Liver transplantation in Korea: past, present, and future

Area of Science:

• Hepatology
• Transplantation Surgery
• Public Health

Background:

• Liver transplantation (LT) in Korea began in 1988 with deceased donor grafts.
• Pediatric and adult living donor liver transplantations (LDLTs) were initiated in 1994 and 1997, respectively.
• From 1988 to 2013, 10,581 LTs were performed, with LDLT comprising 76.5%.

Purpose of the Study:

• To review the historical and current status of liver transplantation in Korea.
• To analyze future trends and challenges in liver transplantation.

Main Methods:

• Review of liver transplantation data in Korea from 1988 to 2013.
• Analysis of deceased organ donation rates and prevalence of liver diseases.

Main Results:

• Deceased organ donation rates increased from <1.5 PMP in the early 1990s to 5 PMP by 2008.
• Hepatitis B virus (HBV)-induced cirrhosis and hepatocellular carcinoma (HCC) drove continued adult LDLT.
• Technical advancements in LDLT include MHV reconstruction and dual grafts, with low donor mortality.

Conclusions:

• In 2010, Korea's LT rate was 23.2 PMP, comparable to Spain and higher than the US.
• Future LT numbers may decrease due to lower HBV prevalence and birth rates.
• Reduced potential for live donors presents a future challenge for LT in Korea.