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.Neutralization Testing–based Immunogenicity Analysis of Recent Prevalent Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Sublineages
Eun Ju LEE ; Hyeokjin LEE ; Sang Won O ; Jee Eun RHEE ; Jeong-Min KIM ; Dong Ju KIM ; Il-Hwan KIM ; Jin Sun NO ; Ae Kyung PARK ; Jeong-Ah KIM ; Chae Young LEE ; Young-Ki CHOI ; Eun-Jin KIM
Annals of Laboratory Medicine 2024;44(3):289-293
Although WHO declared the end of the public health emergency for coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), XBB lineages continue to evolve and emerge globally. In particular, XBB.1.5 and XBB.1.16 are raising concerns because of their high immune evasion, leading to apprehensions regarding vaccine efficacy reduction and potential reinfection. We aimed to investigate the COVID-19 outbreak in Korea and predict the likelihood of reinfection by testing neutralizing activity against live viruses from the S clade and 19 Omicron sublineages.We found a significant risk of infection with the currently prevalent XBB lineage for individuals who were either vaccinated early or infected during the initial Omicron outbreak. Vaccinated individuals were better equipped than unvaccinated individuals to produce neutralizing antibodies for other SARS-CoV-2 variants upon infection. Therefore, unvaccinated individuals do not easily develop neutralizing activity against other variants and face the highest risk of reinfection by the XBB lineage. Our study provides important information to facilitate the development of strategies for monitoring populations that would be the most susceptible to new COVID-19 outbreaks.
6.A Qualitative Study on the Self-Transcendence Experience of Middle-aged Working Women Participating in Self-transcendence and Health Program
Korean Journal of Rehabilitation Nursing 2024;27(2):88-99
Purpose:
This study developed a Psychoeducational Approach to Transcendence and Health Program (PATH) for middle-aged women in Korea, focusing on five key areas of self-transcendence: introspection, relationships, contemplation, spirituality, and creativity. The exploratory qualitative study aimed to investigate participants' experiences by analyzing self-transcendence records they had written.
Methods:
The PATH program involved pairs of participants who met weekly for three weeks to engage in intensive discussions on two topics for 60 minutes each. Participants were also asked to write down weekly tasks in a notebook for 10-15 minutes each day. Content analysis was conducted in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.
Results:
Participants (n=29) had a mean age of 52.5 years. Analysis revealed themes in self-transcendence: Introspection: "patient egoist" and "chameleon in the battlefield," reflecting maturity; Relationships: "solving the puzzle of relationships" and "things still to share," emphasizing empathy; Contemplation:"full of problems but trusting myself" and "I am a winner," showcasing insights; Spirituality: "curious about the afterlife" and "preparing for death," demonstrating a sense of absoluteness; Creativity: "finding happiness in growth," representing aesthetics.
Conclusion
The PATH program effectively promotes successful aging for middle-aged working women by fostering self-transcendence in five key areas.
7.A Qualitative Study on the Self-Transcendence Experience of Middle-aged Working Women Participating in Self-transcendence and Health Program
Korean Journal of Rehabilitation Nursing 2024;27(2):88-99
Purpose:
This study developed a Psychoeducational Approach to Transcendence and Health Program (PATH) for middle-aged women in Korea, focusing on five key areas of self-transcendence: introspection, relationships, contemplation, spirituality, and creativity. The exploratory qualitative study aimed to investigate participants' experiences by analyzing self-transcendence records they had written.
Methods:
The PATH program involved pairs of participants who met weekly for three weeks to engage in intensive discussions on two topics for 60 minutes each. Participants were also asked to write down weekly tasks in a notebook for 10-15 minutes each day. Content analysis was conducted in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.
Results:
Participants (n=29) had a mean age of 52.5 years. Analysis revealed themes in self-transcendence: Introspection: "patient egoist" and "chameleon in the battlefield," reflecting maturity; Relationships: "solving the puzzle of relationships" and "things still to share," emphasizing empathy; Contemplation:"full of problems but trusting myself" and "I am a winner," showcasing insights; Spirituality: "curious about the afterlife" and "preparing for death," demonstrating a sense of absoluteness; Creativity: "finding happiness in growth," representing aesthetics.
Conclusion
The PATH program effectively promotes successful aging for middle-aged working women by fostering self-transcendence in five key areas.
8.Molecular Activity of Inflammation and Epithelial-Mesenchymal Transition in the Microenvironment of Ulcerative Colitis
Yu Kyung JUN ; Nayoung KIM ; Hyuk YOON ; Ji Hyun PARK ; Hyung Kyung KIM ; Yonghoon CHOI ; Ji Ae LEE ; Cheol Min SHIN ; Young Soo PARK ; Dong Ho LEE
Gut and Liver 2024;18(6):1037-1047
Background/Aims:
The genetic expression in the active inflammatory regions is increased in ulcerative colitis (UC) with endoscopic activity. The aim of this study was to investigate the molecular activity of inflammation and tissue remodeling markers in endoscopically inflamed and uninflamed regions of UC.
