUN ; Jong-Chan YOUN ; Jung Ae HONG ; Darae KIM ; Jae-Joong KIM ; Myoung Soo KIM ; Jaewon OH ; Jin-Jin KIM ; Mi-Hyang JUNG ; In-Cheol KIM ; Sang-Eun LEE ; Jin Joo PARK ; Min-Seok KIM ; Sung-Ho JUNG ; Hyun-Jai CHO ; Hae-Young LEE ; Seok-Min KANG ; Dong-Ju CHOI ; Jon A. KOBASHIGAWA ; Josef STEHLIK ; Jin-Oh CHOI
Journal of Korean Medical Science 2025;40(3):e14-
Background:
Shortage of organ donors in the Republic of Korea has become a major problem. To address this, it has been questioned whether heart transplant (HTx) allocation should be modified to reduce priority of older patients. We aimed to evaluate post-HTx outcomes according to recipient age and specific pre-HTx conditions using a nationwide prospective cohort.
Methods:
We analyzed clinical characteristics of 628 patients from the Korean Organ Transplant Registry who received HTx from January 2015 to December 2020. Enrolled recipients were divided into three groups according to age. We also included comorbidities including ambulatory status. Non-ambulatory status was defined as pre-HTx support with either extracorporeal membrane oxygenation, continuous renal replacement therapy, or mechanical ventilation.
Results:
Of the 628 patients, 195 were < 50 years, 322 were 50–64 years and 111 were ≥ 65years at transplant. Four hundred nine (65.1%) were ambulatory and 219 (34.9%) were nonambulatory. Older recipients tended to have more comorbidities, ischemic cardiomyopathy, and received older donors. Post-HTx survival was significantly lower in older recipients (P = 0.025) and recipients with non-ambulatory status (P < 0.001). However, in contrast to non-ambulatory recipients who showed significant survival differences according to the recipient’s age (P = 0.004), ambulatory recipients showed comparable outcomes (P = 0.465).
Conclusion
Our results do not support use of age alone as an allocation criterion. Transplant candidate age in combination with some comorbidities such as non-ambulatory status may identify patients at a sufficiently elevated risk at which suitability of HTx should be reconsidered.
4.Prognostic Value of Ambulatory Status at Transplant in Older Heart Transplant Recipients: Implications for Organ Allocation Policy
Junho HYUN ; Jong-Chan YOUN ; Jung Ae HONG ; Darae KIM ; Jae-Joong KIM ; Myoung Soo KIM ; Jaewon OH ; Jin-Jin KIM ; Mi-Hyang JUNG ; In-Cheol KIM ; Sang-Eun LEE ; Jin Joo PARK ; Min-Seok KIM ; Sung-Ho JUNG ; Hyun-Jai CHO ; Hae-Young LEE ; Seok-Min KANG ; Dong-Ju CHOI ; Jon A. KOBASHIGAWA ; Josef STEHLIK ; Jin-Oh CHOI
Journal of Korean Medical Science 2025;40(3):e14-
Background:
Shortage of organ donors in the Republic of Korea has become a major problem. To address this, it has been questioned whether heart transplant (HTx) allocation should be modified to reduce priority of older patients. We aimed to evaluate post-HTx outcomes according to recipient age and specific pre-HTx conditions using a nationwide prospective cohort.
Methods:
We analyzed clinical characteristics of 628 patients from the Korean Organ Transplant Registry who received HTx from January 2015 to December 2020. Enrolled recipients were divided into three groups according to age. We also included comorbidities including ambulatory status. Non-ambulatory status was defined as pre-HTx support with either extracorporeal membrane oxygenation, continuous renal replacement therapy, or mechanical ventilation.
Results:
Of the 628 patients, 195 were < 50 years, 322 were 50–64 years and 111 were ≥ 65years at transplant. Four hundred nine (65.1%) were ambulatory and 219 (34.9%) were nonambulatory. Older recipients tended to have more comorbidities, ischemic cardiomyopathy, and received older donors. Post-HTx survival was significantly lower in older recipients (P = 0.025) and recipients with non-ambulatory status (P < 0.001). However, in contrast to non-ambulatory recipients who showed significant survival differences according to the recipient’s age (P = 0.004), ambulatory recipients showed comparable outcomes (P = 0.465).
Conclusion
Our results do not support use of age alone as an allocation criterion. Transplant candidate age in combination with some comorbidities such as non-ambulatory status may identify patients at a sufficiently elevated risk at which suitability of HTx should be reconsidered.
5.Metabolic syndrome awareness in the general Korean population: results from a nationwide survey
Hyun-Jin KIM ; Mi-Seung SHIN ; Kyung-Hee KIM ; Mi-Hyang JUNG ; Dong-Hyuk CHO ; Ju-Hee LEE ; Kwang Kon KOH
The Korean Journal of Internal Medicine 2024;39(2):272-282
Background/Aims:
Metabolic syndrome (MetS) raises the risk of cardiovascular disease and type 2 diabetes. An awareness of MetS is vital for early detection and proactive management, which can mitigate the risks associated with MetS. Therefore, our study aimed to investigate the level of awareness of MetS among the Korean population.
Methods:
We conducted a nationwide survey between January and February 2023 among a representative sample of the Korean population using an online survey. Information regarding the awareness of MetS and its risk, the importance of lifestyle modification, and health behavior were collected. The question about the awareness of MetS was “How much do you think you know about MetS?” and there were five answers: 1) I know very well, 2) I know well, 3) I know a little, 4) I do not know, and 5) I have no idea. The high-awareness group was defined as those who answered that they knew very well or well.
Results:
Among 1,000 participants (mean age, 45.7 ± 13.2 yr), 29% were unaware of MetS, and only 20.8% had high awareness. The high-awareness group was significantly more knowledgeable about lifestyle modifications and demonstrated better health behaviors. After adjustment for possible confounding factors, younger age, low household income, and absence of comorbidity were independently associated with a lack of awareness regarding MetS.
Conclusions
The high-awareness group showed greater knowledge of the importance of lifestyle modifications and better health behaviors regarding MetS. The findings highlight the need for improved public education and awareness programs regarding MetS.
6.Preliminary Investigation on Efficacy and Safety of Substance P-Coated Stent for Promoting Re-Endothelialization: A Porcine Coronary Artery Restenosis Model
Dae Sung PARK ; Seok OH ; Yu Jeong JIN ; Mi Hyang NA ; Munki KIM ; Jeong Ha KIM ; Dae Young HYUN ; Kyung Hoon CHO ; Young Joon HONG ; Ju Han KIM ; Youngkeun AHN ; Manuel HERMIDA-PRIETO ; José Manuel VÁZQUEZ-RODRIGUEZ ; Juan Luis GUTIÉRREZ- CHICO ; Luis MARINÃS-PARDO ; Kyung Seob LIM ; Jun-Kyu PARK ; Dae-Heung BYEON ; Young-Nan CHO ; Seung-Jung KEE ; Doo Sun SIM ; Myung Ho JEONG
Tissue Engineering and Regenerative Medicine 2024;21(1):53-64
BACKGROUND:
Current polymer-based drug-eluting stents (DESs) have fundamental issues about inflammation and delayed re-endothelializaton of the vessel wall. Substance-P (SP), which plays an important role in inflammation and endothelial cells, has not yet been applied to coronary stents. Therefore, this study compares poly lactic-co-glycolic acid (PLGA)-based everolimus-eluting stents (PLGA-EESs) versus 2-methacryloyloxyethyl phosphorylcholine (MPC)-based SP-eluting stents (MPC-SPs) in in-vitro and in-vivo models.
METHODS:
The morphology of the stent surface and peptide/drug release kinetics from stents were evaluated. The invitro proliferative effect of SP released from MPC-SP is evaluated using human umbilical vein endothelial cell. Finally, the safety and efficacy of the stent are evaluated after inserting it into a pig’s coronary artery.
RESULTS:
Similar to PLGA-EES, MPC-SP had a uniform surface morphology with very thin coating layer thickness (2.074 lm). MPC-SP showed sustained drug release of SP for over 2 weeks. Endothelial cell proliferation was significantly increased in groups treated with SP (n = 3) compared with the control (n = 3) and those with everolimus (n = 3) (SP:118.9 ± 7.61% vs. everolimus: 64.3 ± 12.37% vs. the control: 100 ± 6.64%, p < 0.05). In the animal study, the percent stenosis was higher in MPC-SP group (n = 7) compared to PLGA-EES group (n = 7) (MPC-SP: 28.6 ± 10.7% vs. PLGAEES: 16.7 ± 6.3%, p < 0.05). MPC-SP group showed, however, lower inflammation (MPC-SP: 0.3 ± 0.26 vs. PLGAEES: 1.2 ± 0.48, p < 0.05) and fibrin deposition (MPC-SP: 1.0 ± 0.73 vs. PLGA-EES: 1.5 ± 0.59, p < 0.05) around the stent strut. MPC-SP showed more increased expression of cluster of differentiation 31, suggesting enhanced reendothelialization.