Methods:
Patients with UC (n=47) and controls (n=20) were prospectively enrolled at the Seoul National University Bundang Hospital. Inflamed tissue was obtained at the most active lesion, and uninflamed tissue was collected from approximately 15 cm above the upper end of the active lesion via colonoscopic biopsies. The messenger RNA expression levels of transforming growth factor β (TGF-β), interleukin (IL)-1β, IL-6, IL-17A, E-cadherin, olfactomedin-4 (OLFM4), leucine-rich repeat-containing G protein-coupled receptor 5 (LGR5), vimentin, fibroblast-specific protein-1 (FSP1), and α-smooth muscle actin (SMA) were evaluated. Mucosal healing (MH) was defined according to a Mayo endoscopic score of 0, 1 or non-MH (Mayo endoscopic score of 2 or 3).
Results:
The messenger RNA expressions of TGF-β, IL-1β, OLFM4, FSP1, vimentin, and α-SMA were significantly higher, and that of E-cadherin was significantly lower in inflamed and uninflamed regions of patients with UC than those in controls. In the inflamed regions, patients in the non-MH group had significantly increased genetic expression of TGF-β, FSP1, vimentin, and α-SMA compared to patients in the MH group. Similarly, the non-MH group had significantly higher genetic expression of TGF-β, IL-1β, IL-6, vimentin, and α-SMA than the MH group in the uninflamed regions.
Conclusions
Endoscopic activity in UC suggests inflammation and tissue remodeling of uninflamed regions similar to inflamed regions.
9.A Qualitative Study on the Self-Transcendence Experience of Middle-aged Working Women Participating in Self-transcendence and Health Program
Korean Journal of Rehabilitation Nursing 2024;27(2):88-99
Purpose:
This study developed a Psychoeducational Approach to Transcendence and Health Program (PATH) for middle-aged women in Korea, focusing on five key areas of self-transcendence: introspection, relationships, contemplation, spirituality, and creativity. The exploratory qualitative study aimed to investigate participants' experiences by analyzing self-transcendence records they had written.
Methods:
The PATH program involved pairs of participants who met weekly for three weeks to engage in intensive discussions on two topics for 60 minutes each. Participants were also asked to write down weekly tasks in a notebook for 10-15 minutes each day. Content analysis was conducted in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.
Results:
Participants (n=29) had a mean age of 52.5 years. Analysis revealed themes in self-transcendence: Introspection: "patient egoist" and "chameleon in the battlefield," reflecting maturity; Relationships: "solving the puzzle of relationships" and "things still to share," emphasizing empathy; Contemplation:"full of problems but trusting myself" and "I am a winner," showcasing insights; Spirituality: "curious about the afterlife" and "preparing for death," demonstrating a sense of absoluteness; Creativity: "finding happiness in growth," representing aesthetics.
Conclusion
The PATH program effectively promotes successful aging for middle-aged working women by fostering self-transcendence in five key areas.
10.A Qualitative Study on the Self-Transcendence Experience of Middle-aged Working Women Participating in Self-transcendence and Health Program
Korean Journal of Rehabilitation Nursing 2024;27(2):88-99
Purpose:
This study developed a Psychoeducational Approach to Transcendence and Health Program (PATH) for middle-aged women in Korea, focusing on five key areas of self-transcendence: introspection, relationships, contemplation, spirituality, and creativity. The exploratory qualitative study aimed to investigate participants' experiences by analyzing self-transcendence records they had written.
Methods:
The PATH program involved pairs of participants who met weekly for three weeks to engage in intensive discussions on two topics for 60 minutes each. Participants were also asked to write down weekly tasks in a notebook for 10-15 minutes each day. Content analysis was conducted in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.
Results:
Participants (n=29) had a mean age of 52.5 years. Analysis revealed themes in self-transcendence: Introspection: "patient egoist" and "chameleon in the battlefield," reflecting maturity; Relationships: "solving the puzzle of relationships" and "things still to share," emphasizing empathy; Contemplation:"full of problems but trusting myself" and "I am a winner," showcasing insights; Spirituality: "curious about the afterlife" and "preparing for death," demonstrating a sense of absoluteness; Creativity: "finding happiness in growth," representing aesthetics.
Conclusion
The PATH program effectively promotes successful aging for middle-aged working women by fostering self-transcendence in five key areas.

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