CONCLUSION
Compared to PLGA-EES, MPC-SP demonstrated more decreased inflammation of the vascular wall and enhanced re-endothelialization and stent coverage. Hence, MPC-SP has the potential therapeutic benefits for the treatment of coronary artery disease by solving limitations of currently available DESs.
8.Effect of the Spinning Babies Program on Birth Outcomes and Satisfaction during Labor: A NonRandomized Controlled Trial
Journal of Korean Academy of Nursing 2024;54(4):607-619
Purpose:
This study evaluated the effects of the Spinning Babies program applied during labor on birth outcomes and satisfaction among pregnant women.
Methods:
This non-equivalent control group, non-synchronized post-test only design study included 42 participants (22 in the experimental group and 20 in the control group). The Spinning Babies program was conducted four times in the experimental group during the first and second stages of delivery for 50 min per session. The program comprised performing pelvic circles on a birth ball, followed by wide squatting and adopting of open knee-chest and side-lying positions.
Results:
Compared with those in the control group, pregnant women in the experimental group had a significantly shorter labor time (t = - 6.64, p < .001), a higher success rate for normal vaginal delivery (χ2 = 4.86, p = .043), improved Apgar scores of newborns (z2 = - 2.18, p = .029), differences in neonatal oxygen therapy use (χ2 = 4.86, p = .043), and improved birth satisfaction (t = 11.99, p < .001).
Conclusion
The Spinning Babies program improves the birth environment by increasing the normal vaginal delivery success rate, as well as pregnant women’s birth satisfaction, and promotes neonatal health.
9.Effect of the Spinning Babies Program on Birth Outcomes and Satisfaction during Labor: A NonRandomized Controlled Trial
Journal of Korean Academy of Nursing 2024;54(4):607-619
Purpose:
This study evaluated the effects of the Spinning Babies program applied during labor on birth outcomes and satisfaction among pregnant women.
Methods:
This non-equivalent control group, non-synchronized post-test only design study included 42 participants (22 in the experimental group and 20 in the control group). The Spinning Babies program was conducted four times in the experimental group during the first and second stages of delivery for 50 min per session. The program comprised performing pelvic circles on a birth ball, followed by wide squatting and adopting of open knee-chest and side-lying positions.
Results:
Compared with those in the control group, pregnant women in the experimental group had a significantly shorter labor time (t = - 6.64, p < .001), a higher success rate for normal vaginal delivery (χ2 = 4.86, p = .043), improved Apgar scores of newborns (z2 = - 2.18, p = .029), differences in neonatal oxygen therapy use (χ2 = 4.86, p = .043), and improved birth satisfaction (t = 11.99, p < .001).
Conclusion
The Spinning Babies program improves the birth environment by increasing the normal vaginal delivery success rate, as well as pregnant women’s birth satisfaction, and promotes neonatal health.
10.Effect of the Spinning Babies Program on Birth Outcomes and Satisfaction during Labor: A NonRandomized Controlled Trial
Journal of Korean Academy of Nursing 2024;54(4):607-619
Purpose:
This study evaluated the effects of the Spinning Babies program applied during labor on birth outcomes and satisfaction among pregnant women.
Methods:
This non-equivalent control group, non-synchronized post-test only design study included 42 participants (22 in the experimental group and 20 in the control group). The Spinning Babies program was conducted four times in the experimental group during the first and second stages of delivery for 50 min per session. The program comprised performing pelvic circles on a birth ball, followed by wide squatting and adopting of open knee-chest and side-lying positions.
Results:
Compared with those in the control group, pregnant women in the experimental group had a significantly shorter labor time (t = - 6.64, p < .001), a higher success rate for normal vaginal delivery (χ2 = 4.86, p = .043), improved Apgar scores of newborns (z2 = - 2.18, p = .029), differences in neonatal oxygen therapy use (χ2 = 4.86, p = .043), and improved birth satisfaction (t = 11.99, p < .001).
Conclusion
The Spinning Babies program improves the birth environment by increasing the normal vaginal delivery success rate, as well as pregnant women’s birth satisfaction, and promotes neonatal health.

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